Guidance

Commissioning quality standard: alcohol and drug treatment and recovery guidance

Published 3 August 2022

Applies to England

© Crown copyright 2022

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Introduction

Context

Dame Carol Black’s review of drugs (part 2) recommended that the Department of Health and Social Care (DHSC) should develop a national commissioning quality standard (CQS) for local authorities. The CQS would clarify the commissioning process that local authorities should follow and specify the treatment services that should be available in each local area, based on the UK clinical guidelines on drug treatment.

This CQS was developed by DHSC’s Office for Health Improvement and Disparities (OHID) with the help of an expert advisory group of external stakeholders. We have designed the CQS to guide processes, partnerships and systems for effective commissioning of alcohol and drug treatment services. It will also help to improve treatment access, outcomes and quality for people affected by problem alcohol and drug use.

The CQS is a high-level framework and we will support its implementation with more products on some of the topics and issues it covers. You should also use the CQS with other products that support implementation of the government’s drug strategy. These include:

  • the Drugs strategy guidance for local delivery partners
  • any alcohol and drug workforce strategies and supporting products developed by OHID and Health Education England
  • plans to improve integrated care for people with co-occurring mental or physical health problems

There is support across government for the strategy and the CQS, which should ensure that all relevant local stakeholders are willing and able to join in commissioning partnerships.

Aim of the commissioning standard

The aim of the drug strategy is to have accessible, high quality, effective, person-centred alcohol and drug treatment and recovery systems throughout England.

The CQS provides a framework to enable this to happen and will help to:

  • encourage partnership approaches to effective commissioning
  • improve the transparency of local alcohol and drug treatment
  • increase accountability between local system partners, national and local government, and local councils and the communities they serve
  • enable local partners to assess their commissioning practices

The CQS also aims to improve the transparency of alcohol and drug treatment commissioning locally. It will increase the accountability between local system partners, national and local government, and local councils and the communities they serve. It will also enable local partners to assess their commissioning practices.

We do not expect that all local areas will immediately fully meet the CQS. It sets out an ambitious standard for commissioning systems, against which you can measure progress. To help this measurement, we have included an auditable self-assessment tool in addition to this text version.

Self-assessment tool and other supporting documents

The CQS is accompanied by supporting documents (or links to them) that set out in more detail how its ambition might be achieved. But this is just a first iteration of the CQS. It will be regularly reviewed and it (and its supporting documents) is expected to grow and evolve in response to feedback and the needs of local areas.

1. Partnerships and governance

You should have an active multi-agency partnership in your area and include all partners in the planning and delivery of harm reduction, treatment and recovery interventions for people affected by problem alcohol and drug use.

Standard 1.1: strategic and commissioning partnership

There is a strategic and commissioning partnership, with a shared purpose to improve the lives of people affected by problem alcohol and drug use.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. There are partnership structures that include relevant local organisations that represent the needs of people affected by problem alcohol and drug use. For example, this could include:

  • people with lived experience, such as lived experience recovery organisations (LEROs)
  • local authority officials, such as elected members, public health, safeguarding and housing
  • crime and justice partners, such as police and crime commissioners and representatives from the police, probation, prisons, and youth offender services and institutions
  • partners from the voluntary sector and other services that reflect the target treatment populations, such as those working with young people, people experiencing rough sleeping, people affected by domestic abuse, people from ethnic minority backgrounds and LGBT+ communities
  • education and employment partners, such as Jobcentre Plus, schools and further education
  • other health partners, such as NHS strategic leads, NHS England and Improvement, primary care, alcohol and drug treatment providers, mental health treatment providers, OHID regional alcohol and drug leads

2. There are regular partnership meetings, accompanied by commissioning and delivery plans.

3. Each partner ensures that their organisational service delivery plan and associated activity incorporates and complements the partnership’s plan to reduce alcohol and drug harm. Partnerships jointly commission services where appropriate.

