Introduction

The transition from prison to the community is a critical time for people who use alcohol or other drugs. Consistent, joined-up support can save lives, reduce reoffending and help people move forward, but too many still fall through the gaps. As highlighted in Clinks' 2026 Voluntary Sector-Led Manifesto, effective resettlement depends on support that begins before release and continues into the community, with services working together to ensure people do not fall through the gaps.

The importance of coordinated support across the transition from custody to community is explored in this guest blog by Will Haydock, Chief Executive of Collective Voice. Drawing on evidence from the drug and alcohol treatment sector, he examines how continuity of care improved when it was backed by national leadership and investment, why progress has since stalled, and what government and the voluntary sector can do to strengthen support for people leaving prison.

Continuity of care: progress, challenges and the case for renewed action

I work for Collective Voice, which is the alliance of charities that provide drug and alcohol treatment across England and Wales.  We work closely with Clinks to ensure they have the support that being part of a wider criminal justice network can bring, and so that their knowledge and expertise can support the policy work of Clinks.

For example, one of our members – Vicki Markiewicz from Change Grow Live – represents substance use services on the RR3 group that Clinks convenes, and we brought together an expert group of practitioners and senior leaders in our field to help inform Clinks’ recent Voluntary Sector-Led Manifesto to Reform the Criminal Justice System.

The Manifesto is packed full of clear, important and urgent recommendations, including a specific section on drug and alcohol support, but here I want to focus on ‘continuity of care’.  This area can be seen as a microcosm of our field, showing the difference the third sector can make by working together, and the support and leadership we need from Government.

What is continuity of care and why is it important?

Continuity of care in this context means where someone is in treatment for their substance use in prison, there should be a seamless transition into community-based treatment when they are released.

This is particularly important because we know that continued treatment in the community reduces reoffending and saves lives.  Release from prison is a particularly highest risk point for overdose and death.  A 2023 report noted that the risk of drug-related death in offenders in the community was over 16 times greater than in the general population.

Fortunately, the evidence suggests that treatment in prison and continuity on release reduces the risk of death substantially.  People receiving opioid substitution treatment on their final day in prison was associated with a 50% reduced risk of all-cause mortality and a 54% reduced risk of drug-related mortality in the 4 weeks following release.

Strategic leadership and investment drives change

Sadly, after years of cuts to community services and disruption in prisons, with the closure of local prisons, continuity of care for substance use treatment had fallen to around 33% by the time COVID hit.

It was encouraging, therefore, that this was set as a priority in the 2021 drugs strategy, From Harm to Hope.  This prioritisation was partly behind the creation of several schemes to improve connections to healthcare on exit from prison, including NHS England’s RECONNECT, HMPPS introducing Health and Justice Coordinators and Probation Notification and Actioning Project (PNAP), and local authorities using their Supplementary Substance Misuse Treatment and Recovery grant funding to create prison in-reach teams.

The results were clear: continuity of care had made it to over 56% by January 2025, an increase of over 20 percentage points.

Similarly, on another key ambition set out by Government – to increase the number of people accessing support for their substance use – the change was dramatic.  By 2024-25, more people were in treatment than ever before, looking right back to 2006, when funding was still increasing for the sector.

A loss of momentum

However, since 2025 the story on continuity of care has been one of pretty much steady decline, as funding and political interest have wanted.  The figure now sits at 50.6%.

Dame Carol Black’s review of drugs, which prompted From Harm to Hope, had outlined a 5-year plan for investment, with funding ratcheting up each year and gradually reaching all parts of the country.

We had made it to year 3 of this plan by the time of the 2024 election, at which point funding was frozen, while charities faced increases in national insurance, generational highs in inflation, and changes in VAT.  This has meant a real terms cut in funding.

At the same time, there has been no policy statement from the Government on drugs or alcohol, no formal ‘Drugs Minister’ as previously confirmed by No10, and a lack of senior leadership on this agenda within the civil service.  There is no longer a dedicated head of the Joint Combating Drugs Unit, which led on the creation and oversight of the 2021 strategy, and no nominated Permanent Secretary lead on the topic, as there was under the Conservative Government.

Continuity of Care is therefore a clear example of what can happen when there is political leadership, prioritisation and appropriate resourcing of key projects – and a lesson in what happens when you lose this.

Towards a new drugs strategy?

Encouragingly, recent correspondence between Sarah Jones, the relevant Minister in the Home Office, and the Home Affairs Select Committee suggests the Government understands there have been some challenges, and it’s open to a renewed focus.  Minister Jones states in her letter:

“we are considering the overall approach of the ‘From Harm to Hope’ strategy to examine what changes may be needed, including whether there are key areas where we should increase focus”.

Earlier this year, Collective Voice outlined five ‘essential next steps’ that the Government should take on drug and alcohol treatment, and this was actually the first step that we outlined:

“The Government should publish a position statement on drug and alcohol treatment and recovery services to reaffirm their commitment to reduce deaths and crime linked to alcohol and other drugs, and maximise recovery.”

We aren’t the only organisation calling for this.  The Institute of Alcohol Studies has a clear view of ‘A Healthier Future’ that would include a strategy on alcohol.  And the Health Foundation just last week published its latest policy tracker, which noted the current level of ambition from the government on both alcohol and other drugs was low, ‘investment remains insufficient, and a move towards evidence-based strategies to prevent and reduce harms is required.’

Of course this doesn’t mean simply re-stating the 2021 drugs strategy.

There are lots of developing challenges and opportunities, often related to technology – whether the continued emergence of synthetic opioids and cannabinoids, and the potential for Artificial Intelligence (AI) to improve tailoring of treatment and deliver efficiency savings.

There’s also the opportunity to learn from previous strategies, including on continuity of care.  We know that this will inevitably require close partnership work between a number of different organisations within prisons and in the community.  But we also know that we could deliver more efficiently by coordinating that work.  The range of programmes working on this across RECONNECT, PNAP, Health and Justice Coordinators and community in-reach were an encouraging sign that it was being taken seriously, but we’ve outlined before that there are opportunities to do this work more efficiently if we coordinate better.

We must also improve the support available to people in prisons using drugs or alcohol, prior to release.  There have been three recent reports all outlining clear recommendations for how this can be done: Dame Carol Black wrote an internal report that is now public, the Justice Committee drew on this and other evidence to write their own report, before the National Audit Office weighed in.  The consensus is clear, but the Government’s response has so far been underwhelming.

Perhaps we should take some encouragement from the recent words of Minister Sarah Jones.  Either way, we have a great resource in the new Clinks manifesto to unite as third sector organisations working on these crucial issues and help to drive change.

As the evidence I’ve cited here shows clearly, if we get this right we save and improve lives. If we don’t, we will continue to see a criminal justice system in crisis, and continued high levels of harm from alcohol and other drugs.