Health fears over drug services

Partnerships including the police and NHS deliver drug services

More must be done by treatment services to stop drugs users contracting infections, a health watchdog says.

The Healthcare Commission's review of 149 local drug partnerships in England praised the management of the groups.

But the report criticised the approach to harm reduction, pointing out problems with needle exchange and HIV and hepatitis C testing.

Campaigners agreed more focus on health needs was necessary, but the government said this was being addressed.

It comes after the number of people using the services more than doubled in the last eight years from 85,000 in 1998-9 to 195,400 in 2006-7.

The rise has been put down to increases in capacity rather than more drug use.

The problem is that drugs policy is based around serving the needs of the criminal justice system Harry Shapiro, of Drugscope

Drug treatment services - both counselling provided in the community and residential-based care - are provided by partnerships between councils, the NHS, police and probation service.

The Healthcare Commission, in partnership with the National Treatment Agency which oversees drug services, quizzed the partnerships in 10 key areas associated with harm reduction and management functions.

The report found that the partnerships had good management, performing well in areas such as managing finances and commissioning services.

This meant that, overall, partnerships were given positive grades - with four fifths rated as good or excellent.

But these results masked the problems relating to preventing harm, which is reflected by the fact that the country has one of the highest rates of drug-related deaths in Europe.

Struggle

In particular, a third of partnerships did not have a multi-agency plan for reducing drug-related deaths.

This meant that in almost all partnerships at least a quarter of patients were not offered hepatitis B jabs and at least half were not recorded as having a test date for hepatitis C - both of which is deemed good practice.

Meanwhile, over a third of partnerships did not have access to HIV testing and a half were rated weak in the provision of out-of-hours needle exchange.

The report pointed out that these problems have occurred as services have struggled to reduce the number of drug-related deaths.

In 2001, the government set a national target to reduce the number of deaths from more than 1,500 by 20% deaths within three years.

Although the previous steep rise in deaths during the 1990s was halted, the target itself was missed.

Anna Walker, chief executive of the Healthcare Commission, said some aspects of the report were encouraging, but improvements were need over harm reduction.

She added: "It is a clear national priority to minimise the impact of substance misuse."

Harry Shapiro, of the charity Drugscope, said: "The problem is that drugs policy is based around serving the needs of the criminal justice system.

"There is not enough emphasis on health, as the issues in this report show."

But the Department of Health said the issue was being addressed.

A spokeswoman said: "To ensure all areas are able to offer the same standards of care the Department of Health and National Treatment Agency have launched an action plan to reduce drug-related harm with a range of initiatives to improve treatment skills."