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Journal cover: Advances in Dual Diagnosis

Advances in Dual Diagnosis

ISSN: 1757-0972

Online from: 2008

Subject Area: Health and Social Care

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All Party Parliamentary Group on Complex Needs and Dual Diagnosis

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Article citation: , (2011) "All Party Parliamentary Group on Complex Needs and Dual Diagnosis", Advances in Dual Diagnosis, Vol. 4 Iss: 2, pp. -



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Article Type: News From: Advances in Dual Diagnosis, Volume 4, Issue 2

Sarah Creighton, Press and Communications Assistant, Turning Point (

The APPG, a group of interested MPs, Peers and individuals working in the health and social care field, was set up in 2007 with the aim of ensuring the needs of people with complex needs and dual diagnosis, loosely defined by their chaotic lifestyle, complexity of need and co-morbidity of a range of conditions remain high on the political agenda.

Report on Bradley Review meeting

It is rare to gain widespread cross party support for a particular policy. However, Lord Bradley’s Review has survived a change in government, a new coalition and is continuing to make good progress. The findings of the review, which examined the experience of people with mental health problems and learning disabilities in the criminal justice system, sits neatly within the new government’s approach to criminal justice.

Recently the APPG held its third annual meeting on the Bradley Review. The meeting was attended by MPs, senior civil servants, members of the National Advisory Group on Offender Health and leaders of health, social care and criminal justice organisations. All representatives shared an interest in this agenda and specifically how this findings of the Bradley Report are being taken forward under the new Government.

The meeting was opened by Lord Adebowale, Co-Chair of the APPG and Chief Executive of Turning Point. The audience then heard from our first speaker, Lord Bradley.

Broadly his presentation focused on the achievements and challenges currently facing the implementation of the 82 Bradley Review recommendations. Lord Bradley said that in general, a lot of recent progress has been made in prisoner healthcare and in the extensive establishment of diversion schemes across the country.

Lord Bradley said he felt that these schemes will need to be closely monitored in order to illustrate the benefits of investment in other parts of the criminal justice system. He felt the main challenge to the recommendations is the risk posed by NHS restructuring. He argued that commissioners risk failing to work together at the local level and instead may fall into silos. One question that reflected this anxiety was given by a representative from the Camden and Islington Foundation Trust. They queried whether a dual diagnosis training package that they had recently developed would be disseminated successfully with the diversion agenda progressing against a backdrop of restructuring. The importance of “skilled up” teams to the agenda and the government’s commitment to it meant that these sorts of initiatives would be sure to continue Richard Bradshaw (Director of Offender Health at the Department of Health and Ministry of Justice) assured.

Richard gave a presentation reassuring attendees that the upper echelons of government are committed to the implementation of Lord Bradley’s recommendations. This includes a recent commitment of £5 million for the national liaison and diversion scheme. As well as this, there has been further commitment made to offender health in the Health and Social Care Bill, Mental Health Strategy and a number of other policy papers.

Harley Allan spoke as someone who has a learning disability and has experience of the criminal justice system. He corroborated much of what had been said by Lord Bradley and Richard Bradshaw. He emphasised the starkly different attitudes towards mental health problems in comparison to physical health problems and the need for more to be done to support individuals with complex needs in a criminal justice setting.

There was a particularly useful discussion from the floor, which included questions relating to specific groups of people with complex needs such as women and young people.

Lord Adebowale, Richard Bradshaw and Lord Bradley all agreed on the fruitfulness of these sorts of meetings. The feeling was that whilst we may still have a long way to go, The Bradley Review has already led to several positive changes, including an apparent desire by staff throughout the criminal justice system to better understand the needs of offenders with learning disabilities and mental health issues.

Response to NHS Future Forum

The All Party Parliamentary Group on Complex Needs and Dual Diagnosis submitted a response to the NHS Future Forum, stating that more needs to be done to ensure those with co-existing complex needs are no longer left out of the system.

A special meeting was held to discuss how the changes being made to the health and social care system will affect people with complex needs. One of the group’s chairs, Lord Adebowale, is on the NHS Future Forum and this meeting was arranged to feed into the listening exercise being conducted.

Following this meeting, a response was drafted on behalf of the group setting out six key concerns and a range of recommendations as to how the future system can better support those with multiple complex needs.

The response set out the following six concerns:

  1. more is needed in the Health Bill to ensure community engagement in commissioning;
  2. the need for greater accountability for addressing health inequalities of the most excluded groups;
  3. the risks to those not registered with a GP becoming invisible;
  4. the risks of competition;
  5. the threat of further fragmentation to services across health and social care; and
  6. GPs lacking the specialist knowledge needed to meet the needs of people with complex needs or dual diagnosis.

Lord Adebowale shared the draft response with the Future Forum members prior to a meeting they had on Friday 13th May with the Prime Minister, David Cameron.

Lord Adebowale CBE and David Burrowes MP, Co-Chairs of the APPG said of the response:

People with complex needs often pose a challenge to commissioners and providers of services due to the complexity of their lives and the need for different agencies to work together around the individual. The lack of integration and understanding in the current system means people often fall through the gaps in provision and their needs go unmet.

The Group’s response to the Future Forum raises a number of concerns that we hope the government considers, but also offers recommendations as to how the Health Bill can rectify the current situation and ensure everyone is in receipt of good quality support.

People with complex needs should be the litmus test which proves whether or not actions taken by GP Commissioning Consortia and Local Authorities to engage with and respond to the populations they are responsible for, really work.

The final version of the response, including the full list of recommendations can be found on the group’s web site at: