With public service reform near the top of the government’s agenda in 2010, taking steps to better understand the cumulative impact of changes is vital. Significant changes connected to the principles of localism occurred in April 2013 which are of particular relevance to the drug and alcohol treatment sector – reforms to public health and to the police. As part of the overhaul of health services, drug and alcohol services are now largely commissioned by local authorities through Directors of Public Health and shaped by priorities established by new health and wellbeing boards. Elected police and crime commissioners, in place of police authorities, are charged with producing a Police and Crime Plan, which should include strategies around drug and alcohol use and related crime. This could include supporting drug intervention programme interventions, community services or, in some cases, residential services. 2013 has also seen the abolition of the National Treatment Agency, with most of its functions transferred to a new body, Public Health England (PHE), but the precise role that PHE will play in the sector and the relationships it will have with public health commissioners in local authorities is not yet entirely clear.
These changes replace the primary mechanisms by which services have been commissioned and funded for over a decade. There is also a broad sweep of other reforms that either have affected the sector and its clients or are likely to do so in future, including welfare reform, NHS and social care reform, Transforming Rehabilitation, the Work Programme, the introduction of payment by results both in pilot schemes and elsewhere, and broader pressure on local authority funding.