In it’s response to the global pandemic, the Third Sector has proven categorically that it is the place for any government to invest if it wants to make radical changes to health and social care delivery. Charities are renowned for having talented tenacious and flexible staff and volunteers. We have the track record of getting to and working effectively with people who most need support and in turn enabling statutory health and social care organisations to engage well with people with multiple disadvantage.
This time last year we had a newly elected government with a large majority. That meant Brexit was going to happen one way or another. We could also see that the new government had ambitions for new policies and investment. COVID came, and with it the promise of new policies and new investment went. The global pandemic has heightened the uncertainty, and there has been a continuation of a vacuum in longer term planning.
However, we are at a particular juncture in our country’s history, where we have both the evidence and a consensus on what we need to do to reduce health and social inequalities. Third Sector organisations and workforces, like Humankind, have evidenced with our response to COVID, that we have the agility, resilience and adaptability to innovate and deliver on this challenge, with the right support and investment.
Humankind welcomes the one-year £148m investment in drug treatment, for services like ours, and increased investment to support the people we work with across housing and wider welfare support. We do recognise that this short-term support is in response to the challenges that COVID brings. Nevertheless, it’s absolutely vital that the next three-year spending review has coordinated policies and increased investment. This needs to, at a minimum, match pre-austerity levels for communities and families that need evidence-based prevention, support and interventions to address the major health and social inequalities they experience. A failure to make this medium-term commitment will only result in more costs to the public purse further down the line.
Our plea is that the increased investment is spent on service delivery and goes directly to the people who use our services. We cannot afford to invest in short term vanity projects, and please don’t create a pressure to spend money quickly, in an unplanned way. We have a clear and compelling case for reinvestment in the services we already know are needed in the communities we work in. We welcome the prioritisation of inpatient detoxification, criminal justice and harm reduction interventions. We want to make sure investment is connected to addressing the health and social care needs of people caught up in the criminal justice system. We don’t support high cost initiatives, that do not make a difference and/or stigmatise and marginalise people further.
Public health requires long term investment and a generational view of improvements — drug deaths have been worsening for over 10 years, and stemming the tide will take time. COVID will have a long recovery period and has added the following pressures:
· further increased demand for substance use and mental health services
· continued significant increases in drug and alcohol deaths
· an exacerbation of deprivation and inequality across the country
· wider suffering behind closed doors for people already living in difficult circumstances
With increased investment, Humankind has a commitment to the following:
· further modernisation and transformation of delivery to reach more people who need and want to use our evidence-based services. We currently work with a fraction of the people who need our help because of lack of funding, but also because we need to further change how we deliver services.
· investing now to transform our service delivery models to be fit for the 21st century, including a blended offer of remote and face-to-face service delivery, and bespoke and tailored packages of care. New interventions will have to connect and be integrated with wider NHS and Social Care transformations.
· continued major investment into the skills of our workforce and improved access to qualifications and professional accreditation.
· a significant investment in staff welfare and wellbeing for our people, who work with many of the neediest people in our communities — this need is likely to be a significant trend over time.
We will support and integrate the seismic shifts in strategy and commissioning with the publication of new strategies including part 2 of the Dame Carol Black Review into drugs, the upcoming Addictions Strategy and changes to structures and commissioning in prisons, probation, NHS and Public Health England.
Our Key Recommendations
1. Create longer term planning cycles, that encourage innovation and partnership. Increased longer term funding needs to reach key players in criminal justice, health, social care and Third Sector services, with shared ownership and genuine accountability.
2. Trust the Third Sector to deliver on key policy changes and the Third Sector, with increased investment, will deliver on improvements to delivery and impact.
3. Over time, investment should be directly linked to drug/alcohol deaths data, deprivation indices and multiple and complex needs indicators. The wider determinants of health and wellbeing — jobs, opportunities for social connection and housing, also need to be invested in.