The findings of this report have been influenced by people who use a wide range of treatment services, those with lived experience of residential treatment, commissioners and providers of residential and community-based treatment.

Key findings

• Residential treatment is an evidence-based intervention which is effective in terms of treatment and cost.
• Residential treatment is delivered to a higher standard than ever before. It enables people with more complex needs to recover and lead happy and healthy lives. 
• But fewer and fewer people are able to access it.
• The report finds that the system that enables access isn’t working.
• Thousands more people every year should be benefiting from life-saving residential
  treatment.
• The report highlights the dramatic decline in access to rehab over the last 10 years
  and provides recommendations make rehab work for everyone.

Recommendations
1. We need renewed focus on the place of Residential Rehabilitation provision at a UK local commissioning level: with clear spending plans for committed resources (PH grant allocations, Universal Grant, RSI investment etc). We recognise this will require collaboration across the sector including local government, commissioners, OHID, providers and others, in order to develop improved approaches across the sector
2. We need to ensure that commissioning at a local level complies with national guidelines and that outcomes across the whole treatment population are effectively tracked. That there are effective and compliant processes in place for aftercare pathways. This will also require collaboration across the sector including local government, commissioners, OHID, providers and others, in order to develop improved approaches across the sector.
3. We need to ensure that those with Lived Experience are integral to the review of eligibility criteria, referral pathways and communication plans.
4. We need to refresh pathways between Inpatient Detox and Residential Rehabilitation – exploring the regional cluster approach of Inpatient Detox as a model that can be applied here.
5. We need a national specification for Residential Rehabilitation – building on NICE guidelines - to unpack eligibility criteria, quality standards, outcome monitoring and resettlement/aftercare provision. The work underway by the English Substance Use Commissioning Group in concert with providers and lived experience group can form the backbone of this.