Lower socioeconomic status is associated with higher mortality for alcohol-attributable causes, despite lower socioeconomic groups often reporting lower levels of consumption. The Government is committed to tackling harms from alcohol. As part of the NHS Long Term Plan, we are establishing specialist Alcohol Care Teams in hospitals with the highest rates of alcohol harm. It is estimated that this will prevent 50,000 admissions over five years. Local authorities will also receive over £3 billion in 2019/20 to be used exclusively on public health including alcohol treatment services. Public Health England is supporting NHS England’s tobacco and alcohol commissioning for quality and innovation scheme, which encourages hospitals to screen all inpatients about their alcohol use and offer appropriate interventions.

Additionally, funding of £6 million has been allocated to support children who live with an alcohol dependent parent which will address the inequalities facing this vulnerable group.

Public Health England’s evidence review ‘The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies’ highlighted that in the English population, rates of alcohol-specific and related mortality increase as levels of deprivation increase and alcohol-related liver disease is strongly related to the socioeconomic gradient.

The NHS Long Term Plan signalled our support for improving treatment for patients in deprived areas with expert Alcohol Care Teams working in the 25% worst affected parts of the country supporting patients and their families who have issues with alcohol misuse. It is estimated that these new measures could prevent 50,000 admissions and almost 250,000 bed days over the next five years. The Government will continue to be mindful of social inequalities whilst developing policies to tackle alcohol harms.

No assessment has been made of the potential merits of monitoring dependence and addiction rates in relation to commonly prescribed opioids.

Public Health England is undertaking a public health evidence review of available data and published evidence on the problems associated with some prescribed medicines, including dependence and withdrawal, including opioids. The review is due to report in summer 2019.

Public Health England (PHE) has not used the term ‘discontinuation syndrome’ to refer to opioid dependence. The term was used in the early stages of the Prescribed Medicines Review in relation to antidepressant medication as that was the only term recognised by some stakeholders at the time the review started.

PHE’s final report on the review will clarify the use of the term. This is due to be published in summer 2019.

No estimate has been made of the addiction rates of the 10 most commonly prescribed opioid drugs in each of the last 10 years.

Public Health England (PHE) has not used the term ‘discontinuation syndrome’ to refer to opioid dependence. The term was used in the early stages of the Prescribed Medicines Review in relation to antidepressant medication as that was the only term recognised by some stakeholders at the time the review started.

PHE did agree to review the use of the term and has done so. It persists in some older review documents but is not being included in current documents. Information and documents on the review are published at the following link:

https://www.gov.uk/government/collections/prescribed-medicines-an-evidence-review

The Department of Health and Social Care is working closely with the Department for Education to improve the mental health of undergraduate students. Our joint document, ‘Transforming children and young people’s mental health provision: a green paper’, includes a commitment to build a new national strategic partnership with key stakeholders to improve the mental health of 16 to 25 year olds in schools, colleges and universities, by facilitating coordinated action, experimentation and robust evaluation on leadership, prevention and improved data collection.

To support this, the NHS Long Term Plan commits to a comprehensive expansion of mental health services, including a new approach to mental health services for people aged 18-25, supporting transitions to college and to adulthood, with services being adapted to create a comprehensive offer for 0-25-year olds.

NHS England is working closely with Universities UK through the Mental Health in Higher Education programme to build the capability and capacity of universities to improve student welfare services and improve access to mental health services for the student population, including focusing on suicide reduction, and improving access to psychological therapies to support treat students suffering from stress and anxiety.

Data on alcohol and drug misuse treatment in prisons and other secure settings is available from Public Health England’s national drug treatment monitoring system (NDTMS). The 2016-17 NDTMS report shows that there were 59,258 adults in contact with drug and alcohol treatment services within secure settings. Most of these (55,721) were in prisons, but there were also 3,015 in young offender institutions and 522 in immigration and removal centres. This report can be viewed at the following link:

https://www.gov.uk/government/statistics/substance-misuse-treatment-in-secure-settings-statistics-2016-to-2017

The general requirement for all RAF personnel to be fit for duty is underpinned by the Service Offence of Unfitness or Misconduct through Alcohol and Drugs as set out in Section 20 of the Armed Forces Act 2006, as amended by the Armed Forces Act 2011.

RAF pilots are subject to the same drug and alcohol testing rules as all other RAF personnel with the addition of lower prescribed alcohol limits.

No research on the effects of drug use disorders on Disability-Adjusted Life Years lost in each region of England has been commissioned by the Department, the National Health Service or Public Heath England in the last seven years.

There has been no formal assessment of disability adjusted life years lost through drug use disorders broken down by regional level.

