“Savings” in specialist services are increasing pressure elsewhere in the NHS
Cuts to addiction services in England are a false economy and are instead increasing pressure elsewhere in the NHS, warns an expert in The BMJ today.
Professor Colin Drummond, Chair of the Addictions Faculty at the Royal College of Psychiatrists, says typically addiction services in England have seen cuts of 30% but some areas are planning cuts of up to 50%
Heroin and morphine-related deaths have more than doubled since addiction services were transferred from NHS control to local authorities in 2012 and are now at the highest level on record. Last year, there were more than 15,000 drug-related, and over 1 million alcohol-related hospital admissions.
The main opportunity to make cuts is in the workforce, explains Drummond, meaning fewer specialist addictions psychiatrists, clinical psychologists and nurses with a greater reliance on doctors without specialist training and volunteers with limited training.
The number of training posts in addiction psychiatry has decreased 60% since 2006.
In addition, NICE approved evidence-based treatments are under attack by the government as being part of “the methadone industry that keeps addicts hooked,” he writes.
This has resulted in some local authorities limiting how long patients can remain on methadone treatment, and ‘payment-by-results’ contracts have removed the incentive for addiction treatment services to take on patients with complex needs who are likely to need longer and more intensive treatment.
Cutting community based addictions services has also transferred the burden of patients with drug and alcohol dependence on already pressured emergency departments and general psychiatry, he warns.
The need for better access to addiction services is clear, writes Drummond.
The Royal College of Psychiatrists is calling for a return to joint commissioning between the NHS and local authorities, for at least 60 addictions psychiatrist training posts in England, and for no further cuts to addiction services by local authorities.
“Our previously high functioning treatment system has been downgraded by a short-term strategy to save money. This is a false economy,” he argues. “If we want to tackle the rise in drugs related deaths, there must be at least 60 addiction psychiatry training posts in England and there must be no further cuts to addiction services by local authorities,” he concludes.