Dame Carol Black's Independent Review of Drugs - Part Two Report is Welcomed by the NHS APA
NHS inpatient network
The current NHS inpatient detox provision in England is at breaking point and there is a risk that patients living with the most life-threatening addictions will not be able to access appropriate treatment in the very near future.
With only 7 remaining units in England, which are all members of the NHS APA, there is already a postcode lottery for patients in terms of access to these vital services.
That is why NHS APA and the members of the NHS IPN have launched a national campaign in order to secure the future funding of NHS Inpatient Units.
support the campaign
We appreciate NHS APA supporters taking the time to support our #KeepTheFewNHSIPUs campaign. The following provides some really easy ways for you to help the campaign:
Use, like and retweet the #KeepTheFewNHSIPUs hashtag on Twitter.
Contact your MP and ask them to support the campaign. We have prepared a letter that you can simply download, sign and email to your MP. If you do not know who your MP is or their email address you can find them easily here. This will take no more than 2 mins.
Sign our electronic petition (takes 30 seconds):
NHS APA and NHS IPN believe that due to the acute nature of the clinical services, commissioning arrangements for NHS Inpatient Detox units should be changed.
They should change to allow NHS England to directly commission/fund all existing NHS Inpatient Detox Units under a single specification, in line with similar Tier 4 specialist services such as Specialist Inpatient CAMHS and Perinatal Mental Health units.
This will safeguard the existence of these acute services in the short term and allow a stable foundation from which to ensure that there is sufficient access to this provision across England for all patients. NHS APA and the NHS Inpatient Network believe there would be substantial improvements to patient care planning and interventions if NHS IPUs were directly commissioned/funded in this way. They have launched a Tier 4 funding business case and will submit an application for specialist commissioning via NHS England.
In addition, NHS APA and NHS IPN are also campaigning for NHS England, in partnership with Public Health England, to undertake further reviews of the demand for this provision as well as scoping what a sufficient national model of NHS Inpatient Detox provision could look like. This will inform future investment and future commissioning decisions.
We welcome the opportunity to speak about our #KeepTheFewNHSIPUs campaign and the situation facing the five remaining NHS IPUs.
To request further information or interviews, please fill out our press contact form.
about inpatient units
what is an IPU?
NHS Inpatient Units (IPUs) are medically managed detox services that also deal with complex physical, mental health and behavioural issues and provide 24-hour nursing care to those with acute substance misuse issues.
They are Consultant Psychiatrist-led, hospital-based and support the most complex patients, who are dependent on substances, to take their first steps on their road to recovery.
There are currently only 6 NHS Inpatient Detox units operating in the entirety of the UK, which equates to less than 100 beds. These include:
ACER - Blackberry Hill Hospital, Bristol
Edward Myers - Harplands Hospital, Stoke-On-Trent
Chapman Barker - Prestwich Hospital, Manchester
Bridge House - Maidstone
New Beginnings - Doncaster
Dame Carol Detoxification Service - Inclusion - Fareham
risks facing NHS IPUs
Disinvestment in the sector, as most recently highlighted in the Dame Carol Black report, shows budgets for substance misuse services have significantly reduced.
This means that Local Authorities that hold the responsibility for commissioning local substance misuse services are often faced with no other option than to focus the funding that they receive from Public Health England, on their community drug and alcohol services, rather than funding inpatient detox units that support a smaller but more acute cohort of service users.
Without secured funding for NHS IPUs to manage and treat the most complex and acute patients which other NHS and 3rd sector services are unable to manage, there will be an increase in the number of substance use and alcohol related deaths & morbidity (such as liver disease).
There is also a high risk of increased admission rates, re-admissions, length of stay and costs to acute trusts, mental health trusts, primary care, adult social care, the criminal justice system and other agencies. Without secure funding there is a significant risk to patients as well as the wider healthcare system including other drug and alcohol services.
Commissioning Tier 4 Medically Managed Detox Provision
2021 PHE Funding Grant
Following the Government announcement of an extra £80 million investment into drug and alcohol treatment services in December 2021, the NHS APA has produced a position paper and blueprint specification to advise Local Authority Commissioners regarding the commissioning of tier 4 inpatient detoxification provision.
In February 2021 Public Health England (PHE) informed Local Authorities and NHS Providers across England of their intention to make £80m of new investment available to support drug and alcohol treatment across England.
The funding is designed to address several areas of the current treatment system as well as to pilot some new treatment models. However, crucially, the area of medically managed (Tier 4) inpatient detoxification provision is specifically referenced as a key priority within the overall £80m investment. In further consultations with PHE, the NHS Addictions Provider Alliance (NHS APA) has learned that £15m of the overall £80m has been earmarked to improve access to medically managed inpatient detoxification in England.
In order to support Local Authority Commissioners the NHS APA has produced an IPU Commissioning Position Paper which articulates how local authorities can secure the provision that they need locally and regionally using the Inpatient Network providers that are members of the NHS APA. We have also developed a blueprint specification that details an evidenced based and clinically compliant model for how Local Authorities can design Tier 4 treatment systems alongside community services.
Commissioners and interested parties can download the position paper and blueprint specification here: