Tier 4: Inpatient Detox and Residential Rehabilitation

The Tier 4 working group conducted a survey of commissioners to identify trends and themes in commissioning residential rehabilitation services. They have worked through different views and arrangements on Tier 4 across local authorities.

The sub-group deliverables and aims include:

• Development of guidance for new commissioners on commissioning and procuring Tier 4 services. This will be refreshed during 2025-26.
• Ongoing work with OHID / Drug and Alcohol Improvement Support (DAIST) leads to inform system thinking and change
• Continuing to share best practice around Tier 4 commissioning/procurement
• Engaging with specialist providers to develop mutual understanding of quality Tier 4 treatment provision and market responses to identified needs (there are now regular opportunities for Collective Voice to attend our meetings and for our Chairs to attend Collective Voice’s Tier 4 Group meetings)
• Considering funding and the 2% ambitions for residential rehabilitation in the national drug strategy
• Support other commissioners to use the OHID Residential Rehab Self-Assessment Toolkit, and share themes of their findings with the group.

Guidance on Residential Rehab in Inpatient Detox

The Tier 4 Sub-Group have produced a guide to aid commissioners in either beginning to commission tier 4 services or who are re-commissioning services.  This guidance is not intended to be a full step-by-step guide but more as a list of factors to consider to meet the procurement needs/priorities of your own local authority/consortia.