The five remaining NHS inpatient detox units (IPUs) in England could permanently close without urgent changes to the way they are funded, a group representing NHS addiction service providers has warned.
Every year, thousands of the most vulnerable people the NHS helps will receive residential detox treatment for severe drug and alcohol addiction as their last hope for recovery. However, there are currently fewer than 100 NHS beds across the country which provide this specialist treatment – a number which is set to freefall without urgent action.
The NHS Inpatient Network (IPN) – part of the NHS Addictions Provider Alliance (APA) which represents 15 NHS Trusts in England that provide drug, alcohol and gambling addiction treatment services – is deeply concerned that local commissioning contracts are putting the future finances of NHS IPUs at ‘breaking point’ and is warning that they are perilously close to closing.
It has launched a national campaign which is calling on the government and NHS England to urgently review the way NHS Inpatient Units are funded and secure the future of the five remaining NHS IPUs. This would bring funding for NHS IPUs in line with other acute residential NHS mental health inpatient services – including Perinatal Mental Health Inpatient Services, Child and Adolescent Mental Health Services and Adult Forensic Inpatient Units, which are all funded directly by NHS England.
"There are currently fewer than 100 NHS beds across the country which provide this specialist treatment – a number which is set to freefall without urgent action".
Local Authorities are currently responsible for commissioning local substance misuse services, however they are often faced with no other option than to focus the funding they receive from Public Health England on community drug and alcohol services, rather than inpatient detox services which provide treatment to a smaller but more complex cohort of patients.
The NHS Inpatient Network is warning that cuts to inpatient services would be felt across the entire healthcare system with 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 other drug and alcohol services who are unable to deliver such acute treatment.
With only five remaining NHS IPUs in England at Blackberry Hill Hospital in Bristol, Harplands Hospital in Stoke-on-Trent, Prestwich Hospital in Manchester, Bridge House in Maidstone and Mersey Care in Liverpool, there is already a postcode lottery for patients in terms of access to these vital services. The units collectively receive around £7.1m a year through local authorities, acute trusts and a small number of private patients. They treated a total of 1,742 patients in 2017/18 – an increase of more than 300 from 2015-16.
"There is already a postcode lottery for patients in terms of access to these vital services".
Conservative MP and Chair of the Conservative Drug Policy Reform Group (CDPRG), Crispin Blunt expressed his concern over the current provision of inpatient units in England stating: “It is no exaggeration to say that the UK’s in-patient detox units bring those who are able to access them back from the brink of death, giving them a fresh chance at life beyond addiction. But with just five of these units operational in the country and the fate of these uncertain due to years of crippling funding cuts, this vital service which should be rolled out nationwide is under threat.”
He continues; “To extinguish a treatment option which for many is a last ray of hope that enables them to turn their life around would be a stride back into the dark ages and away from the public health focused approach to drug use which we know makes our country safer and better for all. I advocate for measures to be taken to safeguard the remaining in-patient detox units and to secure funding to make this acute service as available as needed.”
“It is no exaggeration to say that the UK’s in-patient detox units bring those who are able to access them back from the brink of death, giving them a fresh chance at life beyond addiction".
Service user Anna from Bristol is living proof of why services such as these are so vital. She said: “The staff at the detox unit are fantastic and I owe my life to them. They were there in my darkest times to talk to me and help me overcome the hurdles of addiction. I honestly don’t know where I’d be without them.”
Service user Patryk, also from Bristol, said: “The IPU saved my life and is saving the lives of countless other people. Thanks to treatment, I am clean and sober and have my life back again. We need to make sure that services like this remain for future generations, so that more people like me can get their lives back on track.”
The NHS Inpatient Network is urging the public to support its campaign by using the social media hashtag #KeepTheFewNHSIPUs, following the NHS Addictions Provider Alliance on Twitter @NHS_APA, writing to their local MP and signing their online petition at www.nhsapa.org/ipn.
The campaign comes a year after a major independent review commissioned by the Home Office and published by Professor Dame Carol Black, which supported the case for maintaining NHS IPUs. The review, which was published in 2019, revealed how budgets for substance misuse services had been significantly reduced for many years.
Danny Hames, Chair of the NHS APA said: “The funding system for NHS IPUs is in urgent need of reform. For far too long we have seen decision-making based on finance, rather than clinical need – and this needs to change. Without urgent action, the patients of the future are at risk of not receiving the care and treatment that they so desperately need.”
"For far too long we have seen decision-making based on finance, rather than clinical need – and this needs to change."
Jon Shorrock, Chair of the NHS IPN said: “The future of NHS IPUs is now at breaking point, at a time when these services are needed more than ever. In the last three years, NHS IPUs have seen an increase in the number of patients admitted to their services and a significant increase in the level of complexity of patients. With patient numbers going up, it is vital that we call on the government to secure the future of these services. Time is of the essence. If we don’t take action now, we will continue to see an unnecessary and avoidable increase in the number of substance use and alcohol-related deaths in England.*”
At point of publication the NHS Inpatient Unit have been invited to present at the newly formed English Substance Use Commissioning Group to discuss possible funding solutions. Mr Shorrock, adds; “This is a great development, following the success of the national campaign and a possible lifeline to help save these services.”
*Latest figures released by the Office of National Statistics on the 14th October 2020 shows that Drug Related Deaths are the highest-ever recorded in England and Wales.