Recurring concern
Unreliable integration of substance misuse services into patient care
First reported 9 Dec 2015•Latest report 3 Mar 2026
What this concern includes
Includes failures within an explicitly identified substance misuse service pathway, including referral, liaison, cooperative working or coordination needed to provide integrated care.
Not included
- Excludes generic multidisciplinary or interagency working failures not explicitly tied to substance misuse services.
- Excludes failures solely concerning the internal management, staffing or security of substance misuse services unless they directly prevent integrated patient care.
- Excludes clinical assessment or treatment deficiencies that do not involve access to or coordination with substance misuse services.
- Reports
- 15
- Individual concerns
- 15
- Date range
- 2015–2026
- Stated actions
- 31
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Unavailability of specialist services for dependence on prescribed opiates and opioids
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Participate in a system-wide GIRFT chronic-pain review to identify pathway variation and service-delivery challenges.
Stated by NHS Derby and Derbyshire Integrated Care Board -
Action
Implement recommendations from the GIRFT chronic-pain review in line with national and organisational objectives.
Stated by NHS Derby and Derbyshire Integrated Care Board -
Action
Review and re-procure pain-management services.
Stated by NHS Derby and Derbyshire Integrated Care Board
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Concerns raised1
Failure of liaison with external specialist substance misuse services
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Embed dual-diagnosis capability within community teams through Care Coordinator training and team-based Dual Diagnosis Ambassadors.
Stated by Essex Partnership University NHS Foundation Trust -
Action
Expand STORM training from Crisis Teams into Community Mental Health Teams.
Stated by Essex Partnership University NHS Foundation Trust
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Concerns raised1
Absence of specified prescribed timeframes for intervention, ongoing support and case load allocation for prisoners at risk of substance misuse
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Embed agreed intervention, support and caseload timeframes in the revised service specification for future procurement.
Stated by Cwm Taf Morgannwg University Health Board (CTM -
Action
Reduce the brief-intervention waiting period to the four-week target through recruitment and improved waiting-list management.
Stated by Cwm Taf Morgannwg University Health Board (CTM -
Action
Expand group provision with weekly rolling programmes for people waiting for one-to-one brief interventions.
Stated by Cwm Taf Morgannwg University Health Board (CTM
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Action
Submit a proposal to HMPPS to enhance the clinical substance misuse service at HMP & YOI Parc.
Stated by Cwm Taf Morgannwg University Health Board (CTM
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Concerns raised1
Fragmented provision of substance misuse and mental health treatment across different organisations
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Work with the Department of Health and Social Care to improve access to mental health services and coordination across health services for people experiencing homelessness.
Stated by Ministry of Housing, Communities and Local Government -
Action
Develop a comprehensive action plan to improve provision for people with co-occurring substance-use and mental-health needs.
Stated by Department of Health and Social Care -
Action
Publish UK clinical guidelines on alcohol treatment, including recommendations for co-occurring conditions, multidisciplinary assessment, care planning and care coordination.
Stated by Department of Health and Social Care
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Action
Continue working with NHS England to improve integrated care for people with substance-use and mental-health needs.
Stated by Department of Health and Social Care
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Concerns raised1
Lack of systems and processes to ensure completion of alcohol liaison team referrals
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Update the service specification to include electronic contact, risk, signposting, referral and service-exit recording requirements.
Stated by Adferiad Recovery Ltd -
Action
Implement and roll out the updated service specification to all staff by the end of September 2023.
Stated by Adferiad Recovery Ltd -
Action
Issue communication clarifying the referral process to liaison services and share it with clinical teams across the Health Board.
Stated by Betsi Cadwaladr University LHB
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Action
Review the liaison psychiatry delivery framework with stakeholders and progress revisions through consultation and ratification.
Stated by Betsi Cadwaladr University LHB
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Concerns raised1
Failure to make promised referrals to relevant specialist services
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Review and discuss Hadrian Unit discharge processes with staff to improve communication of onward referrals.
Stated by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust -
Action
Record onward referrals and receiving-team acceptance on the electronic MDT proforma, with monthly compliance audits.
Stated by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
The discharge included planned follow-up, with ongoing support from the Cumbria East Crisis Team and planned referrals to other services.
Stated by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
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Concerns raised1
Failure to refer service users with substance misuse needs to substance misuse services
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of funding and implementation of the Integrated Drug Treatment System in Wales
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Welsh prisons need not implement England’s IDTS because existing Welsh guidance and comparative opioid-substitution services provide equivalent treatment options.
Stated by Welsh Government
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Concerns raised1
Failure to respond to and action clinical information requests from the substance misuse service
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Promote wider uptake of Focussed Care across Oldham practices to support substance-use-related care.
Stated by NHS Greater Manchester Integrated Care Board -
Action
Complete a wide-ranging review of GP communication across all community substance misuse services.
Stated by Turning Point -
Action
Improve recording of GP communications in the electronic client records system.
Stated by Turning Point
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Action
Review and improve follow-up systems for requests to GPs for information.
Stated by Turning Point
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
A joint learning meeting with Turning Point would occur only if Oldham CCG supported it.
Stated by Hopwood House Medical Practice
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Concerns raised1
Dependence of service-user interaction with specialist drug and alcohol professionals on self-referral
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Develop dual-diagnosis champion roles, provide additional training, and cascade substance-use skills through a train-the-trainer model.
Stated by Clare Parker
Data last updated 7 September 2026