Question to the Department of Health and Social Care:

To ask Her Majesty’s Government, in the light of the findings in the <i>Evaluation of the Drugs and Alcohol Recovery Payment by Results Pilot Programme </i>(Interim Summary Report June 2014, National Drug Evidence Centre, University of Manchester) in respect of the impact of payment by results on practitioners and service users (1) what is their policy on reducing the number of service users prescribed opioid substitution medication; (2) what advice they give to local authority public health directorates on the use of the payment-by-result target for successful completions of drug treatment; (3) what regulatory framework covers local authority public health directorates' drug and alcohol commissioning and service delivery; and (4) who is responsible for regulation of the local authority commissioning of drug and alcohol provision.

The Drug and Alcohol Recovery Payment by Results (PbR) pilots ran from April 2012 to March 2014. Their purpose was to develop and test the PbR approach to contracting for drug and alcohol services.

As with services in other parts of the country, providers in the eight PbR pilot sites were expected to take account of the United Kingdom guidelines on the Clinical Management of Drug Misuse and Dependence and the relevant guidance from the National Institute for Health and Care Excellence. Services that prescribe opioid substitute treatment must be registered with the regulator, the Care Quality Commission.

The Government’s 2010 Drug Strategy is ambitious to support more people to recover from dependence on drugs and alcohol, acknowledging that all treatments with a sound evidence base, including opioid substitution medication, have a role to play depending on the clinical circumstances of individual cases.

Pending the publication in 2015 of the independent evaluation of the pilot programme, in August 2014 the Department published a note on lessons learnt. This document was intended for commissioners and providers who are considering using a PbR method and highlights the key areas where additional attention may need to be focussed to optimise the PbR approach.

Local Authority Circular LAC(DH)(2014)2, Public Health Ring-fenced Grant Conditions – 2015-16, dated 17 December 2014, stipulates at paragraph 20 that “in commissioning services using funds from this grant, local authorities should also ensure that appropriate clinical governance arrangements are put in place.” The circular contains a link to a public health commissioning template which emphasises the importance of good clinical practice.

The structures for coordinating local Joint Strategic Needs Assessments and the provision of services are set out in the Health and Social Care Act 2012. Should there be a complaint which cannot be resolved locally about a local authority’s discharge of its functions, an individual can refer the matter to the Local Government Ombudsman.