An assessment of years of life lost through drug use disorders is available in the publication Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. It assesses the scale of health lost from diseases and injuries in 2013, and estimates the attributable impact of risk factors; data for drug use disorders is included. This report does not include a regional assessment of Disability Adjusted Life Years. It was published on 15 September and is available at:

https://www.gov.uk/government/publications/burden-of-disease-study-for-england

This analysis was conceived and produced jointly by Public Health England and the Institute of Health Metrics and Evaluation, University of Washington.

Local authorities and their health and wellbeing board partners are responsible for commissioning services to meet the needs of their local populations.

Each year, every local authority carries out a joint strategic needs assessment to determine the needs of their local area. This provides the basis for planning a full range of alcohol services from early intervention and prevention, through to alcohol treatment services to meet the need in their areas. Local authorities commission alcohol treatment services using the ring-fenced public health grant, and any other funds that they have secured for this purpose.

Local authorities are assisted in this work by Public Health England (PHE) which provides a set of resources as well as bespoke support from PHE’s regional centre teams.

Numbers of people accessing alcohol treatment are increasing. The number of people starting alcohol treatment in 2013-14 was 80,929, up from 67,912 in 2008-09. Waiting times for alcohol treatment are improving too, and the latest figures (2013-14) show that 93% of people waited less than three weeks for their first intervention, up from 78% in 2008-09. These figures suggest access to alcohol treatment is improving.

The Department has commissioned the University of Sheffield, in partnership with Kings College London and the University of Manchester, to develop a model for estimating requirements for specialist alcohol treatment. The study is expected to report in late summer 2015.

Over £400 million is being invested in the Improving Access to Psychological Therapy (IAPT) programme over the spending review period to make a choice of psychological therapies available for those who need them in all parts of England.

We are also investing in improving provision for children and young people, older people and carers, people with long-term physical health problems and those with severe mental illness.

Since 2008 the IAPT programme has seen over 2.6 million people enter treatment, and over 1.5 million complete treatment.

In addition, over 1 million patients have reached recovery and we have seen 90,000 people move off of sick pay and benefits.

The IAPT programme has worked consistently to increase the numbers of older people accessing services, and latest figures suggest that numbers are improving.

To increase the numbers of older people the IAPT programme has supported an advertising campaign delivered through Age UK and Carers UK to ensure older people are aware that IAPT is for them. In addition, a curriculum has been developed and is being rolled out to train both existing IAPT staff and new IAPT staff to work better with older people.

Other innovative approaches to working with older people include Government support to the Alzheimer’s Society to develop online cognitive behavioural therapy for carers of people with dementia. The online resource is in place and ethical approval is being sort prior to clinical trials which started in 2014.

The Severe Mental Illness (SMI) workstream has been added to the IAPT programme to extend the benefits of improved equitable access to psychological therapies to people with SMI, including those with schizophrenia.

This workstream will work closely with secondary care mental health services, local commissioners and providers to document the benefits of access to talking therapies for people who have a SMI. They will lead the development of Patient Reported Outcome Measures for SMI and Personality Disorder who receive talking therapies, and work with professional organisations to develop more appropriate and deliverable care pathways, and determine gaps in current approaches.

NHS England is also currently carrying out a pilot aimed at improving access to psychological therapies for people with long term conditions and/or medically unexplained symptoms including diabetes, chronic obstructive pulmonary disease, stroke and other illnesses/disorders.

There is no cap on the number of IAPT sessions for each person. NHS England expects clinical commissioning groups (CCGs) and providers to have due regard to the National Institute for Health and Care Excellence guidelines and in some cases therapy may exceed 20 sessions in duration.

No estimate has been made by the Department of the proportion of adults or children with diabetes, anxiety disorder, depression, schizophrenia and personality disorder who were untreated in each of the last 10 years.

The most recent drug prevalence estimates suggest that there were 256,153 opiate users in England in 2011-12, of these 62% received treatment in the same year. The equivalent proportions for the preceding years, where there is both prevalence and treatment data, are 2006-07 – 49%; 2008-09 – 64%; 2009-10 – 63%; 2010-11 – 64%. This proportion of opiate users being treated is considered a very high rate internationally – and is a platform for significant public health gains.

No estimate has been made of the proportion of adults or children with alcohol dependency who were untreated in each of the last 10 years. However, it is estimated that 1.6 million adults show some signs of alcohol dependence; around 250,000 of whom are estimated to be moderately to severely dependent and might benefit from specialist treatment. Using this later figure, about 44% of these dependent adult drinkers were in treatment in England in 2013-14. Continued investment in alcohol treatment by local authorities is essential to make inroads into the alcohol dependent population and to help more people recover from alcohol problems.

