Category: Alcohol

Public Health

Current awareness updates

Weight management tier 2 interventions and their effectiveness.
Carried out by Frankie Marcelline from Sussex Health on 2/12/2021
[This evidence search report looks for recent evaluations and reports on the effectiveness of weight management tier 2 interventions for families, adults and children. A starting point might be Public Health England’s 2020 summary: Weight management services during COVID-19: phase 1 insights. Another source is Heggie’s: Tackling reporting issues and variation in behavioural weight management interventions.]

Brain tumours (primary) and brain metastases in adults.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers diagnosing, monitoring and managing any type of primary brain tumour or brain metastases in adults (aged 16 or over). It describes high-quality care in priority areas for improvement.]

Urinary incontinence in women.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers managing urinary incontinence in women (aged 18 and over). It covers assessment, care and treatment options. It describes high-quality care in priority areas for improvement.
It does not cover urinary incontinence in women with neurological disease. In December 2021, changes were made to align this quality standard with the new NICE guideline on pelvic floor dysfunction.]

Pelvic floor dysfunction: prevention and non-surgical management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the prevention, assessment and non-surgical management of pelvic floor dysfunction in women aged 12 and over. It aims to raise awareness and help women to reduce their risk of pelvic floor dysfunction. For women who have pelvic floor dysfunction, the guideline recommends interventions based on their specific symptoms]

Management of acute respiratory illness in prisons and places of detention.
UK Health Security Agency (UKHSA); 2021.
[This guidance will assist in the management of outbreaks of acute respiratory illness in prisons and places of detention. The guidance covers risk assessment, testing recommendations, antiviral therapies and when an outbreak can be declared over. An associated flow chart gives information for management depending on whether COVID-19 and/or influenza have been detected.]

BCG vaccination and SCID screening: patient pathway.
UK Health Security Agency (UKHSA); 2021.
[Flowchart showing the Bacillus Calmette–Guérin (BCG) vaccination and SCID screening patient pathway (updated 09 December 2021)]

Optimising chronic wound care: a human and financial necessity.
Penfold J. British Journal of Healthcare Management 2021;27(11):269-271.
[Comment highlights the importance of evidence-based practice in wound care to reduce the burden on patients and healthcare services.]

Active Lives Children and Young People Survey: Academic year 2020-21.
Sport England; 2021.
[This report contains a full year of coronavirus (Covid-19) restrictions, including comparisons back to summer term 2020, when school sites were closed to most pupils for much of the period. The proportion of children and young people in England who are active remains unchanged compared to 12 months ago. However, inequalities have increased and for some groups of children and young people, in particular teenage girls and Black children are the least likely to be physically active.]

What science has shown can help young people with anxiety and depression.
Wellcome; 2021.
[This report summarises what we’ve learned about the evidence for ‘active ingredients’ of effective interventions for youth anxiety and depression – these are the aspects of interventions that make a difference in preventing or managing anxiety and depression.]

Project ADDER.
Department of Health and Social Care (DHSC); 2021.
[Information on Project ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery), the government’s pathfinder programme combatting drugs misuse.]

Global Drug Survey (GDS) 2021 Global Report.
Global Drug Survey (GDS); 2021.
[The focus is on how COVID-19 changed people’s drug using behaviours especially with regard to alcohol, cannabis and cocaine, how people balance reducing harm and maximizing pleasure when using drugs, and whether microdosing has moved beyond those seeking to improve creativity and work performance to self-treatment for mental health issues.]

Alcohol-specific deaths in the UK: registered in 2020.
Office for National Statistics (ONS); 2021.
[Deaths caused by diseases known to be a direct consequence of alcohol misuse by sex, age, region and deprivation.]

From harm to hope: A 10-year drugs plan to cut crime and save lives.
Home Office, Department of Health and Social Care, Ministry of Justice, Department for Work and Pensions, Department for Education, and Department for Levelling Up, Housing and Communities; 2021.
[This policy paper sets out the government’s 10-year plan to cut crime and save lives by reducing the supply and demand for drugs and delivering a high-quality treatment and recovery system. Commitments are made across the government to break drug supply chains while simultaneously reducing the demand for drugs by getting people suffering from addiction into treatment, and deterring recreational drug use.]

Child of the North: building a fairer future after Covid-19.
NIHR Northern Health Science Alliance; 2021.
[This report paints a stark picture of inequality for children growing up in the north of England post-pandemic compared with those in the rest of the country. It looks at a wide range of factors, from child poverty to children in care, to build up a picture of ‘The Child of the North’. It sets out 18 clear recommendations that can be put in place to tackle the widening gap between the north and the rest of England.]

Children and young people’s mental health: Eighth Report of Session 2021–22.
House of Commons Health and Social Care Committee; 2021.
[Report highlights that the problems identified can only be addressed by government departments, local government and the health system acting together to promote good mental health and prevent new crises emerging. It recommends setting up a Cabinet sub-committee.]

Library Bulletin

Making Every Contact Count

The new edition of ‘Making Every Contact Count’ bulletin is now available to view and download here.

This edition features current awareness for the following topics (with relevant articles related to the Covid 19 pandemic):

Smoking Cessation

Healthy Weight

Healthy Eating

Alcohol

Physical activity

The majority of articles have direct links to the publications, however please get in touch if you are struggling to access any of the articles within the bulletin.

Please remember to contact academic.library@lscft.nhs.uk with any topics you would like to see in future bulletins.

Public Health

Current awareness updates

Avian influenza: guidance for managing human cases.
UK Health Security Agency (UKHSA); 2021.
[Information to assist with the management of possible and confirmed human cases of avian influenza.]

Heart valve disease presenting in adults: investigation and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers investigation and management of heart valve disease presenting in adults. It aims to improve quality of life and survival for people with heart valve disease through timely diagnosis and appropriate intervention.]

Acute heart failure: diagnosis and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers diagnosing and managing acute heart failure or possible acute heart failure in people aged 18 and over. Heart failure may indicate acute myocardial injury in patients with COVID-19. See the recommendations in NICE COVID-19 rapid guideline on managing COVID-19. In November 2021, NICE withdrew the recommendations on valvular surgery and percutaneous intervention because they have been replaced by the NICE guideline on heart valve disease.]

Public health commissioning in the NHS: 2021 to 2022.
Department of Health and Social Care (DHSC); 2021.
[Information about NHS England’s objectives and funding arrangements as it commissions public health services in the ongoing context of coronavirus (COVID-19).]

Cause for concern: Australian youth engaged with alcohol and other drug services are falling behind our community progress in reducing tobacco use.[Abstract]
Hallam KT. Early Intervention in Psychiatry 2021;15(6):1789-1792.
[Tobacco use is decreasing in the general youth population yet little evidence is tracking changes in young people who are engaged with youth alcohol and other drug (AOD) services that are often disengaged from school and work settings. Conclusion: The results highlight a need for the adoption of evidence-based tobacco early intervention programs in youth AOD services to address this significant health risk.]

Quality improvement project to decrease unnecessary investigations in infants with bronchiolitis in Cork University Hospital.[Abstract]
Jansen L. BMJ Open Quality 2021;10(4):DOI: 10.1136/bmjoq-2021-001428.
[Conclusion: An evidence-based protocol improved physicians’ ability in diagnosing and managing infants with bronchiolitis. This led to a reduction in unnecessary and potential harmful investigations, thereby improving patient quality of care. This improvement will contribute to decreased healthcare cost and appropriate use of resources during the high-pressured winter period.]

Adfam Research

Overlooked: why we should be doing more to support families and friends affected by someone else’s drinking, drug use or gambling

This report examines Adfam’s latest research with YouGov on the prevalence of people currently negatively affected by the drinking, drug use or gambling of a family member or friend in 2021, and the different challenges and impacts these families currently face. The report’s findings highlight the need for more recognition of the impacts on families and friends and it includes recommendations on how to better support this overlooked group.

Public Health

Current awareness updates

Influenza season 2021–22: what healthcare managers need to know.
Clough I. British Journal of Healthcare Management 2021;27(10):1-4.
[With the influenza season approaching and COVID-19 case numbers remaining high, this article highlights key points for healthcare managers and leaders going into this potentially challenging period.]

The vicious cycle of tobacco use and mental illness – a double burden on health.
World Health Organization (WHO); 2021.
[This new factsheet examines the intricate connections between tobacco use and mental illness. 2 in 3 people with severe mental health conditions are current smokers, which has an enormous impact on health. Reducing smoking among people with mental illness is identified as the single most effective action for reducing the gap in life expectancy.]

British HIV Association guidelines for the management of HIV-2 2021.
British HIV Association (BHIVA); 2021.
[The overall purpose of these guidelines is to provide guidance on best clinical practice in the treatment and management of adults with HIV-2.]

Promoting the sexual health and wellbeing of people from a Black Caribbean background: an evidence-based resource.
Public Health England (PHE); 2021.
[Provides information on developing interventions for improved sexual health and wellbeing in people from a Black Caribbean background.]

Sexually transmitted infections: promoting the sexual health and wellbeing of gay, bisexual and other men who have sex with men.
Public Health England (PHE); 2021.
[Provides information on developing interventions for improved sexual health and wellbeing among gay, bisexual and other men who have sex with men.]

Sexual and Reproductive Health Services, England (Contraception) 2020/21.
NHS Digital; 2021.
[This publication primarily covers contraceptive activity taking place at dedicated Sexual and Reproductive Health (SRH) services in England, as recorded in the Sexual and Reproductive Health Activity Dataset (SRHAD), a mandated collection for all providers of NHS SRH services. The main focus of this report is contraception.]

Overlooked: why we should be doing more to support families and friends affected by someone else’s drinking, drug use or gambling.
Adfam; 2021.
[This report examines Adfam’s latest research with YouGov on the prevalence of people currently negatively affected by the drinking, drug use or gambling of a family member or friend in 2021, and the different challenges and impacts these families currently face. The report’s findings highlight the need for more recognition of the impacts on families and friends, and it includes recommendations on how to better support this overlooked group.]

Sexually transmitted infections (STIs): annual data tables.
Public Health England (PHE); 2021.
[Information on STI diagnoses and sexual health services provided in England by demographic characteristics and geographical region.]

Public Health

Current awareness updates

Alcohol is one of the biggest risk factors for breast cancer.
World Health Organization (WHO); 2021.
[Alcohol is classified as a Group 1 human carcinogen by IARC. It is causally linked to 7 types of cancer. Besides female breast cancer, it increases the risk of developing oral cavity (mouth), pharynx (throat), oesophagus (gullet), liver, larynx (voice box) and colorectum (large intestine and rectum) cancers. There is no safe level of alcohol consumption. The risk of breast cancer increases with each unit of alcohol consumed per day.]

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers diagnosing and managing myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) in children, young people and adults. It aims to improve awareness and understanding about ME/CFS and when to suspect it, so that people are diagnosed earlier. It includes recommendations on diagnosis, assessment and care planning, safeguarding, access to care and managing ME/CFS and its symptoms.]

Eligible for a free flu vaccine this winter? Don’t wait, book it.
UK Health Security Agency (UKHSA); 2021.
[With flu and COVID-19 expected to be in wide circulation together this winter, UK Health Security Agency is urging more people than ever to get their free flu vaccine, if they are eligible. In this blog the UK Health Security Agency answers some common questions about this year’s flu season.]

