COMMISSIONING |
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‘ No one provider can do everything on their own – we need that collaboration locally .’
SARAH ALLEN
The CQS has been well received , says O ’ Connor , and ‘ aims to support partnerships to improve the consistency and quality of treatment and recovery systems in England . It has been welcomed by commissioners , providers and partners – in particular , feedback has praised how the CQS understands commissioning as a process of system leadership and development . We look forward to supporting local partnerships as they work towards meeting the standards over the course of the drug strategy .’
So are we genuinely entering a new era for commissioning , and the treatment field in general ? ‘ Notwithstanding the backdrop that public finance and government policy are quite changeable at the moment , I ’ ve not seen anything like the Dame Carol Black report in the ten years I ’ ve been doing this ,’ says Howard , ‘ nor have I seen something that ’ s actually translated into policy so quickly and with impact . It ’ s quite difficult to get attention on our sector and that actually managed it , and I think the government investment has actually been very much in line with what the report says is needed .’
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TIME AND INVESTMENT ‘ The investment is long overdue ,’ says Allen . ‘ It ’ s extremely welcome and the recommendations in Dame Carol Black ’ s report are absolutely vital to us as providers to be able |
to reinvigorate the sector and get back to where we need to be , and we hope that investment commitment to 2025 remains for that stability .’ For the sector to be able to deliver on the strategy it will need that time and investment , she says – ‘ without that it will be really hard to achieve some of those commissioning standards .’
Although treatment funding escaped the knife in the chancellor ’ s recent Autumn Statement , the great unknown remains what will happen to the new investment after the first three years .
‘ Hope for the best , prepare for the worst ’ might be a wise strategy , says Middleton . ‘ We ’ re having conversations with commissioners trying to understand what the plans are for the next few years , because obviously there ’ s a commitment up to a certain point but we need to understand what ’ s going to happen after that as soon as we can . With the new money , the sector obviously has an opportunity to grow again , and we ’ ve got to bring in a whole new generation of practitioners to meet the expectations of the new investment .’
SERVICE IMPACT If the funding is maintained , however , then ‘ we should absolutely be seeing its impact in services ,’ says Howard . ‘ Some of that will take a longer amount of time , because one of the problems Dame Carol Black identified was that certain professional and medical roles have been diminished , and those can ’ t just be created out of thin air . We need to get people training for them and going through years of study , so even in a ten-year cycle we might potentially only start to see the dividends of that towards the end .’
So does that mean that people should possibly try to manage their expectations ? ‘ Commissioners and providers need to be both pragmatic in the short term in the context of the current challenges , but also remain ambitious about improving the quality of treatment in the longer term ,’ says O ’ Connor .
‘ It ’ s vital that we increase the skills mix of the workforce if we are to deliver high-quality treatment and recovery systems which reduce harm and help more people to
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initiate and sustain recovery . OHID has commissioned Health Education England to develop a ten-year workforce strategy that will set out a clear roadmap for the future , including the training of registered professions .’
The government has also commissioned a new drug and alcohol treatment and recovery capability framework , which is due to be published next summer , O ’ Connor points out . ‘ This will be a refreshed drugs and alcohol national occupational standards , reflecting the sector ’ s current needs . Work will begin soon to scope and develop this framework with the sector .’
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‘ Price / quality splits in favour of price are not helpful ... investment should be going to frontline delivery .’
GRAHAM HOWARD
SUPPORT AND DEVELOPMENT ‘ I think we ’ re in a position where those who want to can seize the ground and make a good job of it ,’ says Hager . ‘ It ’ s what ’ s behind the standard to support commissioners who aren ’ t experienced , to understand what commissioning is – or could be – the evidence around it and approaches they can take . Those who ’ ve been around a while know how to navigate that , but we ’ re a minority .
There needs to be support for commissioners to develop in their role . The standard ’ s good for that , but it ’ s about how much people buy into that – how do we develop the learning ? In our joint commissioning group we
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discuss ‘ what do we mean by commissioning ’, because often what you encounter in local authorities is they just think it ’ s shopping and procurement . It ’ s strategic leadership and acting on behalf of the people we represent , making the best use of the resources available . We ’ re that link . Transforming commissioning isn ’ t just about transforming procurement – it ’ s about a learning approach , not a top-down approach .’
SKILL SHARING ‘ It ’ s a really interesting time ,’ says Allen , and retaining some of the hybrid models and approaches around staff training and development that developed during the pandemic will be important . ‘ That very virtuallybased offer – we ’ ve got really skilled and experienced staff , and we need to make sure those new staff coming in have the opportunity to work alongside and be close to them , and have the combination of face-to-face and different training options .
‘ It ’ s sharing those skills and best practice that ’ s really going to allow the workforce to develop – a lot of people have worked in this sector for a long time , and we need to value that . We ’ re going to be having staff coming in with less experience and we need to do as much as possible to wrap around them so they don ’ t feel overwhelmed by this .
‘ I am optimistic and I ’ m going to remain optimistic ,’ she says . ‘ I think we also have a huge sense of responsibility . We want to show that this funding works and has impact , and if we want to make the argument for continued investment beyond 2025 we need to deliver on that . We can ’ t waver on that passion , commitment and enthusiasm – we have to remain committed on that path .’ DDN
This series has been produced with support from an educational grant provided by Camurus , which has not influenced the content in any way .
We welcome your thoughts , feedback and experiences on commissioning and hope to take the conversation forwards from this series of three articles ( Oct , Nov and Dec / Jan issues ). Please email the editor .
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