Achieving Better Access to Mental Health Services by 2020, published October 2014, articulates our ambition and the immediate actions we will take this year and next to achieve better access and waiting times in mental health services. It includes the Improving Access to Psychological Therapies commitment of treatment within six weeks for 75% of people with 95% of people being treated within 18 weeks.

For the year 2013-14 the mean waiting time for IAPT services was 40 (days) and the median was 21 (days). Information on the number of referrals waiting more than 28, 90 and 180 days for IAPT services, for each CCG, for the year 2013-14, is attached.

No estimate has been made of the proportion of time general practitioners (GPs) spend with patients who have a mental illness.

From September 2014, over 800,000 people with the most complex health and care needs (including mental health conditions) will benefit from the Proactive Care Programme, receiving personalised, joined-up care and support, tailored to their needs. This is being delivered through an enhanced service to the GP contract.

NHS England is working with commissioners to make mental health a bigger priority, with better integration of physical and mental health care.

Improving the diagnosis of mental illness is one of four national goals for 2014-15 – where providers will be rewarded for better assessing and treating the mental and physical needs of their service users, through the Commissioning for Quality and Innovation framework.

We do not centrally hold information on the proportion of patients with a mental illness that receive drug, talking or mindfulness therapy.

The table below shows information on the number of referrals received, entering treatment and finishing a course of treatment, within IAPT services for 2013-14.

There were 53,326.6 prescription items written in the United Kingdom and dispensed in the community, in England, for medicines classified as anti-depressants in British National Formulary (BNF) section 4.3 Antidepressant drugs, for the calendar year 2013.

The Department has not estimated the proportion or number of the people estimated to experience a mental illness who are being treated by the National Health Service.

No estimate has been made by the Department of the proportion of patients with mental illness who prefer to be treated by drug therapy or talking therapies.

The Department’s 2014-15 Mandate to NHS England makes clear that ‘everyone who needs it should have timely access to evidence based services’. The Mandate sets a clear objective for NHS England to deliver the key objectives of the IAPT programme – providing access to therapies to 15% of those eligible (around 900,000 people), with a recovery rate of 50%.

The Outcomes Framework for the NHS in England clearly states that the NHS should carry on expanding access to psychological services as part of the IAPT programme.

The Government holds the NHS to account by setting objectives in the NHS England Mandate and monitoring their delivery through the NHS Outcomes Framework.

If NHS England is failing to deliver against its objectives, Ministers can ask NHS England to report on what action it has taken, or to set out a plan for improvement.

CCG commissioning plans, including for mental health, should be informed by the content of their local Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategy, which should address the needs of their local population. In addition, Health and Wellbeing Boards must include local Healthwatch as part of their core membership, Healthwatch represent the concerns and interests of local people- in their role as champions of the population.

Statistics on those who have found work through the Work programme are not available.

Statistics on how many job outcomes have been claimed by Work programme providers can be found at:

http://research.dwp.gov.uk/asd/index.php?page=tabtool

Guidance for users can be found at:

http://research.dwp.gov.uk/asd/asd1/tabtools/guidance.pdf

Figures on alcohol dependence are available from the Adult Psychiatric Morbidity Survey, which was run in 2000 and 2007. This survey covered those aged 16 and over, so estimates for 11 to 15-year-olds are unavailable. Estimates are presented for 16 to 17-year-olds and 18 to 25-year-olds.

The following tables estimates the prevalence (percentage) of alcohol dependence by age group and severity for adults living in private households in England, based on the Severity of Alcohol Dependence Questionnaire (SADQ).

Survey results above were weighted to ensure they are representative of the population.

The SADQ-C, asked of all respondents with an audit score of 10 or more, consists of 20 items, covering a range of dependence symptoms, with the six months before the interview as the reference period. Answers to all questions are scored from zero to three, and summed to give a total score ranging from zero to 60. Established thresholds indicate different levels of alcohol dependence:

No dependence (scores of three or less);

Mild dependence (scores ranging from four to 19);

Moderate dependence (scores ranging from 20 to 34); and

Severe dependence (scores ranging from 35 to 60).

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated October 2012:

As National Statistician, I have been asked to reply to your Parliamentary Question asking how many people died of alcoholic poisoning in each principal seaside town in each of the last five years. (123841)

The table shows the number of deaths from alcohol poisoning in each local authority in England and Wales that has a principal seaside town, for each of the years 2007 to 2011 (the latest data available). Where more than one seaside town is within an authority, these towns are presented together. For instance, the towns of Falmouth, Newquay, St. Ives and Penzance are displayed under the local authority of Cornwall.

The following table shows Home Office advertising spend on alcohol awareness campaigns in each of the last five financial years.