Service inspections: independent substance misuse services

For independent substance misuse providers, we inspect the following services:

Hospital inpatient-based services

These services provide assessment and stabilisation, and assisted withdrawal for people with substance misuse problems. Services are available 24 hours a day, and are provided by a multidisciplinary clinical team with specialist training in managing addiction and withdrawal symptoms.

The clinical lead in these services is usually a consultant in addiction psychiatry, or another substance misuse medical specialist. The team may also include psychologists, nurses, occupational therapists, pharmacists and social workers. People whose use of alcohol or drugs needs to be supervised in a controlled medical environment may be admitted to an inpatient unit. Treatment may be provided on a specialist ward, or as part of their care on another ward.

Residential substance misuse services

These services provide structured drug and alcohol treatment where people have to be resident at the service in order to receive treatment. This includes abstinence-based recovery services, as well as medicine-assisted recovery programmes, such as detoxification or stabilisation services. Teams vary according to the service’s treatment programme, but may include psychosocial project workers, social workers, doctors and nurses.

Community-based services

These services provide care, treatment and support in the community for people with substance misuse problems. They may also help people who have a dual diagnosis or co-occurring disorders (COD), where the person is experiencing a mental health problem and also has a substance misuse problem.

People are primarily cared for by a doctor, nurse or social worker, but services are provided by a broad range of health and social care professionals, working in multidisciplinary teams. This could include in GP practices or other community settings, or part of health services in secure settings. The teams are also supported by community pharmacists when providing controlled drugs. Treatment is likely to involve the use of medicines, usually opioid substitution therapy, alongside psychosocial interventions.