Joining Things Up (again ....)
Sunday/03/Aug 2008 Filed in:
Policy - Local
Partnerships and Administration
In
Sunday's Times, Tim Hollis
the Chief Constable of Humberside Police called for a more joined
up approach to tackling drugs, saying
"It’s no good having the Ministry of Justice, the Department of Health and the Department for Children, Schools and Families each responsible for a separate section of the strategy, as they are now. All the different elements must be brought together to ensure that policy is devised and implemented in a coherent fashion...."
There are times, you know, when I start to feel terribly old. Sometimes these coincide with vetting a job application from someone who was born after I started being able to legally drink, but most often its when I recognise that I'm seeing something I know we've done before - often more than once - being suggested as a new idea and I have this terrible fear we'll make the same mistakes all over again.
As many of you may know I've something of a fetish for old drug strategies and policy. This has proved useful in pulling together stuff like The Goodenough Drug Strategy and The LDPF Guide to The National Strategy. Knowing this, an old colleague last week sent me something that I'd been asking for for a while - the planning template for the DAT plan from 2000/1 (I know, its sad isn't it?). This was the last year before the NTA introduced the Treatment Plan, and my first as a DAT co-ordinator, and its quite startling to see both how much we have gained - and how much we have lost - in terms of managing local partnerships.
The modern Treatment Plan is a major undertaking for every DAT. It comes in four sections each of which relate to a function of the commissioning process (you can check out the guide for more information about this if you like) There are some big problems with the document of course. For one thing, its proliferating - with new off shoots appearing all over the place - like the IDTS plan and the Young People's Treatment Plan. This kind of shifts away from integration - and can make it difficult to see how stuff joins up locally. Also while the strategic summary and RAG rating of the Treatment Plan are pretty straight forward and easy to read, the bits dealing with what's going to happen and who's going to pay for it lend themselves to a level of obfuscation that isn't helpful. In order to be useful for a partnership, plans and strategies need to be comprehensible, clear and jargon free. However, these may be just quibbles - and a good DAT team should be able to make this stuff meaningful and comprehensible to their partnership.
When you look at the old DAT plan, the information gathered about treatment is simple and - some might say - perfunctory. Its just a simple section asking the DAT how they plan to meet the Government targets for numbers in treatment, what the milestones are and how much money from where will be used to fund it. There can be little doubt that the level of information now required in treatment plans has made the output management of the Drug Strategy much easier for those in central government charged with meeting the PSA targets, and makes the role of the NTA teams in monitoring DAT progress on this straightforward and functional. Given its single strand focus, how useful it is for joined up working and partnership development is less clear.
When Tim Hollis says that he believes we should see more of our drug strategy being delivered in partnership, he is unconsciously echoing not the current drug strategy but the previous two. In 1995, John Major's drug strategy made a commitment to partnership that was picked up and developed in the 1998 strategy - Tackling Drugs to Build a Better Britain. here, with the central co-ordination of a Cabinet Office Unit (UCADCU), DATS were charged with joining up local and regional activity across the four areas of Community, Young People, Treatment and Availability into a single local strategy that would ensure a co-ordinated response.
When you look at the 2000/1 plan, you can see they were trying to do just that. Right at the front of the document there's a section on Strategic Links which asks the DAT to identify what its links were to other parts of local strategy. This is quite a detailed section - with the DAT being required to identify whether they had formal or informal partnerships, drugs mainstreamed in departmental or thematic plans, joint specific drug plans and/or jointly commissioned or funded services. This information was required across a range of local services and strategies including Health, Housing, Social Care, Crime and Disorder, Education, Regeneration and Employment. A series of brief tables asks the DAT how they plan to meet Government PSA targets, and then space is provided fro the identification of appropriate local objectives. Finally there is a section on funding - looking at which partners are bringing what to the JCG table. It lacks detail - space for managing specific outcomes, and so its hard to see how it could be monitored. But what it does do is set the DAT clearly at the centre of local partnership, and makes all partners accountable for a locally driven cross cutting approach to drugs. And it went badly wrong.
