By Karen Biggs

Chief Executive Blog

13th November 2023

Missed opportunities to create a world class treatment system

Under cover of the dramatic reshuffle the Government have announced additional funding for drug and alcohol treatment of £267m from April 2024. This is the 3rd year of additional monies committed to support the Government’s 10-year Drug Strategy. 

The National Audit Office recently reported on the progress of the strategy. They found that the delay in funding announcements in previous years had made progress difficult. So this very timely announcement will be welcomed by the sector. 

Those of us working in the sector all agree the way to achieve a ‘world class treatment system’ and stem the increase in drug related deaths, is to ensure that all treatment options are open to people across the country. 

As the charity providing the largest number of residential treatment services in the UK, we have a particular focus on how residential treatment is supported through the drug strategy implementation. Sadly, the news is not positive. 

Despite the additional £250m additional funding over the last 2 years, we have seen a reduction in the number of people accessing residential treatment to below 1%of all people in treatment. That compares to 7% in Portugal (a country known for its funding of a wide range of treatment options) and an average across Europe as a whole, of 11%. 

We will be publishing a report later this week that sets out the raft of missed opportunities created by the lack of strategic support for residential treatment including a gap in treatment options for women and families and those whose multiple needs would be best met by this intensive form of treatment. 

The UK Government’s 10 Year Drug Strategy published in 2021 recognised that intensive treatment options, such as residential treatment, weren’t available across the country in line with clinical guidance. The strategy committed to developing mechanisms to address this and ensure equal access to inpatient detox and residential rehabilitation treatment in all areas of the country. 

A 2% benchmark was set for each local authority area, setting an expectation that 2% of people in treatment accessed residential treatment each year. Local Authorities were expected to consider this as a ‘floor’ and not a ‘ceiling’ but the aim was to ensure that pathways into residential treatment were created in every part of the country.

Some local authorities have been able to increase access to residential treatment, showing good practice in relation to targeted funding and appropriate trauma informed pathways. 

However, in 2022/23 there were still areas in the country in which state funded residential treatment was denied to people unless they had the means to pay for it privately.

  • There were still areas of the country that create punitive and unrealistic hurdles for people to navigate before they get to residential treatment. 
  • Even though Nice Guidance recommends residential treatment as an appropriate form of treatment for people who ‘have not benefited from previous community based psychosocial treatment’. 
  • Pathways from prison to residential treatment are still not created despite NICE Guidance stating residential treatment should be considered within care plans of people who want to be abstinent from drugs following their release. 
  • And some local authority areas who have yet to achieve the 2% benchmark are freezing residential treatment budgets until April next year.


By comparison inpatient detox funding has been ringfenced for the last 3 years and today the ringfence has been confirmed again for a further year. 

The lack of comparative strategic support for residential treatment means it isn’t universally available in line with Nice Guidance across the country and it is being denied people who would benefit from it as a critical part of their drug treatment care plan. 

So once again we will be asking the new relevant Ministers (once we are clear who they are after today’s reshuffle) to give the Drug Strategy their full focus and ensure that all treatment options are available to all parts of the country. Only then will we have a chance of reducing the number of people who needlessly die of drug related issues.