4. There is a strategic and collaborative relationship with alcohol and drug treatment providers.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include:

  • terms of reference for the partnership
  • agendas and records of discussions and decisions
  • documented analysis of gaps in partners’ contributions to strategy and commissioning
  • local strategic and action plans, which are regularly reviewed and have recorded actions
  • strategic plans and commissioning plans that show how they enable and complement each other

Standard 1.2: strategic and commissioning capacity and competence

The partnership ensures there is enough strategic and commissioning capacity and competence.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership ensures there is sufficient capacity to coordinate strategy and planning, proportionate to local budget and activity.

2. Partnership representatives or commissioners are actively involved in other relevant strategic groups, and feed back information from those groups to the partnership. Strategic groups may include those for:

  • integrated care
  • mental health
  • criminal justice
  • young people
  • housing and homelessness

3. Strategic and commissioning leads are provided with protected learning time to maintain and develop their specialist knowledge. This could include subjects such as alcohol and drug harm, treatment and recovery, and their understanding of the health and social care system and how it can provide effective support and treatment to people affected by problem alcohol and drug use.

4. Access to specialist training and support is available to partnership members to support specialist knowledge.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. Terms of reference for the partnership specify dedicated capacity responsible for coordinating partnership delivery and commissioning.

  2. Terms of reference for the partnership include named representatives for linked programmes of work, for example on safeguarding and criminal justice issues.

  3. Record of alcohol and drug specific continuous professional development for strategic and commissioning teams.

2. Commissioning cycle

Partnerships should follow well-thought-out processes to ensure their local system to support people affected by alcohol and drug problems includes partners from other relevant service areas. They should also commission services based on a comprehensive understanding of local need.

Standard 2.1: understanding local need

The partnership ensures it has a shared understanding of local need, including the experiences of diverse populations.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership designs and co-produces a needs assessment that:

  • builds on the alcohol, drugs and tobacco commissioning support packs to understand local need
  • includes equality impact assessment processes to understand the diverse needs of local populations (including groups of people with protected characteristics) and health inequalities affecting them
  • takes account of strategic partner data and intelligence
  • identifies community assets (like education, employment, mutual aid and leisure activities) that support people affected by problem alcohol or drug use as part of a recovery-oriented systems of care
  • incorporates the views of people who may benefit from support for problem drug or alcohol use, including people who are attending treatment and recovery services and those who are not

2. Processes are in place to quickly review relevant alcohol and drug related deaths and any near misses to determine action to be taken and to monitor actions agreed previously by the relevant stakeholders.

Example of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. A current comprehensive needs assessment, incorporating data and intelligence from a range of partners.

  2. A record of local recovery assets that are independent of commissioned services.

  3. Minutes of a partnership meeting that reflects on the needs assessment and discusses and agrees recommendations based on it.

  4. An alcohol and drug related deaths protocol, reflecting local data analysis, with recorded actions to improve local responses.

  5. Equality impact assessments that show details about local priority groups and under-represented groups and make recommendations for action.

Standard 2.2: outlining priorities

The partnership develops and champions a strategy that is in line with need and outlines its priorities to reduce stigma and harm, treat dependence and promote recovery.

Criteria

You will know you are achieving this standard if you meet the following criteria.

  1. The partnership has developed a strategy that outlines your priorities for alcohol and drug treatment.

  2. The strategy is a whole partnership one, with mechanisms for monitoring progress, and ensuring all partners are contributing to the actions of the strategy.

  3. The partnership regularly undertakes an equality impact assessment of its planning and delivery of services and activity.

  4. The partnership has a plan to respond to its equality impact assessment, which ensures engagement and quality of care for all people affected by problem alcohol and drug use.

  5. The partnership has a plan to reduce alcohol and drug related deaths, informed by local review processes.

  6. Local strategic plans include a range of primary, secondary and tertiary prevention responses to reducing alcohol and drug harm, in line with the needs assessment.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. The equality impact assessment of the local strategy has a regular audit.

  2. Minutes of partnership meetings and local data monitoring show progress to meeting objectives in the plan to reduce alcohol and drug related deaths.