By 2002 New Labour was well into its stride. the performance management culture at the heart of Gordon Brown's Treasury had taken hold and through the 2001 Spending Review was reaching into all areas of policy - and particularly those into which the Government was putting most new funding - such as education - and crime. Drugs began to benefit from much needed new investment - and new monitoring systems. Finding that the existing template did not provide sufficient detail to meet the Treasury's demands for detailed monitoring, Whitehall officials decided - more by default than anything else - that each new funding stream would be accompanied by its own separate plan - and DATs would be required to complete them all. I remember this period of time well. Each time a new initiative was announced we knew a new plan would not be far behind. At one point in 2002, DATS were responsible for submitting 18 different plans to central government, reporting on between 40 and 50 separate funding streams. This issue is covered in Nick Davies 2003 article How Britain is Losing the Drugs War (also known as "Tales of the Purple Arm")
Planning and management was in a mess. Things had to change. At the 2002 DAT conference in Blackpool, DAT Co-ordinators famously slow hand-clapped civil servants unwilling to listen to reports of the problems local partnerships were experiencing in tackling the increasing bureaucracy. The new drug strategy update was published - and with it the emphasis clearly, and irrevocably turned to treatment - and with the announcement of the first DIP Schemes, to crime. Following the Blackpool conference, civil servants swore to never deal with DATs as a group again. The NTA were quick to take the lead. Understanding the central government priority to meet its targets and the local need to improve access to drug treatment, they began to beef up NDTMS and the Treatment Plan. Working closely with the NTA, the Home Office turned their attention - pretty much to the exclusion of all other areas of work - to the new DIP programme and the monitoring that sat alongside that. All other plans dropped off the agenda. DATS breathed out.
For the first time ever, government had been able to create a framework through which they were able to show local progress towards national output targets. Unfortunately the ability to monitor outcomes in any meaningful way remained evasive. So a new phrase was born - the "proxy outcome indicator" - essentially an output measure from which an outcome would be assumed. So, for example, numbers in treatment was used as a proxy outcome measure of the reduction of drug related harm. Retention to 13 weeks was used as a proxy indicator of an individual experience of improved quality of life through engagement in effective treatment. Engagement with a compulsory Required Assessment was taken to be an indicator of reducing criminal activity and so on. For local areas and government, despite the assumption of outcomes, this meant that the focus came down to outputs - and outputs in a fairly narrowly defined part of the strategy. No longer were local areas being - as Nick Davies put it - micro managed across a huge range of disparate plans and strategies. They were now being micromanaged across a narrow range of outputs - and were meeting the targets for those outputs. Over the next few years, treatment provision increased across the country. In 2002, the NTA analysis of treatment plans identified that only 48% of DATS were able to report waits for specialist prescribing that were under 12 weeks - and that the national average was 14 weeks - or 31/2 months. Current estimates suggest that reported waiting times are now under three weeks.
The downside of this however was that any elements of the DAT agenda not covered by the new plans and frameworks - work in communities, education and youth work, harm reduction, employment support, housing schemes - and the critical issues about integration of the DAT agenda across other aspects of local strategy, effectively disappeared. Not only this, but the idea of a multi agency partnership tackling drugs through a cross cutting agenda began to look as out of date as the former Drug Czar's immaculately combed moustache. Unsurprisingly, with neither central government nor DATs themselves taking any interest in the wider issues, representation from senior officers dropped off - and accordingly drugs has dropped off the agenda of many mainstream services - like housing and regeneration. There is now no requirement for DATs to produce any kind of planning at all that does not relate to treatment or criminal justice interventions or to consider local integration or mainstreaming. Not only that but since the apocalyptic Blackpool DAT conference in 2002, there appears to have been no central government initiative or team charged with either supporting, informing or communicating with DATs about the cross cutting substance use agenda. A simple once over at the www.drugs.gov.uk website bears this out. The only items that appear under the Guidance for DATs section ("Help and Information Specifically for DATs") are a guide to "Annex B" and the ill fated Performance Management Framework from 2003, a link to a previous incarnation of the old CDRP audit toolkit and some partnership grant guidance from 2004. If I was a new DAT co-ordinator today I think I'd just keep my head down, do what the NTA asked, and hold a PR jamboree every now and then, so I have huge admiration for those DAT Co-ordinators around the country still trying to do more than that.
