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Since 2005 there have been major changes affecting both the
commissioning and provision of services for people who use drugs
and alcohol. There has been a growing emphasis on recovery, with
provision increasingly oriented towards outcome measurement and
third sector involvement. Drug and alcohol treatment have a very
significant place within the evolving new arrangements for
improving public health. All of this is taking place in the context
of the wider health reforms in the Health and Social Care Act
2012.
At the same time, the profile of drug use has changed. Heroin and
cocaine use is stable or in decline, whereas new drugs such as
‘legal highs’ are emerging. Increasing numbers of young people are
using alcohol and stimulants, and long-term drug and alcohol use by
older people is becoming more significant.
It is therefore timely to look again at the roles, responsibilities
and competencies of the various types of doctors involved in
helping people recover from drug and alcohol use. This report –
which constitutes official guidance from the Royal College of
Psychiatrists and the Royal College of General Practitioners – will
help commissioners, providers, regulators, policy makers, doctors
and those seeking recovery from drug or alcohol use to ensure that
drug and alcohol services make the best use of resources to deliver
the highest possible standard of care across the entire pathway and
that all doctors working with people using drugs and alcohol have
the right level of competency for the roles and responsibilities
they undertake.
This report replaces
CR131: Roles and Responsibilities of
Doctors in the Provision of Treatment for Drug and Alcohol
Misusers from 2005.
Contents
- Working Group
- Foreword
- Executive summary
- Introduction: aims and structure of this report
- The diversity of doctors working with drug and alcohol
users
- Roles and responsibilities of doctors working with drug and
alcohol users
- The three levels of competency for doctors working with drug
and alcohol users
- Training, qualifications and supervision arrangements for
doctors working with drug and alcohol users
- Principles for service design
- References
- Further reading
Chapter 1 describes the recovery context, the
range of doctors working with drug and alcohol users, and the
regulatory requirements regarding their roles and
competencies.
Chapter 2 delineates the main distinctive roles and
responsibilities carried out by doctors working with drug and
alcohol users, and outlines their importance in delivering
high-quality, effective care and support.
Chapter 3 defines three levels of competency for doctors in this
field – specialist, intermediate and generalist – based on these
roles and responsibilities. It also gives examples of the
background and training of the kinds of doctors usually found
working at each of these levels of competency in practice.
Chapter 4 provides further information on the training,
qualifications and supervision arrangements currently available for
doctors in this field. It sets out the Working Group’s
recommendations for the training, qualifications and supervision
requirements that should be expected of doctors at each level of
competency. The Working Group expects that following these
recommendations should normally be sufficient to ensure that
regulatory requirements are met.
Chapter 5 uses the roles, responsibilities and competencies of
doctors in this field to propose a number of broad principles for
commissioning drug and alcohol services.