Standard 2.3: designing and contracting for services

The partnership’s approach to designing and contracting treatment and recovery support services is well-thought-out and inclusive, in line with the best interests of its affected populations.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership prioritises treatment system quality and stability, and follows well thought out, collaborative processes to commission services.

2. Service specifications make it clear that treatment services need to integrate with other services that provide support for people affected by problem alcohol and drug use.

3. The partnership develops commissioning plans that are appropriately financed to provide accessible, good quality services for people affected by problem alcohol and drug use. For example, this could mean that commissioning plans consider:

  • how quickly people get appointments
  • how close the services are to the people they serve
  • if services are welcoming to new people
  • how accessible services are for disabled people
  • how to provide services for people with low literacy
  • how responsive services are to different groups of people

4. Commissioners proactively seek partners’ engagement in commissioning decisions and processes and consider opportunities for joint or integrated commissioning.

5. To avoid instability in treatment provision, the partnership only uses competitive tendering if necessary. Where competitive tendering processes are required, they prioritise quality and clinical safety, while also ensuring legal compliance and value for money.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  • financial reporting of investment in treatment for problem alcohol and drug use
  • partnership commissioning and delivery plan
  • local procurement audit processes
  • service specifications
  • evidence of consultation with people who use services and recorded responses to them
  • evidence of a competitive processes, including tender scoring, which prioritises quality and safety

Standard 2.4: quality and performance

Quality and performance are regularly reviewed against agreed outcomes and appropriate actions are taken.

Criteria

You will know you are achieving this standard if you meet the following criteria.

  1. The partnership identifies, agrees and publicises its priorities and develops mechanisms to monitor and report on progress.

  2. Commissioners have a system of monitoring, evaluating and reporting treatment performance and quality, using national and local data and intelligence.

  3. Commissioned services have transparent and accessible complaints procedures, which respond at the right time.

  4. The partnership co-produces monitoring systems with people who use the services, acts on their contributions and provides feedback to them on the actions they take.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. Regular performance reports showing progress to meet priorities.

  2. Records of regular performance meetings between commissioners and providers using the National Drug Treatment Monitoring System (NDTMS) and local data.

  3. Anonymised records of complaints that are made available to service commissioners.

  4. Evidence you have developed data and other intelligence to review and measure progress, including progress towards objectives in local and national outcomes frameworks.

  5. Service audit reports which record progress against any service improvement plans.

3. Whole and integrated system approaches

Partnerships should ensure that the treatment services they commission are part of a broader system of effective integrated pathways and packages of care. This is so anyone affected by problem alcohol and drug use can access the right support at the right time.

Standard 3.1: engaging other services

The partnership engages other relevant services to identify and respond to the support needs of people affected by problem alcohol or drug use, including people affected by other people’s use.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership develops pathways to meet identified local need, working with stakeholders, including people with lived experience.

2. Plans to develop and improve pathways into treatment reflect broader strategic health and social care objectives.

3. The partnership publicises pathways and support available, including in:

  • schools and youth services
  • community services
  • primary and secondary healthcare (including hospital-based alcohol and drugs care teams)
  • housing and accommodation services (including homeless services)
  • criminal justice services
  • employment support services
  • domestic abuse services
  • adult and children’s social care services

4. The partnership works to improve accessibility, pathways, and continuity of care for people who are:

  • from a protected and under-represented group
  • engaged in the criminal justice system
  • receiving safeguarding interventions
  • living with co-occurring conditions

5. People working in other services are offered training to provide services to people affected by problem drug or alcohol use, including:

  • basic screening to identify problem alcohol or drug use
  • advice and harm reduction interventions
  • referral to appropriate services

6. The partnership has pathways for transition between young people’s services and adult services. These have been developed in partnership between young people’s treatment services and adult treatment services, to ensure there is appropriate support for young adults transitioning to adult services.

7. The partnership makes sure that care pathways and joint protocols are agreed between treatment and recovery services and the wider health and social care system.