The use of wearables and health apps and the willingness to share self-collected data among older adults.
Seifert A. Aging and Health Research 2021;1(3):100032.
[The aim of this study was to examine the extent to which older adults utilize mobile health tracking tools in everyday life and their willingness to share the collected health-related data with doctors, health insurance companies, or research institutions. 75.0% of the participants used at least one mobile device; 22.9% used health-related apps. Participants were more often willing to share their data with doctors than with health insurance companies or researchers.]

Changes in childhood experimentation with, and exposure to, tobacco and e-cigarettes and perceived smoking norms: a repeated cross-sectional study of 10–11 year olds’ in Wales.
BMC Public Health; 2021.
[Children’s experimentation with and exposure to tobacco, and their perceptions of smoking as a normative behaviour, have continued to decline alongside growth in exposure to e-cigarettes. Although a large majority of pupils reported they minded people smoking around them, there was some evidence of diminishing disapproval of secondhand smoke since 2007.]

Understanding Sexual Aggression in UK Male University Students: An Empirical Assessment of Prevalence and Psychological Risk Factors.
Sexual Abuse; 2021.
[University-based sexual aggression is an international public health issue; however, to date, there have been no formal assessments of the prevalence or psychological indicators associated with the proabuse behaviors of the most common perpetrators at UK universities: heterosexual male students.]

Patients as team members: Factors affecting involvement in treatment decisions from the perspective of patients with a chronic condition.
Health Expectations; 2021.
[From the patients’ perspective, this study shows that there is no one-size-fits-all approach to involving patients more actively in their healthcare journey. Strategies aiming to enhance active patient involvement among patients with a chronic condition should consider this diversity in perspectives among these patients.]

Lead exposure in children: surveillance reports (from 2021).
UK Health Security Agency (UKHSA); 2021.
[Results of laboratory-based surveillance of elevated blood lead concentrations in children in England.]

Seasonal flu vaccine uptake in children of school age: monthly data, 2021 to 2022.
UK Health Security Agency (UKHSA); 2021.
[Cumulative vaccine uptake data for the childhood seasonal flu programme in England.]

Review: Physical activity interventions for the mental health and well-being of adolescents – a systematic review. [Abstract]
Hale GE. Child and Adolescent Mental Health 2021;26(4):357-368.
[Rates of physical activity decline throughout adolescence, and evidence indicates that this has an adverse impact on psychological health. This paper aims to synthesise available evidence for physical activity interventions on the mental health and well-being of young people (11-19 years) from the general population.]

Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD). [Abstract]
Janjua S. Cochrane Database of Systematic Reviews 2021;7:CD013196.
[BACKGROUND: Face-to-face visits with health professionals can be hindered by severity of COPD or frailty, and by people living at a distance from their healthcare provider and having limited access to services. Telehealth technologies aimed at providing health care remotely through monitoring and consultations could help to improve health outcomes of people with COPD.]

Strategies to improve smoking cessation rates in primary care. [Abstract]
Lindson N. Cochrane Database of Systematic Reviews 2021;9:CD011556.
[OBJECTIVES: To assess the effectiveness of strategies intended to increase the success of smoking cessation interventions in primary care settings. To assess whether any effect that these interventions have on smoking cessation may be due to increased implementation by healthcare providers.]

Living with dementia: my life, my goals.
Alzheimer’s Society; 2021.
[A new self-help guide for people living with dementia. The guide helps people with dementia achieve their goals step-by step. It was created by researchers from the GREAT trial in collaboration with people living with dementia.]

Covid 19

Current awareness updates

Covid-19 Loneliness Fund evaluation.
Department for Digital, Culture, Media and Sport; 2021.
[The Covid-19 Loneliness Fund was launched in May 2020 to support 9 national organisations working to tackle loneliness and build social connections to help them to continue and adapt their critical work during the pandemic. The National Centre for Social Research was appointed as evaluator for this fund. This report presents the results of a process evaluation of the fund, to see how it supported the delivery and adaption of services aimed at addressing loneliness during Covid-19 restrictions.]

