PCT FACES HIGH COURT CHALLENGE
AFTER AXING ALCOHOL REHAB FUNDING
A campaign group dedicated to securing effective abstinence treatment for the UK’s 1.1m alcohol dependents today launched a High Court challenge against a Primary Health Care Trust after it axed all funding for places at one of the country’s leading rehabilitation centres. This PCT also axed funding for places at a day programme which helped alcoholics to recover.
Lawyers for UK Advocates wrote threatening proceedings against Nottinghamshire County PCT in the Administrative Division of the High Court after learning of the health authority’s plan to stop all referrals to the Priory Clinic in Nottingham from the end of September this year.
Central to UKA’s challenge is the PCT’s use of a single sentence from the National Treatment Agency's 2006 Review of the Effectiveness of Treatment for Alcohol Problems as evidence to justify denying county residents access to detoxification beds, residential rehabilitation places and aftercare programmes provided at the clinic.
In a letter to referral agencies, seen by UKA and Addiction Today, the PCT uses that one quote from the NTA's Review questioning the effectiveness of residential rehabs that base treatment programmes partly on the 12 Steps of Alcoholics Anonymous.
However, on being informed of the use of the 212-page report in this context by the Addiction Recovery Foundation, the authors of the quote – Duncan Raistrick and Nick Heather - responded that they "are very unhappy that the Effectiveness Review might have been misrepresented" and that the report found that "there is a place… for residential care… for those with greater impairments particularly with regard to social deterioration and high risk of relapse" and "we are supportive of mutual aid, including 12-step programmes and of Twelve Step Facilitation".
SPURNING DoH GUIDELINES
Nottingham PCT's letter makes no reference to a series of definitive guidelines from the Department of Health that commissioners of alcohol treatment services are expected to follow when making decisions on the shape of NHS alcohol treatment services, and that make it clear that both residential rehabilitation and 12-step based treatments should be included in a range of treatment interventions.
It also pre-empts forthcoming guidance from the National Institute of Clinical Excellence (NICE) on the management and treatment of alcohol dependency, expected early next year.
The PCT’s decision comes amidst deepening concern among service providers and users over the future of alcohol treatment in the county, which are currently ’under review’.
Earlier this year UKA threatened similar action against Nottinghamshire County PCT when it abruptly pulled funding for an intensive day care programme for alcohol dependents in the city commissioned from a private sector provider, despite highly promising early results.
UKA chairman Robert Beckett said: “I’ve spent over 20 years trying to work in cooperation with NHS commissioners to secure the rights of alcohol dependents to treatment that gives them the best possible chance of getting sober and staying sober. Sadly this has failed and we have no option but to ask the courts to intervene. The PCT has cherry picked one sentence from one of scores of academic studies – some of which have very different findings - to justify doing this, even though it runs contrary to the Department of Health guidelines they are committed to following.
"This is serious blow for alcohol dependents in Nottinghamshire and will have a huge knock on effect on thousands of people either in need of treatment or already in recovery through the clinic.
“We are caught in an epidemic in alcohol dependency that is killing thousands every year and costing the country billions of pounds, yet the PCT is prepared to stop providing a service that has been proven to be outstandingly successful for 20 years.
“We hear similar stories about inadequate and poorly structured services elsewhere in the UK all the time and this action could be just the first of many.”
Review of the effectiveness of treatment for alcohol problems (Raistrick et all, 2006)
Models of Care for Alcohol Misusers, (National Treatment Agency, 2006)
Alcohol Misuse Interventions: Guidance on developing a local programme of improvement (DoH, 2005)
Signs for Improvement – commissioning interventions to reduce alcohol related harm (NTA, 2006)