8. Well-resourced harm reduction services, that include options for blood borne virus testing, diagnosis and vaccination, are available to everyone in accessible locations. These services target people and groups who have been identified as at risk of harm in the needs assessment (including people at increased risk of drug-related death).

9. Services and sessions for people affected by problem alcohol or drug use are targeted and located together where appropriate, considering:

  • health services, like primary care, A&E, relevant acute wards and mental health
  • children’s services
  • youth offending services
  • adults’ services
  • police
  • probation
  • housing and accommodation services
  • employment support

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

1. Evidence that feedback from people who access treatment is used to identify service accessibility issues and that this informs planning and delivery of services.

2. Data shows that the sociodemographic characteristics of the people referred into treatment reflects the local population and its needs.

3. Reports from contract monitoring.

4. Needle and syringe programme data that monitors:

  • numbers and types of equipment
  • geographic distribution of equipment
  • blood borne virus testing
  • diagnosis and treatment of blood-borne viruses

5. A protocol in place to support care of young adults (18 to 25 years old), including transition pathways, which is adhered to by contracted treatment providers.

6. Local service directory which includes sites of co-located service provision.

Standard 3.2: enabling joined up care

The partnership champions and enables joined-up care for people with co-morbidities or complex needs through pathways and partnerships.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership works to improve accessibility, pathways, services and continuity of care for people with co-morbidities or complex needs. For example, this could include people needing support for:

  • co-occurring mental ill health
  • respiratory health conditions
  • liver diseases

2.The partnership works with organisations that support people with co-morbidities and complex needs to develop pathways and protocols so that local care pathways are integrated across all relevant service providers.

3. Treatment and law enforcement partners establish integrated criminal justice pathways and care, including at a minimum:

  • drug testing on arrest with arrest referral pathways into treatment
  • out of court disposal schemes
  • liaison and diversion schemes
  • court-based support for assessment
  • information about the full range of alcohol, drug treatment and monitoring requirements and packages of community sentence treatment requirements
  • advanced care coordination, integrating ongoing treatment and support, for people before they are released from custody
  • community treatment for people that takes account of their circumstances and any restrictions placed on them through licences and other legal orders

4. Health and social care partners share intelligence on how people directly affected by problem alcohol and drug use make use of their services.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. Having reducing reoffending boards that monitor arrangements for people affected by problem alcohol and drug use who are leaving prison.

  2. Case management system records demonstrate aligned care pathways and integrated working with health and social care partners, and improved physical and mental health of people accessing support.

  3. NDTMS data demonstrates that people are successfully engaged in treatment after being referred from criminal justice services.

Standard 3.3: enabling recovery-oriented systems of care

The partnership actively enables and promotes recovery-oriented systems of care so that there is a hope and ambition for every person who enters treatment to recover and live a life independent of services.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership actively promotes support that makes recovery more visible and increases opportunities for people to recover, such as recovery communities. Local systems also support people in different stages of recovery, including through abstinence-based recovery and medically-assisted recovery.

2. Recovery-oriented systems of care integrate recovery and harm reduction approaches so that they are not mutually exclusive.

3. People affected by problem alcohol and drug use can see other people in recovery and visible recovery is a strong focus for treatment services. Service support people to identify their post-treatment support needs as early as possible from their initial contact with treatment.

4. At a minimum, recovery planning includes:

  • housing
  • learning and employment
  • people’s social connections (friends, family, peers, colleagues)
  • meaningful activity and connections with people in recovery, and recovery networks

5. The intensity of support after treatment is tailored to each person and recovery planning incorporates the needs of their families, carers and dependants.

6. The treatment system is part of a wider recovery-oriented system of care and the partnership explores opportunities to align, integrate or co-commission treatment and other recovery focused services.

7. Organisations that provide care to people with alcohol and drug problems (such as prisons hospitals and mental health facilities) engage treatment and recovery providers to ensure that people are supported to build and maintain their recovery capital.