The other difficulty has been the extent to which the public and those directly affected by substance use have been excluded from decision making. The Drug Reference Groups that were a feature of the 1995 strategy may not have been much cop, but they did at least provide a forum where local drug issues could be discussed by people who weren't just the great and the good of the DAT. At a time when Government is telling us that community empowerment is critically important it seems a shame that in this area that affects so many people, so few decisions are made by them. Peter McDermott of The Alliance tells me that user organisation is happening in a way that he's never experienced before - and it certainly seems that the increase in treatment coupled with a refocussing on recovery has opened up real opportunities. However, if policy is only ever managed centrally, it restricts the people who are able to influence it. Making more decisions locally and using instruments like the new Community Involvement White Paper should enable more people directly affected by substance use to make decisions about strategy and service responses.
Additionally, over the past year or so, more and more questions have been asked about whether the proxy outcome indicators (or outputs) actually are doing what they say on the tin. At the time of the preparation of the last drug strategy, a number of reports - including official government research and media coverage began to suggest that while the output targets had been met, there may be more to tackling problems related to substance use than treatment and the criminal justice system. The view from many experts in the field seemed to be that although we knew we had met the government targets, we simply didn't know if the targets had been right.This had a whole range of impacts - including a resurrection of the contention that abstinence is the only reasonable goal of drug policy as reported by the redoubtable Mike Ashton. It also had an impact on thinking about the new drug strategy. Maybe there was more to tackling drugs than counting numbers in treatment? Also - and maybe more pertinently - if the outputs hadn't realised the PSA outcomes (reduction of drug related harm, crime, drug related deaths etc) then would or should any more money be forthcoming?
There are signs that this critique - both of the single focus of the strategy and of the style of management and support available to local partnerships - has had an impact on the views of many in Government. The new strategy has a strong focus on reintegration, housing and unlike its predecessors identifies that this support should come through mainstream services. Despite this however there does not as yet seem to be a shared vision in the centre as to the levers and supports necessary to enable partnerships to deliver. If the ambitions of the new drug strategy - particularly those around employment, housing and reintegration are to be met, we need to do some serious work soon to look at how we can strengthen and re-establish our local partnerships such that they're up to delivery. For example the Welfare Reform Green Paper (more of which later this month) is clear that there is a big role for local areas to play in ensuring the headline grabbing benefits clampdown on drug users doesn't just become a case of more conditionality and less opportunity. In their planning DWP seem to be assuming the existence of a local infrastructure that may not be particularly robust anymore - and that certainly has not been particularly focussed on employment and reintegration. The danger is that unless we tackle the disintegration of local infrastructure that's taken place over the past 6 or more years that things will go downhill fast. As each new initiative is developed we will replicate the proliferation of plans, the inconsistency and the micro management that dogged DATs in the early years of the century or will risk allowing three quarters of our ambition to falter as we continue to tightly performance manage and focus on just one part of the strategy. Tim Hollis is absolutely right when he says partnership is critical for the successful implementation of strategy - but co-ordination needs to be undertaken locally. What central government needs to do is ensure that the performance management systems it imposes are consistent, light touch and recognise that tackling drugs needs cross cutting activity not silos. The problem with creating single autonomous structures is that eventually they turn into silos too.
When I raised the issue of the DAT Guidance on the website with the Home Office recently they did have the decency to blush - and they assured me that supporting local partnerships was now high up on their agenda. Apparently plans are afoot to bring back a monthly drug strategy newsletter and they have been organising events across the regions to ask people what support they'd like. The Home Office say that they don't want to go back to the old days - with hugely prescriptive guidance on partnership structures, ring-fenced funding and paint -by-numbers instructions on how to develop local strategy. If this commitment is genuine, this is an approach that more than anything needs to be *consistently* applied across the strategy - and its one that DATs will need some time to adjust to.
