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Drugs services: commissioning failure after funding cuts

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Cuts make Bristol one of a growing number of local authorities who received no bids from service providers.

Illustration: Tom Deason/ tomdeason.co.uk

Bristol City Council has been blasted for its failure to recommission drugs and alcohol support services because the money it was offering was too low to receive any bids.

One sector worker told the Cable that the service changes and funding reductions made one of the contract’s delivery ‘unsafe and therefore unviable’. The news emerges during a spike in drug-related deaths in the city among the most vulnerable drug users.

The unprecedented commissioning failure has left the council at a ‘standstill’, one councillor commented, and resorting to extending all current contracts until February 2018.

A ‘gross error’

The problematic part of the new treatment model for the council’s commissioners has been the provision of the ‘complex needs service’ which treats patients with the most severe needs.

A worker from one of Bristol’s services, who wished to remain anonymous, said the proposed funding reductions and changes to the contract “made its deliverability unsafe and therefore unviable”.

“When we have record numbers dying in our city from drugs, the mayor has to act.”

The service worker estimated that compared to the current contract, the new level of funding was a drop of 36%.

“At a time when drug-related deaths are nationally at an all-time high,” the anonymous source told the Cable, “Bristol council have decided to disinvest from the service that is established to meet the needs of those with the highest risks and the greatest vulnerability.”

Levels of drug-related deaths in the city are higher than 10 years ago and following an upward trend.

The service worker stated there was a “gross error on the part of the commissioning team”.

“We are facing a huge mess and levels of uncertainty, which lead to staff departures which impact directly on drug and alcohol service delivery and service users. The failure to commission means hundreds of thousands more pounds of taxpayers’ money will be spent. This is obviously far more than the re-commissioning intended.”

The service worker called for “an investigation to be undertaken and all of the findings made public so that this failure in re-procurement can be avoided in future”.

A spokesperson for the council commented: “We will be looking very closely at this to see what lessons we can learn from this process.”

Market failure


Illustration: Tom Deason/ tomdeason.co.uk

The government’s Advisory Council on the Misuse of Drugs (ACMD) recently warned that reductions in local funding are “the single biggest threat to drug misuse treatment recovery outcomes being achieved in local areas”.

“The only way to put a floor in the market is to not bid,” said Paul Hayes, CEO of Collective Voice, an organisation representing service providers in the drug and alcohol treatment sector.

“If providers continue to bid to deliver services for undeliverable contract prices, it will encourage the market price to fall, further diminishing the quality of services and the capacity to deliver positive outcomes for individuals and communities.”

According to Hayes, refusing to bid has become an increasingly common practice for service providers across the country.

Following concerns expressed by stakeholders during the consultation period that “all services will be underfunded as a result of spending cuts”, the council’s commissioning strategy warned it should be “mindful of the potential for ‘market failure’”.

The ACMD report also took aim at the frequent re-procurement of drug misuse treatment which is “costly, disruptive and mitigates drug treatment recovery outcomes”.

“The only way to put a floor in the market is to not bid.”

In response to the recommendations made by the ACMD report, a spokesperson for the council said the commissioners were looking at limiting the amount of budget reductions in this area, ensure the contracts can run for up to nine years, and that the commissioning strategy look to jointly commission services and promote partnerships.

However, Martin Powell from Transform, a Bristol based organisation advocating for drug legalisation, said, “Bristol’s mayor and cabinet can’t duck responsibility for these vicious cuts to drug treatment. Yes, the government should provide ring-fenced full funding for treatment. Every £1 spent on treatment actually saves £2.50 in reduced health and social costs.”

“… When we have record numbers dying in our city from drugs, the mayor has to act. Because make no mistake, many more poor and vulnerable people will die unless more money is found. Especially if so little is available that no treatment groups are willing to even bid for whole sections of the services.”

Crunching the numbers

The annual planned expenditure for substance misuse treatment services reported by local authorities reduced by 15.5% between 2013/14 to 2017/18. While ring-fenced until 2019, public health grants to local authorities have decreased across the country for 2017-18.

Bristol City Council said they will spend over £8m per year on substance misuse treatment services. This represents a £2.9m cuts from the 2016/17 payments to providers of existing contracts. A spokesperson for the Bristol City Council said the council will reduce its investment in these services by £160k in line with its corporate plan.

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Comments

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  • Worth looking at the fact that Lifeline, a big 3rd sector charity in this sector, effectively went bust because of under-cutting the rest of the market. Didn’t get much national press like Kids Company. The sector is in a sorry state across the whole of England.

    Reply

  • It is indeed. But its organisations like Lifeline – and there are about 6 of them nationwide – who allow commissioners to do this. They consistently undercost and over promise just to deliver the work, assuming the client group are so disempowered and stigmatised, no one will care when they start to drop dead. And you know what, by and large they get away with it.

    Reply

  • I’ve both used Bristol’s Drug Services and have done some work in the field of getting Drug Users voices heard in treatment. The Complex Needs Service has been a brave initiative to try and assist people living with a complex range of problems-including drug&alcohol problems.
    As our Ex Commisioner wisely states, it is indeed large organisations over promising and price cutting in order to secure tenders that has been one of the deflationary forces on budgets. This hits alongside the wider picture of “Austerity” . Meanwhile BCC hang on to large reserves in Bonds that it apparently holds in case of emergency and seems unwilling to sell. If the massive disinvestment in Drug Services at a time of much more visible homelessness on the streets of Bristol isn’t an emergency I don’t know what is!

    Reply

  • Well doshing it out to Maggie Telfer et al at BDP wont help……they’ve had enormous funding for years and the problem gets worse….

    Reply

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