8. The recovery-oriented system of care ensures rapid and supported re-entry into treatment for people who have relapsed.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include:

  • NDTMS records and case file audits
  • consultation findings from people who use services, with records of improvement plans
  • a directory of local recovery support networks and services documented and evidence that the partnership promotes these
  • contract and partnership delivery plan monitoring processes

4. High quality treatment system

Partnerships should have a wide range of high-quality support available for children, young people and adults affected by problem alcohol and drug use. This should be provided by a multi-disciplinary skilled workforce which is part of a recovery-oriented system of care.

Standard 4.1: the workforce can meet the needs of the people they treat

The partnership ensures that the workforce is skilled and supported to provide treatment to meet the needs of its population.

Criteria

You will know you are achieving this standard if you meet the following criteria.

  1. Treatment services employ a multi-disciplinary workforce who are competent to treat and support the treatment population, including people with co-morbidities.

  2. All members of the workforce who provide care and support have a caseload that is clinically safe and appropriate to be able to deliver quality treatment.

  3. Treatment service specifications and legal contracts make sure that service providers comply with treatment workforce standards. This also includes any mandatory training and development plans for the workforce and the partnership has dedicated funding to support this.

  4. Any gaps in skills are identified by a training needs analysis.

  5. Entry level roles and opportunities for trainee posts, including addiction psychiatry posts, are incorporated into workforce strategies and clear career progression routes are available.

  6. All members of the treatment workforce receive regular supervision, including clinical supervision.

  7. The partnership supports opportunities to exchange staff between different partner organisations to promote skill and practice sharing and to improve communication and collaboration.

  8. There is a long-term local treatment and recovery workforce strategy to maintain a flexible and sustainable workforce model.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. Contract monitoring processes.

  2. A workforce structure chart which is part of a service’s contract.

  3. Workforce skills analysis and training and development plans for the treatment workforce, which services can prove are routinely monitored and shared with their commissioner.

  4. A record of continuous professional development (CPD) for each staff member, which is demonstrated in staff CPD records and in broader workforce consultation and feedback reports.

  5. Evidence that service providers have met local management and clinical supervision standards

  6. The partnership’s commissioning and delivery plan.

Standard 4.2: providing dedicated support for children and young people and adults

The partnership ensures treatment services are structured to provide dedicated support for children and young people, adults affected by problem alcohol use and adults affected by problem drug use.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. Commissioning plans and service specifications outline dedicated provision to deliver specialist young people’s treatment services. These deliver evidence-based interventions for under 18 year olds, focused on early identification of young people affected by alcohol and drugs. They also provide comprehensive assessment and support for young people with complex needs.

2. Age-appropriate specialist services are available for young people that consider:

  • the young person’s age and maturity
  • safeguarding duties
  • the legal frameworks for safeguarding
  • consent and confidentiality
  • the young person’s developmental needs
  • the patterns of young people’s problem alcohol and drug use that pose unique challenges

3. Commissioning plans and service specifications outline dedicated provision for adults affected by problem alcohol use and adults affected by problem drug use.

4. Where adult treatment is provided as part of an integrated service provision, commissioners and providers take steps to safeguard proportionate funding and service provision for people affected by problem alcohol use.

5. Treatment services are contracted to offer tailored responses to under-represented groups identified in the partnership’s needs assessment, for example, women and people from ethnic minority backgrounds.

6. Treatment services offer specialist and targeted provision for groups with protected characteristics or who are under-represented, as identified by needs assessments.

7. Family members and carers directly affected by another person’s problem drug or alcohol use can access support for their own needs.

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

  1. Commissioning plans and service specifications that show dedicated provision for young people and other specific groups, in line with the needs of local populations

  2. Contract performance monitoring and evaluation reports for all groups identified in the needs assessment.

  3. Policies and procedures which have been developed to support effective transition from children and young people’s services to adult services, and evidence that these have been monitored to check that they are working well.

Standard 4.3: providing a full range of evidence-based support

A full range of evidence-based alcohol and drug support is available to keep children, young people and adults safe, improve their physical and mental health and wellbeing and support recovery.

Criteria

You will know you are achieving this standard if you meet the following criteria.