Annual Organ Donation and Transplantation Data for Black, Asian, and Minority Ethnic (BAME) communities: report for 2020/2021.
NHS Blood and Transplant; 2021.
[This report provides information related to organ donation and transplantation within the white and Black, Asian and minority ethnic (BAME) communities in the UK. It finds the Covid-19 pandemic has had a significant impact on the numbers of living donor kidney transplants that could be performed. In 2020/21 there was a comparable drop in both white and non-white deceased donors, but a 61 per cent decrease in the number of BAME living donors, compared with a 58 per cent drop overall.]

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data.
Addiction; 2021.
[Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.]

Public Health

Current awareness updates

Alcohol and self-harm: A qualitative study.
Alcohol Change UK; 2021.
[This study explores how and why alcohol and self-harm are related, and how alcohol, self-harm, and related services, are experienced and understood. Eleven people who had experience with self-harm and alcohol use were recruited through mental health support organisations across England and Wales. Interviews invited participants to ‘tell their stories’ about self-harm, alcohol use, the relationship between the two practices and their experiences with services in relation to these.]

Chronic kidney disease: assessment and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers care and treatment for people with, or at risk of, chronic kidney disease (CKD). It aims to prevent or delay the progression, and reduce the risk of complications and cardiovascular disease. It also covers managing anaemia and hyperphosphataemia associated with chronic kidney disease.]

Bonded By Blood: A Mothers Story.
ACLT; 2021.
[A new nationwide blood donation campaign, created by a group of Black health charities and community organisations with support from NHS Blood and Transplant, the campaign will focus on amplifying the need for more blood donors of Black heritage to donate. It is launched in memory of sickle cell patient Richard Okorogheye. The campaign will share the stories of mothers with children who receive regular blood transfusions.]

Good Childhood Report 2021.
The Children’s Society; 2021.
[Our Good Childhood Report 2021 shows that modern life continues to erode the happiness of young people. Dissatisfied with school, friendships and how they look, children deserve drastic change. Our tenth annual report finds that 7% of 10 to 15 year-olds (an estimated 306,000 children) in the UK are not happy with their lives.]

The health impacts of Sure Start.
Institute for Fiscal Studies (IFS); 2021.
[This briefing note from the Institute for Fiscal Studies extends the evidence from its previous 2019 report to show how Sure Start has influenced children’s health. Specifically it assesses the programme’s impact on hospitalisations of very young children, who are still eligible to use its services (ages 1-4), and of adolescents (ages 12-15), who may still enjoy medium-term benefits from Sure Start exposure.]

Building Connections Fund evaluation final reports.
Department for Digital, Culture, Media and Sport; 2021.
[The £11.5 million Building Connections Fund (BCF) was the first ever government fund dedicated to tackling loneliness in England. There are two separate reports for this evaluation: part one, the evaluation report, which covers findings before the Covid-19 pandemic; and part two, focusing on the evaluation activity following the Covid-19 pandemic.]

Public Health

Current awareness updates

Drug users urged to be extra careful following a high number of likely heroin overdoses.
Public Health England (PHE); 2021.
[Public Health England (PHE) has issued a warning of a sharp rise in the number of overdoses linked to people using drugs in several areas across England. To date, there have been at least 46 poisonings resulting in 16 deaths but investigations are still ongoing. The areas affected include South London, the South East, South West and East of England.]

Mental Health Crisis Care Profile.
PHE Fingertips; 2021.
[The Crisis Care Profile collates and analyses a wide range of publicly available data on associated prevalence of mental health crisis. Risk factors include access to care, treatment, and outcomes. Includes risk factors around age, deprivation, illness and disabilities, crime and social isolation. Other topics – urgent and emergency care, quality of treatment, access to support. Data available by local authorities.]