While government has shown that it listened and prepared a drug strategy that at least at a headline level understands that the future's local - "To build on the achievements of the previous strategy and bridge some of the delivery gaps highlighted by the consultation process, we must now ensure that action to tackle substance misuse is at the core of national, regional and local planning and delivery processes in ALL departments" (Drugs, Protecting Families and Communities, 2008), they seem to have missed some bits out. In particular (as I've explained before) they appear to have overlooked the fact that the way to ensure joined up working is to focus on embedding indicators for the outcomes we know we need to achieve around drugs (like universal access to effective treatment, community and individual level harm reduction and effective drug education focussed on minimising risk) into performance management frameworks across all relevant public services. But even with a robust outcome framework, "Protecting Families and Communities" would present a real challenge to local partnerships. For the first time since 2002, the relationships around the DAT table should become as important as the relationship with cental government. Local areas will need the kind of support that leaves strong partnerships in place, rather than the top down management we've become used to.
Its often said that the drugs field is an area of policy that, required as it is to continually reinvent itself to attract sufficient public investment, tends to forget its own history. But any new structures or frameworks will need to avoid the pitfalls of the past. The central micro-management of a crosscutting local agenda simply doesn't work. While strong central performance management of Government defined outputs can be effective in hitting essential if primitive targets within a clearly ringfenced area of practise, they have proven less successful in terms of stimulating and sustaining local partnership. It tends to be difficult to centrally mandate partnership working. Revolutionary as it may seem, before we develop new performance management models for aspects of the strategy - like treatment or employment, it would be worth our while to actually take some time out to work out how they're actually going to work *together*. New approaches from different central government agencies developed in isolation won't help anyone. Learning from our own recent history to ensure they're delivered without duplication, efficiently and focussing on establishing meaningful local structures that put the people affected by substance use - including people in drug treatment - in the driving seat, just might.
"It’s no good having the Ministry of Justice, the Department of Health and the Department for Children, Schools and Families each responsible for a separate section of the strategy, as they are now. All the different elements must be brought together to ensure that policy is devised and implemented in a coherent fashion...."
There are times, you know, when I start to feel terribly old. Sometimes these coincide with vetting a job application from someone who was born after I started being able to legally drink, but most often its when I recognise that I'm seeing something I know we've done before - often more than once - being suggested as a new idea and I have this terrible fear we'll make the same mistakes all over again.
As many of you may know I've something of a fetish for old drug strategies and policy. This has proved useful in pulling together stuff like The Goodenough Drug Strategy and The LDPF Guide to The National Strategy. Knowing this, an old colleague last week sent me something that I'd been asking for for a while - the planning template for the DAT plan from 2000/1 (I know, its sad isn't it?). This was the last year before the NTA introduced the Treatment Plan, and my first as a DAT co-ordinator, and its quite startling to see both how much we have gained - and how much we have lost - in terms of managing local partnerships.
The modern Treatment Plan is a major undertaking for every DAT. It comes in four sections each of which relate to a function of the commissioning process (you can check out the guide for more information about this if you like) There are some big problems with the document of course. For one thing, its proliferating - with new off shoots appearing all over the place - like the IDTS plan and the Young People's Treatment Plan. This kind of shifts away from integration - and can make it difficult to see how stuff joins up locally. Also while the strategic summary and RAG rating of the Treatment Plan are pretty straight forward and easy to read, the bits dealing with what's going to happen and who's going to pay for it lend themselves to a level of obfuscation that isn't helpful. In order to be useful for a partnership, plans and strategies need to be comprehensible, clear and jargon free. However, these may be just quibbles - and a good DAT team should be able to make this stuff meaningful and comprehensible to their partnership.
