Hard_Edges_Mapping_SMD_FINAL_VERSION_Web

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with only drug issues declines throughout
the period. This pattern may be related to
the apparent recent decline in illicit drug use
amongst younger age cohorts (Health and
Social Care Information Centre (HSCIC), 2013;
Home Office, 2013). However, there were
also potentially relevant changes affecting
the treatment system over this period, with
a significant policy move in 2008 in favour of
promoting recovery as opposed to numbers
in treatment (Roberts, 2009). In 2010 drug
treatment responsibility moved to Public Health
England, with new outcomes for commissioners
that were wider in scope. Thus, changes to
incentive structures around treatment could
also explain part of the pattern indicated
in Figure 2.
In addition to considering how the net total of
people affected by SMD changes over time,
it is also instructive to look at how ‘dynamic’
this population is, i.e. the extent to which it is
the same individuals affected by SMD year on
year, or if there is a substantial ‘inflow’ and
‘outflow’, so that there is significant turnover
in the actual individuals involved. Our analysis,
taking SMD2/3 as the threshold, suggests
that the extent to which the SMD population
is ‘static’ or ‘dynamic’ in this sense differs
between the datasets reviewed. In other words,
the proportion of the total number (‘stock’)
receiving services in a year comprised of new
cases (‘inflow’) in any given year (i.e. people
who were not in this population in any previous
year for which we have data) differs markedly
between them. For example, in the case of
the offending dataset we estimate that the
inflow of new cases is only one-quarter of
the stock (45,000 vs 184,000), underlining the
high level of re-offending for this group. In the
homelessness-services based SP data, the
inflow of cases in 2010/11 was much higher
at 85,000 compared with the stock estimate
of 109,000, but in this case the inflow includes
cases who may have been in SMD category in
previous years. For drug and alcohol treatment
data, the inflow of cases was somewhere
in between relative to the stock (59,000 vs
124,000). Thus, as things stand, it is difficult to
come to a clear view on the extent to which this
population can be characterised as dynamic
or static.
t new client-journeys by SMD categories 2006–11
Figure 2: Drug treatment new client-journeys by SMD categories 2006–11
90,000
80,000
NUMBER
70,000
60,000
50,000
40,000
30,000
20,000
10,000
ALL 3
DRUG AND
OFFENDING
DRUG AND
HOUSING
DRUG
ONLY
0
2006 2007 2008 2009 2010 2011
YEAR
Source: NDTMS