Alcohol treatment services

Public Accounts Committee Closed Inquiry
Opened: 30 Jan 2023 Closed: 21 Jul 2023 Parliament page
Harmful drinking appears to be increasing. The upward trend in alcohol-related death and hospital admissions accelerated in the pandemic. The costs of this to drinkers, their families and society are significant. Alcohol costs the NHS an estimated £3.5 billion per year in England and costs an estimated £21 billion per … Read more
3 Recommendations
22 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
21 Jul
2023
Report published
24 May
2023
Report published
17 Apr
2023
Correspondence
28 Mar
2023
Correspondence
2 Mar
2023
Oral evidence
2 Mar
2023
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
Oral evidence sessions 1 session
2 Mar 2023
View on parliament.uk
Alcohol Treatment Services
Alice Wiseman · Association of Directors of Public Health Clare Taylor · Turning Point Jonathan Marron · Department for Health and Social Care Professor Dame Carol Black · Combating Drugs Sir Chris Wormald · Department of Health and Social Care Sir Ian Gilmore · Alcohol Health Alliance
Title HC No. Published Items Response
Fifty-Fourth Report - Alcohol treatment services HC 1001 24 May 2023 25 Responded
Recommendations & Conclusions
25 results
2 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Undertake work to improve understanding of up-to-date costs of alcohol harm to society
The Department for Health and Social Care, as the lead department, does not have sufficient understanding of total cost of alcohol harm. The harms to individuals and society that alcohol misuse can cause are well-known. Alcohol is linked to over … Read more
Government Response
The government agreed and stated the recommendation is implemented, having updated the 2012 alcohol harm cost estimate for inflation to £25 billion in 2021 prices. It has also initiated an additional, longer-term project to fully update the estimate, beginning with a review of evidence on costs to the NHS and labour market.
HM Treasury
View details
3 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Confirm Public Health Grant allocations earlier to provide long-term funding certainty for treatment services
Delays by the Department in finalising the allocation of the Public Health Grant, coupled with short-term funding and reductions to the public health grant, make it difficult for local authorities to plan and commission alcohol treatment services effectively. Since 2015–16, … Read more
Government Response
The government agreed and stated the recommendation is implemented, committing to provide as much notice as feasible for Public Health Grant allocations. It confirmed that indicative allocations for 2024-25 have already been published, and aims to publish the final 2024-25 allocations before the end of 2023 to support local planning.
HM Treasury
View details
4 Recommendation Accepted
Fifty-Fourth Report - Alcohol trea…
Address barriers to alcohol treatment access and improve integrated care for co-occurring conditions
We are concerned that a high proportion of people with alcohol dependency are not in treatment and that there are unnecessary barriers to people in need of treatment. Treatment services for alcohol dependency are commissioned by local authorities. They show … Read more
Government Response
The government agreed, detailing existing support for local authorities in addressing treatment barriers and announcing plans to develop the first UK-wide clinical guidelines for alcohol treatment, with consultation in Summer 2023 and publication later in the year. It is also developing a joint action plan with NHS England to improve integrated care for co-occurring alcohol and mental health problems.
HM Treasury
View details
5 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Identify ways to increase alcohol treatment uptake and share best practice for success rates
There is concerning local variation in reported spending on, and outcomes from, alcohol treatment. In 2021–22, the amount local authorities reported spending on alcohol treatment varied from £4,000 per 100,000 people to over £1 million, with median spending of £313,000. … Read more
Government Response
The government agreed and stated the recommendation is implemented, having released a Local Outcomes Framework dashboard on April 20, 2023, for local authorities to benchmark and analyze treatment outcomes. The department committed to using this data and an unmet need toolkit to support local areas in improving services, prioritizing areas with low success rates, and facilitating best practice sharing.