When you look at the old DAT plan, the information gathered about treatment is simple and - some might say - perfunctory. Its just a simple section asking the DAT how they plan to meet the Government targets for numbers in treatment, what the milestones are and how much money from where will be used to fund it. There can be little doubt that the level of information now required in treatment plans has made the output management of the Drug Strategy much easier for those in central government charged with meeting the PSA targets, and makes the role of the NTA teams in monitoring DAT progress on this straightforward and functional. Given its single strand focus, how useful it is for joined up working and partnership development is less clear.
When Tim Hollis says that he believes we should see more of our drug strategy being delivered in partnership, he is unconsciously echoing not the current drug strategy but the previous two. In 1995, John Major's drug strategy made a commitment to partnership that was picked up and developed in the 1998 strategy - Tackling Drugs to Build a Better Britain. here, with the central co-ordination of a Cabinet Office Unit (UCADCU), DATS were charged with joining up local and regional activity across the four areas of Community, Young People, Treatment and Availability into a single local strategy that would ensure a co-ordinated response.
When you look at the 2000/1 plan, you can see they were trying to do just that. Right at the front of the document there's a section on Strategic Links which asks the DAT to identify what its links were to other parts of local strategy. This is quite a detailed section - with the DAT being required to identify whether they had formal or informal partnerships, drugs mainstreamed in departmental or thematic plans, joint specific drug plans and/or jointly commissioned or funded services. This information was required across a range of local services and strategies including Health, Housing, Social Care, Crime and Disorder, Education, Regeneration and Employment. A series of brief tables asks the DAT how they plan to meet Government PSA targets, and then space is provided fro the identification of appropriate local objectives. Finally there is a section on funding - looking at which partners are bringing what to the JCG table. It lacks detail - space for managing specific outcomes, and so its hard to see how it could be monitored. But what it does do is set the DAT clearly at the centre of local partnership, and makes all partners accountable for a locally driven cross cutting approach to drugs. And it went badly wrong.
By 2002 New Labour was well into its stride. the performance management culture at the heart of Gordon Brown's Treasury had taken hold and through the 2001 Spending Review was reaching into all areas of policy - and particularly those into which the Government was putting most new funding - such as education - and crime. Drugs began to benefit from much needed new investment - and new monitoring systems. Finding that the existing template did not provide sufficient detail to meet the Treasury's demands for detailed monitoring, Whitehall officials decided - more by default than anything else - that each new funding stream would be accompanied by its own separate plan - and DATs would be required to complete them all. I remember this period of time well. Each time a new initiative was announced we knew a new plan would not be far behind. At one point in 2002, DATS were responsible for submitting 18 different plans to central government, reporting on between 40 and 50 separate funding streams. This issue is covered in Nick Davies 2003 article How Britain is Losing the Drugs War (also known as "Tales of the Purple Arm")
Planning and management was in a mess. Things had to change. At the 2002 DAT conference in Blackpool, DAT Co-ordinators famously slow hand-clapped civil servants unwilling to listen to reports of the problems local partnerships were experiencing in tackling the increasing bureaucracy. The new drug strategy update was published - and with it the emphasis clearly, and irrevocably turned to treatment - and with the announcement of the first DIP Schemes, to crime. Following the Blackpool conference, civil servants swore to never deal with DATs as a group again. The NTA were quick to take the lead. Understanding the central government priority to meet its targets and the local need to improve access to drug treatment, they began to beef up NDTMS and the Treatment Plan. Working closely with the NTA, the Home Office turned their attention - pretty much to the exclusion of all other areas of work - to the new DIP programme and the monitoring that sat alongside that. All other plans dropped off the agenda. DATS breathed out.
