Table 1 Extraction table of literature specific to examining the impact of disinvestment from alcohol and drug treatment
From: The impact of disinvestment on alcohol and drug treatment delivery and outcomes: a systematic review
Author and year published | Paper title | Peer reviewed | Population | Country setting | Sample size | Focus of paper | Method(s) | Publication type | Findings |
|---|---|---|---|---|---|---|---|---|---|
Adfam, 2017 [15] | Commissioning impact on drug treatment | No | Stakeholders - providers, commissioners, Police and Crime Commissioner, Directors of Public Health, National probation service | England | 23 | Alcohol and drug treatment | Mixed methods: semi-structured interviews and secondary data analysis via convenience and snowballing sampling | Charitable organisation primary research report | Disinvestment thus far has not resulted in diminished quality or safety of the provision of alcohol and drug treatment services. Further service development is required to respond to need. Concerns about future cuts. |
Advisory Council on the Misuse of Drugs, 2017 [38] | State of the Sector: Beyond tipping point | No | 149 commissioning teams of drug treatment | England | 106 | Drug treatment | Mixed methods: literature review, secondary data analysis, survey, and statements from professional bodies | Statutory advisory non-departmental public body primary research report | Disinvestment is the biggest threat to drug treatment and achievement of recovery outcomes. Concerns regarding service quality and effectiveness, disconnection from other health services and impact of re-tendering. |
Alcohol concern, 2014 [45] | A measure of Change: an evaluation of the impact of the public health transfer to local authorities on alcohol | No | England’s alcohol treatment providers and local authorities and Clinical Commissioning Groups | England | 75 | Alcohol treatment | Quantitative: two cross-sectional surveys | Charitable organisation primary research report | Majority of alcohol treatment services had maintained or increased funding. Concerns that areas of high harm least likely to increase funding. Treatment providers less optimistic than local authorities about funding. Funding for alcohol treatment is insufficient for its priority focus. |
Alcohol concern, 2018 [39] | The hardest hit: addressing the crisis in alcohol treatment services | No | Mailing list of Alcohol Concern’s consultancy and training and “friends.” Includes range of professionals and service users | England | 154 Surveys and 40 interviews | Alcohol treatment | Mixed methods: secondary data analysis, cross-sectional survey and telephone interviews | Charitable organisation primary research report | Reported insufficient funding of alcohol treatment and reduced workforce. Majority of stakeholders reported re-tendering within last three years. Mixed views regarding alcohol and drug service integration. Concerns regarding insufficient support for those with complex needs and older drinkers. |
Blenheim, 2018 [40] | Failure by design and disinvestment | No | Alcohol and drug treatment provision in criminal justice settings | England and Wales | N/A | Alcohol and drug treatment | Opinion / Review of existing research | Charitable organisation research report | Concerns about disinvestment and its relationship to a reduction in the quality of support during transition from custody to community services for people dependent on drugs. |
Cook (Harm Reduction International), 2017 [41] | Harm reduction investment in the European Union current spending, challenges and successes | No | Harm reduction leads from 18 countries | Europe | 18 EU member states | Drug treatment | Quantitative: cross-sectional survey and secondary data analysis | Non-Government Organisation research report | Future sustainability of harm reduction varies from fairly certain, to extremely insecure. Public sector austerity, reductions in international donors and poor political support were perceived as factors contributing to the poor funding of harm reductions. |
Drink and drug news, 2018 [44] | On a knife edge | No | Drug treatment population | UK | N/A | Drug treatment | Journalism | Magazine article | Concerns that disinvestment has contributed to a reduced focus on, and delivery of, harm reduction. |
Hayes, 2018 [43] | At the heart of the matter | No | Alcohol and drug treatment population | UK | N/A | Alcohol and drug treatment | Opinion piece | Magazine feature | Concerns regarding disinvested and reduced treatment offer despite insufficient reach of alcohol services, increasing drug-related deaths, fragmentation from health services and increases in drug-related crime. |
Mohammadi, 2014 [42] | Addiction services in England: in need of an intervention | No | Stakeholders within alcohol and drug treatment sector, including clinicians, consultants and commissioners | England | Quotes from six sector stakeholders | Alcohol and drug services | Editorial, including quotes from stakeholders | Journal opinion piece | Exploration of changes in way services are commissioned. Changes from NHS to non-NHS providers and mixed views about the effects in terms of specialism and appropriateness for treatment population. |