Staying Alive: Reviving The NHS Inpatient Detox Provision

Members of the NHS Inpatient Network (IPN) continue to call for urgent action to save the last remaining NHS Inpatient Detox Units (IPUs) in England.

Back in September Members and expert guest speakers presented to the NHS APA conference about why the NHS IPUs are at risk of closure and the vital steps that are needed to secure their future. They also urged people to support the #KeepTheFewNHSIPUs national campaign which the NHS APA is leading.


Professor Colin Drummond, from the National Addiction Centre at Kings College London, described two key factors that have contributed to the current situation. First is the introduction of the 2012 Health and Social Care Act, which shifted the commissioning of drug and alcohol inpatient services from the NHS to Local Authorities. Second is the cut to the Public Health Grant which also took funding away from addiction services. He described how these two changes have led to a “marketisation” of treatment services and a gradual erosion of NHS and third sector inpatient treatment services.

“These changes have led to a “marketisation” of treatment services and a gradual erosion of NHS and third sector inpatient treatment services.”

Professor Drummond also illustrated how numbers of admissions to addiction units had changed since the introduction of the Health and Social Care Act, namely a decrease of admissions to specialist units and an increase of admissions to non-specialist units. This shows how a closure of inpatient beds has displaced the problem onto acute mental health services and could be setting up a future “revolving door” of admissions.


Kate Hall, Head of Operations for Greater Manchester Mental Health NHS Foundation Trust’s Substance Misuse Division explained how local commissioning contracts have put the future finances of NHS IPUs in jeopardy and the negative impact this is having on patients. With decisions about patient access often made by a “local gatekeeping panel”, she described how clinical recommendations were being based on financial resources instead of patient need.


Kate also highlighted the ‘bed per night’ pricing model which is pushing all financial risk onto local providers and causing huge anxiety for those who deliver services. She said, “I’m not aware of another NHS healthcare setting where this is the case. This is stigmatising our service user populations.”


Dr Annie McCloud, Consultant Addictions Psychiatrist from the Kent & Medway NHS & Social Care Partnership Trust highlighted the medically-led ethos of the NHS IPUs. She is based at the only NHS IPU in the south east of England and treats a range of people with complex needs from across London and the Home Counties.


She described the importance of having clinically-trained staff on site who are available not just to talk to patients, but to also conduct physical examinations, ECGs, blood tests and other aspects of essential care, such as regular monitoring of pulse, blood pressure and oxygen levels. She talked through the treatment journey of a typical service user at the unit, using a real-life case study as an example.


Finally, we heard from Jon Shorrock, Chair of the IPN and Specialist drug and Alcohol Services Manager at the Avon and Wiltshire Mental Health Partnership. He explained how the need for inpatient detox units is “greater than ever”, particularly within the alcohol patient group, with the level of acuity increasing year on year.

“There will be an “untold” loss of expertise in learning and research as consultant psychiatrists could all but disappear from the field of addiction.”

He described the impact of the closure of these units, describing a ripple effect throughout the wider health service, social care sector and the criminal justice systems. He also highlighted the “untold” loss of expertise in learning and research as consultant psychiatrists could all but disappear from the field of addiction.


He urged people support the campaign by “raising awareness and making some noise” on social media, using the hashtag #KeepTheFewNHSIPUs campaign and writing to their local MP using the downloadable letter. The message is clear – take action now to save lives.


You can also continue to watch the full recorded presentation from the IPN Members as part of the 2020 Conference on demand sessions.

#IPN #KeepTheFewNHSIPUs #DrugRelatedDeaths #JonShorrock #ColinDurmmond #KateHall #AnnieMcCloud #APAConf