For the first time ever, government had been able to create a framework through which they were able to show local progress towards national output targets. Unfortunately the ability to monitor outcomes in any meaningful way remained evasive. So a new phrase was born - the "proxy outcome indicator" - essentially an output measure from which an outcome would be assumed. So, for example, numbers in treatment was used as a proxy outcome measure of the reduction of drug related harm. Retention to 13 weeks was used as a proxy indicator of an individual experience of improved quality of life through engagement in effective treatment. Engagement with a compulsory Required Assessment was taken to be an indicator of reducing criminal activity and so on. For local areas and government, despite the assumption of outcomes, this meant that the focus came down to outputs - and outputs in a fairly narrowly defined part of the strategy. No longer were local areas being - as Nick Davies put it - micro managed across a huge range of disparate plans and strategies. They were now being micromanaged across a narrow range of outputs - and were meeting the targets for those outputs. Over the next few years, treatment provision increased across the country. In 2002, the NTA analysis of treatment plans identified that only 48% of DATS were able to report waits for specialist prescribing that were under 12 weeks - and that the national average was 14 weeks - or 31/2 months. Current estimates suggest that reported waiting times are now under three weeks.
The downside of this however was that any elements of the DAT agenda not covered by the new plans and frameworks - work in communities, education and youth work, harm reduction, employment support, housing schemes - and the critical issues about integration of the DAT agenda across other aspects of local strategy, effectively disappeared. Not only this, but the idea of a multi agency partnership tackling drugs through a cross cutting agenda began to look as out of date as the former Drug Czar's immaculately combed moustache. Unsurprisingly, with neither central government nor DATs themselves taking any interest in the wider issues, representation from senior officers dropped off - and accordingly drugs has dropped off the agenda of many mainstream services - like housing and regeneration. There is now no requirement for DATs to produce any kind of planning at all that does not relate to treatment or criminal justice interventions or to consider local integration or mainstreaming. Not only that but since the apocalyptic Blackpool DAT conference in 2002, there appears to have been no central government initiative or team charged with either supporting, informing or communicating with DATs about the cross cutting substance use agenda. A simple once over at the www.drugs.gov.uk website bears this out. The only items that appear under the Guidance for DATs section ("Help and Information Specifically for DATs") are a guide to "Annex B" and the ill fated Performance Management Framework from 2003, a link to a previous incarnation of the old CDRP audit toolkit and some partnership grant guidance from 2004. If I was a new DAT co-ordinator today I think I'd just keep my head down, do what the NTA asked, and hold a PR jamboree every now and then, so I have huge admiration for those DAT Co-ordinators around the country still trying to do more than that.
The other difficulty has been the extent to which the public and those directly affected by substance use have been excluded from decision making. The Drug Reference Groups that were a feature of the 1995 strategy may not have been much cop, but they did at least provide a forum where local drug issues could be discussed by people who weren't just the great and the good of the DAT. At a time when Government is telling us that community empowerment is critically important it seems a shame that in this area that affects so many people, so few decisions are made by them. Peter McDermott of The Alliance tells me that user organisation is happening in a way that he's never experienced before - and it certainly seems that the increase in treatment coupled with a refocussing on recovery has opened up real opportunities. However, if policy is only ever managed centrally, it restricts the people who are able to influence it. Making more decisions locally and using instruments like the new Community Involvement White Paper should enable more people directly affected by substance use to make decisions about strategy and service responses.
Additionally, over the past year or so, more and more questions have been asked about whether the proxy outcome indicators (or outputs) actually are doing what they say on the tin. At the time of the preparation of the last drug strategy, a number of reports - including official government research and media coverage began to suggest that while the output targets had been met, there may be more to tackling problems related to substance use than treatment and the criminal justice system. The view from many experts in the field seemed to be that although we knew we had met the government targets, we simply didn't know if the targets had been right.This had a whole range of impacts - including a resurrection of the contention that abstinence is the only reasonable goal of drug policy as reported by the redoubtable Mike Ashton. It also had an impact on thinking about the new drug strategy. Maybe there was more to tackling drugs than counting numbers in treatment? Also - and maybe more pertinently - if the outputs hadn't realised the PSA outcomes (reduction of drug related harm, crime, drug related deaths etc) then would or should any more money be forthcoming?
