LET ’ S GET THIS RIGHT
The new money in the wake of the drugs strategy provides an enormous opportunity for the sector to transform itself after years of disinvestment , but it ’ s vital we get the basics right . In the first of a three-part commissioning series we ask whether commissioners are fully ready and hear about some of the immediate challenges they face
When Dame Carol Black surveyed the treatment landscape for the second part of her Independent review of drugs the findings were ‘ disturbing , even shocking ’, she said . Not only had funding cuts left services ‘ on their knees ’, but commissioning had become fragmented , with deteriorating partnerships between local authorities , health , housing and criminal justice agencies , and little accountability for outcomes . The government did take notice , however , and since then we ’ ve had the drugs strategy and the significant amounts of money announced on the back of it . However , while the funding is clearly welcome – and desperately needed – a robust commissioning framework also needs to be in place to make sure it gets to all the places it needs to go and is used in the right way .
GOOD COMMISSIONING The government has now provided a comprehensive view of what good commissioning should look like in the shape of the new Commissioning Quality Standard ( CQS ), which was published this summer in response to a key recommendation of the Carol Black review . The CQS aims to offer a framework to help ensure an accessible , effective person-centred treatment system , covering areas like partnership and governance , the commissioning cycle and integrated system approaches .
‘ I ’ m absolutely hopeful that it will help ,’ says public health specialist at Lancashire County Council , Chris Lee , who was part of the expert advisory group involved in developing the standard . ‘ There will always be people who do things a bit differently , but if you ’ re newer into this space then I think it ’ s a really good tool . It ’ s one of those structural pieces that might help support the system , part of that landscape of improvement .’
And improvement is clearly something that ’ s sorely needed . So was Carol Black ’ s stark assessment of commissioning as a fragmented , almost broken , system accurate ?
‘ I think it was , in most areas ,’ says drug and alcohol treatment commissioning consultant Tony Margetts , who was commissioner for the East Riding for 16 years . ‘ One thing is you had this relentless retendering of services , and every time there was less money in the system . When you retender you can get very slick presentations in effect colluding with commissioners seeking to deliver services as cheaply as possible . She brilliantly summarised where we were .’
RETURNING PRIDE Part of building back a quality system will mean returning some of the pride that ’ s been eroded over years of shrinking budgets and stretched workforces to the field – forging a real collective identity and creating a sector that people want to work in . ‘ For that it needs to have a bit of rigour and robustness to it , and I think the Commissioning Quality Standard could give us that ,’ says Lee .
The challenge , however , as many organisations are already finding , is it ’ s one thing to finally have the money to recruit new staff , and quite another to actually find those staff . ‘ Everyone ’ s after them ,’ says Margetts . ‘ There ’ s thousands of vacancies in the NHS and even more in adult social care – there ’ s a massive workforce issue across the board . I ’ m pretty sure the sector can get itself sorted out , it ’ s just going to take a long time . You ’ ve got to get the people in who want to do this and are committed to it , and get them qualified . We need better salaries , but also really decent national training programmes . We ’ re not alone in this .’
While the ongoing cost of living
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12 • DRINK AND DRUGS NEWS • OCTOBER 2022 WWW . DRINKANDDRUGSNEWS . COM