HM Treasury
View details
6 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Update on implementation progress of the substance misuse workforce strategy
There has been a marked reduction in the size of treatment workforce, in particular, of addiction psychiatrists. Dame Carol Black’s independent review on drugs highlights that a prolonged shortage of funding has depleted the treatment and recovery workforce and resulted … Read more
Government Response
The government agreed, stating it is developing a substance misuse workforce strategic plan with a target publication date of Autumn 2023. It is also developing the first phase of a national drug and alcohol treatment and recovery capability framework and a workforce calculator, both for publication in Autumn 2023, while continuing to support local authorities with workforce planning.
HM Treasury
View details
1 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Committee gathered evidence on alcohol treatment services from key stakeholders
On the basis of a Report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department) on alcohol treatment services.1 We also took evidence from Alice Wiseman, Director of Public Health, … Read more
Government Response
The government agreed and stated the recommendation is implemented, explaining that it has already published a comprehensive assessment of strategies to tackle alcohol harm through former Public Health England. It continues to monitor the evidence base, including outputs from Public Health Scotland's MESAS programme.
HM Treasury
View details
7 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Government drug strategy begins to address alcohol but lacks sufficient prevention focus
When we asked if government’s drug strategy adequately dealt with alcohol, Dame Carol told us that she thought it began to deal with it. She hoped that of the circa 50,000 new treatment places that came with her independent review, … Read more
Government Response
The government highlights its provision of additional funding through the drug strategy, which has enabled local authorities to increase alcohol treatment targets to 92,000 people in 2023-24 and over 100,000 in 2024-25.
HM Treasury
View details
8 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Department contests preventative measures while experts cite clear evidence for action
On discussing the merits of preventative measures, the Department told us that what works and does not work on alcohol was very well researched but that the right approach for some areas was highly contested. By way of example, it … Read more
Government Response
The government states it has already published a comprehensive assessment of effective strategies to tackle alcohol harm in England via the former Public Health England and continues to monitor the evidence base, including outputs from Scotland's alcohol strategy.
HM Treasury
View details
9 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Extensive alcohol harm impacts deprived communities, but cost and dependency data are outdated
Alcohol harm impacts not only drinkers themselves but also their families and wider communities. It is linked to over 100 illnesses, can drive mental disorder, self-harm, and suicide, and is a major cause of preventable death. The Office for National … Read more
Government Response
The government agrees and has updated the 2012 estimated cost of alcohol to society to £25 billion in 2021 prices. It has also initiated a longer-term project to fully update this estimate, beginning with a review of evidence on costs to the NHS and labour market productivity.
HM Treasury
View details
10 Recommendation Accepted
Fifty-Fourth Report - Alcohol trea…
The Department's alcohol harm cost calculations are outdated, hindering effective policy decisions.
The NAO’s report shows that drinking patterns have changed considerably since 2012 when the cost of alcohol related harms were last calculated, with young people generally drinking less.21 The Department told us that we had also seen more liver disease … Read more
Government Response
The government agrees and has updated the 2012 estimated cost of alcohol to society to £25 billion in 2021 prices. It has also initiated a longer-term project to fully update this estimate, beginning with a review of evidence on costs to the NHS and labour market productivity.
HM Treasury
View details
11 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Significant Public Health Grant cuts have severely reduced funding for alcohol treatment services.
The Department is responsible for allocating the annual ring-fenced Public Health Grant (PHG) to local authorities each year. The PHG fell by £630 million (in 2021–22 prices), from £3.96 billion to £3.32 billion, over the period from 2015–16 to 2021–22.23 … Read more
Government Response
The government agrees with the committee's implied recommendation regarding funding certainty. It committed to giving as much notice as feasible for Public Health Grant allocations, having already published indicative allocations for 2024-25 and aiming to publish final 2024-25 allocations before the end of 2023.
HM Treasury
View details
12 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
New substance misuse treatment funding is welcomed, but remains short-term and insufficient.
We heard from Ms Wiseman that local government welcomes the additional £533 million boost to funding for substance misuse treatment services provided through the 10-year drug strategy, and that it was good to have it ringfenced. However, Ms Wiseman cautioned … Read more
Government Response
The government agrees to improve certainty and timeliness of funding allocations, committing to giving as much notice as feasible. It has already published indicative Public Health Grant allocations for 2024-25 and aims to publish final 2024-25 allocations before the end of 2023.
