Abstract
Aims and MethodWe undertook a postal questionnaire survey of drug action teams in England and Wales with the aim of clarifying the nature of statutory specialist drug services.ResultsOf 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. Other providers were primary care and acute trusts, the non-statutory sector and social services. The majority of medical leads were psychiatrists (123 senior posts with 20% vacant/occupied by a locum), then general practitioners (GPs) (42) and other specialists (4).Clinical ImplicationsSpecialist drug services are offered by a range of treatment providers, with the medical lead being taken by GPs and other specialists in some areas. In view of the current difficulty in recruiting psychiatrists, we propose that alternative training pathways are considered for addiction specialists.
Highlights
Specialist drug services are offered by a range of treatment providers, with the medical lead being taken by general practitioners (GPs) and other specialists in some areas
Thirty-four had services provided by primary care trust (PCT), of whom 11 had the service provided exclusively by one or more PCT provider, Table 1
Nine drug action teams had services provided by non-statutory services, of whom three had services provided exclusively by this sector, with the remainder in combination with other providers, such as a community trust, mental health trust or PCT
Summary
Of 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. In 2001, the National Treatment Agency was formed (http://www.nta.nhs.uk) This has the status of a special health authority and it is to this body that the drug action teams are responsible. The ‘traditional’ model of service delivery would be a mental health trust providing the statutory drug treatment in a particular locality under the medical supervision of a consultant psychiatrist. Other treatment providers have moved into the field; these include primary care trusts and non-statutory organisations. These agencies require a doctor to have medical responsibility, but there is no requirement for this doctor to be a psychiatrist. As part of our survey we asked the drug action teams to comment on whether posts were occupied or not
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