PROVISION OF SPECIALIST DRUG AND ALCOHOL TREATMENT SERVICES

The RISE consortia (lead contractor is CRI) currently deliver a medical and psychosocial treatment service to adult substance misusers in Ealing. The services were competitively tendered in 2012 to ensure value for money, by integrating provision of different elements of treatment and introducing peer lead elements to enhance recovery outcomes.

Ealing is categorised as having one of the most complex treatment populations with the least likelihood of achieving abstinence from alcohol and drugs. Notably Ealing’s performance has since the tender been consistently above the national average.

In June 2015 authority was given by Cabinet to extend the contract from 1st November 2015 until 31st March 2017. At the same time it was approved that the Public Health Drug and Alcohol Budget needed to be reduced by 30% between 2015/16 and 2017/18 as part of larger council efficiencies.

Unexpectedly, in July 2015 the government proposed a further reduction of 6.2% to the Public Health Grant on top of the savings that have already been agreed. The contractor has expressed cooperation in frontloading the required savings already established for 2017/18 as well as achieving a further 6.2% budget reduction by 2016/17 if a direct award was to be granted with a minimum contract period of 3 years.

The current provider has a strong track record of performance and change management. However to achieve the required savings a service re-design will be required alongside the development of new models of service delivery/co-commissioning arrangements.

The contract is currently due to expire in March 2017 and undertaking a competitive tender during this time period would not allow sufficient time to assess the potential negative impact of these savings on the treatment system as well as not allowing the necessary time to pilot new models which would potentially require the development of integrated health and social care commissioning arrangements with the CCG/other council departments. It would also bring repeated disruptions to the treatment system in 2016/17 and subsequent disruptions in 2017/18 if a competitive tender was to take place and a new provider was to be appointed.

A direct award would allow Public Health and the CCG to jointly explore the substance misuse provider becoming part of a multidisciplinary care delivery team and being co-located within the Primary Care Hubs that are currently in the planning stages and likely to be up established over the course of the next 3 – 5 years. This would also allow for an increased focus to be placed on early intervention and self-management to reduce the future demand on services as well as developing integrated health and social care packages for those with complex needs. Any learning obtained during this period would be utilized for the development of the new service that would be competitively tendered and commence in April 2020.