HM Treasury
View details
13 Recommendation Accepted
Fifty-Fourth Report - Alcohol trea…
Late allocation of the Public Health Grant creates significant uncertainty for local authorities.
When we asked the Department why, at 2 March 2023, it had not yet awarded its PHG for 2023–24, the Department acknowledged that it was very late but not unusually so. The Department explained that over the last three years … Read more
Government Response
The government agrees to improve certainty and timeliness of funding allocations, committing to giving as much notice as feasible. It has already published indicative Public Health Grant allocations for 2024-25 and aims to publish final 2024-25 allocations before the end of 2023.
HM Treasury
View details
14 Conclusion
Fifty-Fourth Report - Alcohol trea…
Alcohol treatment is effective and cost-efficient, yet only a small minority access it.
There is convincing evidence that alcohol treatment services are accessible, successful, and cost effective. As the NAO’s report sets out, data from the National Drug Treatment Monitoring System show that around 60% of those leaving treatment for problems with alcohol … Read more
HM Treasury
View details
15 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Low public awareness and poor NHS identification hinder access to effective alcohol treatment.
When we asked Ms Wiseman what was preventing people from accessing treatment, she explained that there was a big issue with people being able to accept that they have a problem in the first place. We heard that drinking alcohol … Read more
Government Response
The government agrees, aiming for Spring 2025, and is developing UK-wide clinical guidelines on alcohol treatment to address barriers, a joint action plan with NHS England for co-occurring mental health and substance misuse conditions, and supports local authorities in identifying engagement barriers.
HM Treasury
View details
16 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Stigma surrounding alcohol dependency, especially with drug users, prevents people seeking treatment.
Even once people accept they may have a problem, issues with stigma can prevent them from accessing help. For example, we heard that people often feel a sense of shame at being unable to “drink responsibly”.36 Dame Carol described the … Read more
Government Response
The government agrees, aiming for Spring 2025, and is developing UK-wide clinical guidelines on alcohol treatment to address barriers, a joint action plan with NHS England for co-occurring mental health and substance misuse conditions, and supports local authorities in identifying engagement barriers.
HM Treasury
View details
17 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Health services are failing to adequately identify and refer alcohol-dependent individuals for treatment.
Most people entering treatment for alcohol dependency in England self-refer. In 2021– 22, only 23% of referrals were from health services.40 Our expert witnesses thought much more could be done to identify people early and direct them towards treatment. Ms … Read more
Government Response
The government agrees with the committee's implicit recommendation on early identification and treatment pathways. It is developing UK-wide clinical guidelines on alcohol treatment for consultation in Summer 2023 and final publication later in the year, and a joint action plan with NHS England to address co-occurring conditions by Spring 2025.
HM Treasury
View details
18 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Co-occurring mental health and alcohol problems frequently result in denial of vital treatment.
Dame Carol, Sir Ian, Ms Taylor and Ms Wiseman all raised concerns about the relationship between mental ill health and alcohol. Sir Ian told us that an estimated 70% of people entering treatment for alcohol dependency have co-occurring mental health … Read more
Government Response
The government agrees to address the relationship between mental ill-health and alcohol dependency. It is developing UK-wide clinical guidelines on alcohol treatment, with public consultation in Summer 2023 and final publication later in the year, and a joint action plan with NHS England to address co-occurring conditions by Spring 2025.
HM Treasury
View details
19 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
A lack of in-patient and residential alcohol treatment creates significant access barriers.
Sir Ian and Ms Wiseman spoke of the cost effectiveness of in-patient and residential treatment services. We heard examples of how the lack of in-patient and residential services in some areas of the country meant patients were left either bouncing … Read more
Government Response
NHS England is funding the development of specialist alcohol care teams in 25% of non-specialist acute hospitals by the end of 2023-24 to reduce alcohol-related ill health in the secondary care inpatient population.
