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Five Principles For Designing Quality Substance Misuse Services Which Improve Lives.

We are celebrating 70 years of the NHS, and therefore 70 years of NHS providers supporting those affected by drugs and alcohol. As providers, our understanding of what contributes to an effective service offer has grown and evolved but our aspirations to improve treatment and support recovery has always been part of our DNA.

The NHS Substance Misuse Providers Alliance (NHS SMPA) has been in existence for just over a year. We are a collaboration of 13 NHS trusts, all of which provide substance misuse services in the community and prisons. Just over a quarter all community substance misuse treatment systems are provided by the NHS and our services continue to provide the majority of in-patient detoxification provision nationwide.

Our aims are to work more closely as NHS providers (and with our colleagues in the third sector), to improve outcomes for service users by sharing and developing practice, and to engage policy makers with the NHS substance misuse community.

What unites the NHS SMPA is a belief that people deserve high quality services which can improve their lives. We are clear that services should be built on the following five principles meaning they should be:

  1. Practitioner and Clinician led - Services are comprised of competent and qualified multi-disciplinary teams where volunteers complement but are not relied upon and effective leadership and governance systems are in place.

  2. Evidence based not finance led - That interventions are designed using evidence based practice and accepted standards of clinical excellence rather than protracted interventions founded on cost reduction rather than harm reduction.

  3. Local partnerships not local gatekeepers - That Service Providers are effective partners and contributors to a local health and social care economy rather than siloed “specialists”.

  4. Safe -  That we protect the safety of our service users whilst walking alongside them to provide the best chance of recovery.  

  5. Personalised - Finally (and most importantly) that service user voice and influence is at the core of all care planning, service design and innovation.

The ‘abstinence vs. harm reduction’ debates of the last few years have directly and indirectly manifested in some treatment systems, leading to individuals being pushed through services too quickly, offering support that is over-simplified and dangerous.


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