1. The partnership develops commissioning plans, delivery plans and service specifications in line with clinical guidelines, to ensure that people are assessed within agreed waiting times and have swift access to the type of treatment that would most benefit them. This covers a range of interventions which includes:

  • individualised information, advice and awareness, including on harm reduction
  • providing harm reduction equipment, including injecting equipment, naloxone and safe storage boxes, and training on how to use it
  • triage, risk assessments and comprehensive assessments, including health assessment and assessment of recovery capital
  • care planned support, which is co-produced with the person in treatment, goal directed and regularly reviewed by a keyworker
  • one-to-one keywork that consists of evidence-based practices that enable people to develop alternative activities to alcohol and drug use, build social networks that support change and learn skills to better manage and desist from problem alcohol and drug use
  • the option of groupwork to build motivation and strengthen recovery
  • psychosocial interventions for alcohol and drug use recommended by the National Institute for Health and Care Excellence (NICE), including behavioural couples therapy, contingency management and cognitive behavioural relapse prevention
  • the relevant NICE-recommended interventions for any co-occurring mental health problems
  • pharmacological interventions to stabilise health, and safely reduce problem drug or alcohol use, including vitamin therapies, opioid substitution treatment, community detoxification and relapse prevention medicines
  • routine testing and quick referral to care and treatment for blood borne viruses
  • inpatient assessment, stabilisation, and detoxification
  • residential and non-residential rehabilitation programmes
  • recovery-focused support, including housing, learning and employment, personal finance, healthcare, social connectivity, meaningful activity and mutual aid

2. Coordinated packages of treatment and care identify support needs to improve personal safety, health, and wellbeing. This includes support for people who have co-occurring conditions and those receiving criminal justice or safeguarding interventions, for example case management of people subject to alcohol and drug support court orders.

3. Treatment services offer high quality information and advice and appropriate support to people directly affected by another person’s problem drug or alcohol use. Relatives are actively engaged in the treatment of a family member if appropriate.

4. Treatment services are structured to ensure business continuity and enable staff to continue to offer support through unexpected challenges. This includes providing support to people when face-to-face interventions are not possible (for example during COVID-19 restrictions, or in rural council areas).

Examples of evidence

You should have evidence available that you are meeting this standard. This could include the following examples.

1. Service specifications that specify the full range of evidence-based treatment the service should provide.

2. Case management records and local case file audits.

3. Client records show compliance with local safeguarding children and adults’ arrangements and processes.

4. Records of consultation with people who use services, their families and carers.

5. Contract performance monitoring and evaluation reports and a Care Quality Commission inspection report which identifies that treatment is in line with latest clinical guidelines. This includes:

6. Recorded comprehensive clinical governance arrangements and patient group directions.

7. Clear eligibility criteria for inpatient detoxification and residential rehabilitation that reference clinical guidance and meet the local requirements identified the needs assessment.

Glossary

Commissioning

Commissioning is a continual process of assessing needs, and planning, agreeing, procuring and monitoring services to meet those needs. Integrated commissioning is incorporating more than one service within one contract and co-commissioning refers to more than one organisation aligning resources to commission together.

Commissioning plan and delivery plan

Commissioning and delivery plans are produced as part of the short, medium and long term planning of partnership activity to reduce alcohol and drug related harm. Commissioning plans should outline the aim and objectives of planned activity, and detail the activity, timelines and resources required. Delivery plans should be specific, measurable, achievable, realistic and timely.

Effective interventions

These are interventions that are evidence-based, recommended by guidelines, or innovative and being evaluated.

People affected by problem drug or alcohol use

People affected by their own or other people’s drug or alcohol use, including children, families, carers, friends and communities.

People with lived experience

This term includes people with current or previous experience of drug or alcohol dependence, and families and carers of people experiencing problem drug or drug use. Engagement of people with lived experience should be done in a way which reflects the demographics of local populations.

Protected characteristics

It is against the law to discriminate against anyone because of:

  • age
  • gender reassignment
  • being married or in a civil partnership
  • being pregnant or on maternity leave
  • disability
  • race including colour, nationality, ethnic or national origin
  • religion or belief
  • sex
  • sexual orientation

Quality standard

Sets out priority areas for quality improvement, highlighting issues with variations in current practice. The standard includes:

  • statements to help improve quality
  • a guide to what resources can be used to show and measure progress

Recovery-oriented system of care

A co-ordinated network of community-based services, support groups and activities that are person-centred and build on strengths and resilience of individuals, families and communities. It has many pathways to recovery and offers choice by providing a range of services and support that are tailored to individual needs.

Treatment

Incorporates the full range of pharmacological, psychosocial and recovery interventions provided by (or through) specialist services (including GPs and primary care practices that are competent in alcohol and drug treatment).

Needs assessment

Needs assessment is the process where a partnership ensures it has a comprehensive understanding of local alcohol and drugs needs, and any gaps in local responses. The partnership should use the needs assessment to determine its priorities and how they allocate resources.

Primary, secondary and tertiary prevention

Primary prevention aims to prevent alcohol and drug use, or the negative effects of problematic use.

Secondary prevention is the early identification of problematic use and an intervention for someone who has developed it.

Tertiary prevention is to reduce harm associated with problem alcohol or drug use.

Recovery capital

Recovery capital is the range of resources that help a person start recovery and maintain it. Recovery capital is often categorised as:

  • personal, which are things like having safe and secure accommodation, physical and mental health and wellbeing and meaningful activity
  • social, which is having things like peer support and supportive friends and family
  • community, which includes activities and transport, being part of recovery communities, and attitudes to recovery

Mutual aid

Mutual aid describes the social, emotional and information support provided to each other by members of a group recovering from drug or alcohol dependence. Some groups support families, children and friends affected by substance misuse. You can find more information about mutual aid in the Mutual aid toolkit for alcohol and drug misuse treatment.

Expert advisory group

Our development of these commissioning quality standards was advised by an expert group of external stakeholders, which included:

  • Jim Armstrong, Phoenix Futures
  • Dr Prun Bijral, Change Grow Live and Collective Voice
  • Linda Burke, Care Quality Commission
  • Apollos Clifton-Brown, Framework Housing Association
  • Adrian Crossley, Centre for Social Justice
  • Stephen Cupit, Inclusion and NHS Addictions Provider Alliance (NHS APA)
  • Helen Denyer, St Mungos
  • Viv Evans, Adfam
  • Dr Emily Finch, South London and Maudsley NHS trust and NHS APA
  • Dr Eilish Gilvarry, Cumbria, Newcastle, Tyne & Wear NHS trust and NHS APA
  • Angela Hall, North Yorkshire County Council and English Substance Use Commissioners Group (ESUCG)
  • Kate Halliday, Addiction Professionals
  • Danny Hames, Inclusion NHS trust and NHS APA
  • Dr Linda Harris, NHS England health and justice
  • Dave Higham, The Well, representing lived experience
  • Ben Hughes, Essex County Council and ESUCG
  • Chris Kelly, NHSE health and justice
  • Mark Knight, Greater Manchester Combined Authority and ESUCG
  • Chris Lee, Lancashire County Council and ESUCG
  • Cathy Lovatt, Greater Manchester Mental Health Trust and NHS APA in-patient group
  • Kieran Lynch, NHS England health and justice
  • Clare Lynn, Humankind and Collective Voice
  • Vicki Markiewicz, Change Grow Live
  • Richard McVey, Aquarius
  • Paul Ogden, Local Government Association
  • Marcus Roberts, Association of Police and Crime Commissioners
  • Sohan Sahota, BAC-IN
  • Tim Sampey, Build on Belief, representing lived experience
  • Oliver Standing, Collective Voice
  • David Targett, Westminster Drug Project and Collective Voice
  • Mike Trace, Forward Trust
  • Laura Ward, Oasis
  • Alice Wiseman, Gateshead Council and Association of Directors of Public Health
  • Tim Young, The Alcohol and Drug Service
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