Dental health: migrant health guide.
Public Health England (PHE); 2021.
[Advice and guidance on the health needs of migrant patients for healthcare practitioners. 17 August 2021: New model of care to support refugees and asylum seekers to access NHS dental services.]

Cervical screening: support for people who find it hard to attend.
Public Health England (PHE); 2021.
[Guidance on support for people who find it hard to attend cervical screening due to having a mental health condition, or having experienced trauma or abuse. 16 August 2021: Clarification that this guidance is based on research conducted with users of mental health services and addition of signposting to guidance to support other underserved groups.]

Oral healthcare: model for asylum seekers and refugees.
Public Health England (PHE); 2021.
[This model of care provides professionals with guidance to support access to NHS dentists. Asylum seekers and refugees can face barriers when accessing NHS dentists. This model of care details the processes, rights and entitlements to care and includes supporting information and links to forms and guidance. It is designed for local authorities, support services and health professionals who work with asylum seekers and refugees.]

Antenatal care.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers care for healthy women and their babies during pregnancy (up to 42 weeks). It covers routine antenatal care in primary, community and hospital settings. It describes high-quality care in priority areas for improvement. In August 2021, changes were made to align this quality standard with the updated NICE guideline on antenatal care.]


Service specification: Cystinosis diagnosis and co-ordination of management (all ages).
NHS England; 2021.
[This service specification covers the provision of services for patients with Cystinosis, all ages.]

Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome.
National Institute for Health and Care Excellence (NICE); 2021.
[Evidence-based recommendations on continuous positive airway pressure for treating obstructive sleep apnoea/hypopnoea syndrome in adults. August 2021: The recommendation on continuous positive airway pressure (CPAP) for mild obstructive sleep apnoea/hypopnoea syndrome (OSAHS) has been updated and replaced by recommendation 1.5.2 on CPAP for mild OSAHS in the NICE guideline on obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.]

Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.]

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
Woolf K. The Lancet Regional Health – Europe 2021;8(-):100180.
[Using a nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK healthcare workers (HCWs) researchers analysed ethnic differences in SARS-CoV-2 vaccine hesitancy. Of the 11,584 HCWs included in the cohort analysis, 23% (2704) reported vaccine hesitancy. Ethnicity was a significant predictor of hesitancy.]

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data.
Addiction; 2021.
[Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.

Everybody active, every day: 5 years on.
Public Health England (PHE); 2021.
[Summary of the 5 year review to the national physical activity framework, ‘Everybody active, every day’ and the PHE response.]

Quality in Qual: a proposed framework to commission, judge and generate good qualitative evaluation in wellbeing impacts.
whatworkswellbeing; 2021.
[Based on interviews with ten leading organisations and individuals who have in-depth evaluation and methodological expertise this report sets out why work on qualitative evaluation is valuable and important, what resources already exist. The report identifies six prompts for potential uses of qualitative research in evaluations.]

Genomics nation: A benchmark of the size and strengths of the UK genomics sector.
UK Bioindustry Association; 2021.
[The NHS Long Term Plan promised greater focus on prevention to help people stay healthy and ease the burden on the health service. The early detection of disease, rather than merely the diagnosis and treatment of illness, will be critical to achieve this objective. The NHS Genomic Medicine Service (GMS), launched in 2018, provides a single, national coordinated approach to genomic testing and genomic research in the NHS.]

A joint thematic inspection of community-based drug treatment and recovery work with people on probation.
HM Inspectorate of Probation (HMIP); 2021.
[Probation services across England and Wales supervise nearly 156,000 people in the community. HM Inspectorate of Probation estimates that almost 75,000 of these individuals have a drugs problem, yet fewer than 3,000 people were referred by probation services to specialist drug misuse treatment in 2019/2020. HMIP partnered with the Care Quality Commission to examine how probation services supervise this cohort and found probation services are responding poorly to drugs misuse and addiction cases.]