Thread by @OliverStanding

Thread of @DameCarolBlack's landmark Review of Drugs Pt 2. Firstly, thanks to its author who has engaged and listened with patience and rigour. There is a huge amount in there, below is not definitive🧵1

Great to see the call for a central unit to coordinate, drive policy and hold accountability. Cabinet Office would be ideal but other arrangements can work - political and official buy-in, sponsorship, governance and accountability mechanism are more important than location. 2

The need for resource is very clear in report. Real impact requires real investment and the figures put forward are substantial. Local gov has been hammered by austerity. Resource must be protected, & crime focus of recent £80m broadened to reflect all of the system's needs. 3

DCB gets how stigma prevents people asking for and getting help - "A lower standard of care for this vulnerable stigmatised population is not acceptable." "This is rarely a priority ‘doorstep’ issue for local politicians." 🙏 4

Good to see tier4 services rehab and detox discussed. The idea of sub/regional commissioning to support their sustainability is very welcome and called for by @collect_voice. Psychosocial support is essential for change and rightly picked out in the report. 5

Local Outcomes Framework & Commissioning Quality Standard could both be useful approaches to drive quality & partnerships – but must be developed in consultation w. experts in the field. We must work alongside @PHE_uk @DHSCmedia, 'on the same side'. We have a common mission. 6

There must be flex on what counts as success, w people in recovery having some autonomy in shaping that measure. This is hard but crucial "Previous payment-by-results pilots in the sector have shown that it is difficult to attach incentives to complex and long-term outcomes." 7

The vital role of recovery communities like @RRR_LUF @TheThewell2 @thebasementproj @CLERO57024569 and many others is recognised. I'm sure @EdDay71 has championed their involvement and importance. 👍 8

The terrible drop off in support from custody to community for people with drug problems has been well documented by ACMD, @AlexStevensKent @russwebt etc. The report is right to highlight this - will be an indicator of interest to PM chaired Crime and Justice Taskforce. 9

A huge amount of the report is focused on partnership and how to bring it about. Closer working between MOJ/DHSC/NHSE on prison treatment, health and local gov on dual diagnosis and departments in central gov. All good - all hard. 🤝 10

DCB talks about importance of local partnerships of health, crime, justice & local gov. Back to the future! It is sometimes suggested pre HSCA commissioning sat solely in NHS - not true, was in health frame but though local partnerships. Let's bring back the best of the DATs. 11

What happens next? It's essential **we** the field are part of a whole systems response. We are all systems colleagues and part of a shared mission. "The government should convene a long-term representative group of external stakeholders" 👌 12

**We must now all focus on the political response to this independent Review.** The Home Sec who commissioned the Review is now the Health Sec who's desk it will land on. Shout the recommendations from the rooftops, activate you public affairs contacts, write to your MPs. 13

Last night England beat Denmark but there's still a final before us. DCB's powerful report is our semi-final: all eyes must now be on our 'final': political action from @sajidjavid & others and commitment in the Comprehensive Spending Review. Let's hope #Itscominghome.

Statement from @ukhomeoffice, @DHSCgovuk & @PHE_uk on the "Joint Combating Drugs Unit" called for by Dame Carol in her report. gov.uk/government/new…

The Joint Unit is confirmed as sitting in @ukhomeoffice with @kitmalthouse as the named minister.

- @DameCarolBlack presents the gains possible with her system refresh - over 3000 lives saved from opiate overdose, 95k more people in recovery and 2.8million crimes prevented. For politicians to ignore the report is to say 'no thanks' to these gains.

"We can and we should do better" @Jochurchill4 Public Health Minister responding to Dame Carol. Good to hear.

- @Jochurchill4 talking about families, waste of life of people dying, addiction existing in a context, hinting at the structural causes. "The 80m signals a turning point, but also the start of something". Good narrative - now is the time for action.

I've not had time to read and digest but @TheKingsFund has just published the work they were commissioned by DHSC to do on commissioning and accountability structures around drug treatment. york.ac.uk/healthsciences…