Report highlights nurse workforce challenges in drug addiction services – Nursing Times

‘Nurses must be heard as going digital in healthcare gains pace’
09 July, 2021 By Megan Ford
Urgent action is needed to boost the number of nurses and other key health professionals working within substance misuse teams to ensure people with drug addiction can receive a higher quality service, a new report has warned.
An independent review into the illegal use of drugs in England stressed that sufficient capacity in such services and quality of the treatment offered depended on a “suitably trained workforce”.
“The government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences”
Carol Black
But it stated that in recent years, drug misuse teams had “deteriorated significantly in quantity, quality and morale” and were up against “excessive caseloads, decreased training and a lack of clinical supervision”.
There are now an estimated 300,000 opiate and crack users in England, and around one million people using cocaine per year.
Meanwhile, drug misuse poisoning deaths are at a record high, having increased by almost 80% since 2012.
The new report from Professor Dame Carol Black, who advises government departments on health, work and wellbeing, warned that “we cannot expect a reduction in demand” without taking action to invest in treatment and recovery services, including within the workforce.
As part of more than 30 recommendations for the government, the review urged the Department of Health and Social Care to commission Health Education England to create a workforce strategy for substance misuse by the end of the year.
It proposed that the comprehensive strategy should look to increase the number of professionally qualified drug treatment staff, such as nurses, doctors, psychiatrists, psychologists and social workers.
This was because services were “increasingly reliant on drug workers who often have minimal professional qualifications or none”, noted the report.
The government was also asked to fund HEE to cover the costs of training the suitable workforce required.
The responsibility for commissioning substance misuse services was passed from the NHS to local authorities under the Health and Social Care Act 2012.
“Tackling this issue requires strong collaboration across government and the new specialist unit will help us to do just that”
Sajid Javid
While local authorities were “well placed” to do so, the review warned that the move came with “a number of challenges”, especially around staffing.
“Job security and access to professional development are more readily available within NHS mental health services, so are more attractive to many healthcare workers,” said the report.
In addition, it warned that disruption caused by the “frequent retendering” of drug treatment services made the recruitment of health professionals difficult and that “many” nurses, psychiatrists and psychologists had left as a result.
Responding to the report, Gill Campbell, head of nursing at social enterprise Turning Point, welcomed the recommendation “for greater professionalisation in the workforce”.
She reiterated that the “majority of nurses working in substance misuse are employed by third sector providers, and do not have access to a personal training budget”, noting that this was “something which urgently needs to change”.
Ms Campbell added that nurses would be “instrumental” in delivering Dame Carol’s vision for more “responsive services for people with complex needs”.
Other recommendations within the review from Dame Carol, who is also chair of the British Library and chair of the Centre for Ageing Better, encouraged government departments to work together to improve treatment, housing support and the way people with addictions are treated in the criminal justice system.
Importantly, her report also called for addiction to be recognised as a “chronic health condition”, which required long-term follow-up from health professionals.

Sajid Javid
Commenting on the report, Dame Carol said: “The government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences.
“A whole-system approach is needed, and this part of my review offers concrete proposals, deliverable within this parliament, to achieve this.”
The report, published on Thursday, came as a second phase of a wider review into drug misuse in England.
Following the report, the government has set up a new Joint Combating Drugs Unit, bringing together multiple government departments, including the Department of Health and Social Care, Home Office, Ministry of Housing, Communities and Local Government, Department for Work and Pensions, Department for Education and Ministry of Justice, to help tackle drugs misuse across the country.
Health and social care secretary Sajid Javid said: “Tackling this issue requires strong collaboration across government and the new specialist Joint Combating Drugs Unit will help us to do just that.”
He added that the government would “look closely at these recommendations and publish an initial response shortly on the urgent action we can take to turn the tide on drug-related deaths and get more people access to higher quality services”.
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