HM Treasury
View details
20 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Local authority alcohol treatment spending varies significantly, actual figures obscured by poor data.
In 2021–22, the amount individual local authorities reported spending on alcohol treatment varied from £4,000 per 100,000 people to over £1 million, with median spending of £313,000. Three local authorities reported spending £0 on alcohol treatment services.45 In her independent … Read more
Government Response
The government agrees and will release a toolkit in Summer 2023 to help local authorities compare treatment numbers, identify pathway needs, and reduce unmet need. It has also released a Local Outcomes Framework dashboard (April 2023) to benchmark and analyse local performance, using this data to support areas with low success rates.
HM Treasury
View details
21 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Wide local variation in alcohol treatment coverage and patient success rates exists.
The NAO’s report showed considerable local variation in both the proportion of dependent drinkers in treatment and the success rates from those treatments. Nationally, an estimated 82% of alcohol dependent adults in England were not in treatment in 2018– 41 … Read more
Government Response
The government agrees and will release a toolkit in Summer 2023 to help local authorities compare treatment numbers, identify pathway needs, and reduce unmet need. It has also released a Local Outcomes Framework dashboard (April 2023) to benchmark and analyse local performance, using this data to support areas with low success rates.
HM Treasury
View details
22 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Department believes local authorities effectively commission public health services, despite regional performance variations.
While noting the variation in performance outlined in the NAO’s report, the Department told us that local authorities broadly did “a great job of commissioning public health services.” The Department told us that it had published a set of guidelines … Read more
Government Response
The government agrees to provide targeted support to local authorities. It committed to releasing a toolkit in Summer 2023 to help compare treatment numbers and identify referral pathway needs, and released a Local Outcomes Framework dashboard on 20 April 2023 for benchmarking performance.
HM Treasury
View details
23 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Chronic underfunding and staff shortages severely deplete the addiction treatment workforce and skills.
Dame Carol’s independent review on drugs highlighted that a prolonged shortage of funding and frequent retendering of treatment services had led to a high turnover of staff and depletion of skills. During the session, Dame Carol explained that the number … Read more
Government Response
The government agrees to address workforce issues, committing to develop and publish a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator by Autumn 2023. It also continues to support local authorities with workforce planning guidance and analysis.
HM Treasury
View details
24 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Department acknowledges workforce shortages, developing strategy to increase mental health and addiction professionals.
The Department acknowledged the fall in clinical psychiatrists and mental health practitioners and agreed that services needed access to the full set of professionals.54 The Department noted that it had already committed to securing an additional 800 mental health and … Read more
Government Response
The government agrees to address workforce issues, committing to develop and publish a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator by Autumn 2023. It also continues to support local authorities with workforce planning guidance and analysis.
HM Treasury
View details
25 Conclusion Accepted
Fifty-Fourth Report - Alcohol trea…
Additional funding aims to reintroduce health professionals, yet stable funding is crucial for specialist staff.
The Department assured us that, as part of its monitoring activity, it would be looking closely at the numbers of people employed. We heard it was keen that the additional funding (£533 million) serve to reintroduce health professionals into treatment … Read more
Government Response
The government agrees and is developing a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator, all to be published by Autumn 2023, in addition to supporting local authorities with workforce planning.
HM Treasury
View details
Government Response AI assessment · 24 of 3 classified
Accepted 24
Total 3 recs + 22 conclusions
Correspondence 2 letters
17 Apr 2023 Correspondence from Jonathan Marron, Director General, Office for Health Improvement and Disparities (OHID) Department of Health and Social Care, re PAC Hearing – Alcohol Treatment Services, dated 28 March 2023
Parliament page
28 Mar 2023 Correspondence from Alice Wiseman, Gateshead ADPH treasurer and lead for addiction, re Public Accounts Committee Oral evidence: Alcohol treatment services, Thursday 2 March 2023, dated 22 March 2023
Parliament page