There are signs that this critique - both of the single focus of the strategy and of the style of management and support available to local partnerships - has had an impact on the views of many in Government. The new strategy has a strong focus on reintegration, housing and unlike its predecessors identifies that this support should come through mainstream services. Despite this however there does not as yet seem to be a shared vision in the centre as to the levers and supports necessary to enable partnerships to deliver. If the ambitions of the new drug strategy - particularly those around employment, housing and reintegration are to be met, we need to do some serious work soon to look at how we can strengthen and re-establish our local partnerships such that they're up to delivery. For example the Welfare Reform Green Paper (more of which later this month) is clear that there is a big role for local areas to play in ensuring the headline grabbing benefits clampdown on drug users doesn't just become a case of more conditionality and less opportunity. In their planning DWP seem to be assuming the existence of a local infrastructure that may not be particularly robust anymore - and that certainly has not been particularly focussed on employment and reintegration. The danger is that unless we tackle the disintegration of local infrastructure that's taken place over the past 6 or more years that things will go downhill fast. As each new initiative is developed we will replicate the proliferation of plans, the inconsistency and the micro management that dogged DATs in the early years of the century or will risk allowing three quarters of our ambition to falter as we continue to tightly performance manage and focus on just one part of the strategy. Tim Hollis is absolutely right when he says partnership is critical for the successful implementation of strategy - but co-ordination needs to be undertaken locally. What central government needs to do is ensure that the performance management systems it imposes are consistent, light touch and recognise that tackling drugs needs cross cutting activity not silos. The problem with creating single autonomous structures is that eventually they turn into silos too.
When I raised the issue of the DAT Guidance on the website with the Home Office recently they did have the decency to blush - and they assured me that supporting local partnerships was now high up on their agenda. Apparently plans are afoot to bring back a monthly drug strategy newsletter and they have been organising events across the regions to ask people what support they'd like. The Home Office say that they don't want to go back to the old days - with hugely prescriptive guidance on partnership structures, ring-fenced funding and paint -by-numbers instructions on how to develop local strategy. If this commitment is genuine, this is an approach that more than anything needs to be *consistently* applied across the strategy - and its one that DATs will need some time to adjust to.
While government has shown that it listened and prepared a drug strategy that at least at a headline level understands that the future's local - "To build on the achievements of the previous strategy and bridge some of the delivery gaps highlighted by the consultation process, we must now ensure that action to tackle substance misuse is at the core of national, regional and local planning and delivery processes in ALL departments" (Drugs, Protecting Families and Communities, 2008), they seem to have missed some bits out. In particular (as I've explained before) they appear to have overlooked the fact that the way to ensure joined up working is to focus on embedding indicators for the outcomes we know we need to achieve around drugs (like universal access to effective treatment, community and individual level harm reduction and effective drug education focussed on minimising risk) into performance management frameworks across all relevant public services. But even with a robust outcome framework, "Protecting Families and Communities" would present a real challenge to local partnerships. For the first time since 2002, the relationships around the DAT table should become as important as the relationship with cental government. Local areas will need the kind of support that leaves strong partnerships in place, rather than the top down management we've become used to.
Its often said that the drugs field is an area of policy that, required as it is to continually reinvent itself to attract sufficient public investment, tends to forget its own history. But any new structures or frameworks will need to avoid the pitfalls of the past. The central micro-management of a crosscutting local agenda simply doesn't work. While strong central performance management of Government defined outputs can be effective in hitting essential if primitive targets within a clearly ringfenced area of practise, they have proven less successful in terms of stimulating and sustaining local partnership. It tends to be difficult to centrally mandate partnership working. Revolutionary as it may seem, before we develop new performance management models for aspects of the strategy - like treatment or employment, it would be worth our while to actually take some time out to work out how they're actually going to work *together*. New approaches from different central government agencies developed in isolation won't help anyone. Learning from our own recent history to ensure they're delivered without duplication, efficiently and focussing on establishing meaningful local structures that put the people affected by substance use - including people in drug treatment - in the driving seat, just might.