Exploring the gendered impact on women of the impact of the changes in commissioning in drug and alcohol services.

Since 2010 the drug and alcohol treatment sector has witnessed significant change. The growth of New Public Management (NPM); increase in competition and subsequent changes to comissioning and procurement has negatively impacted treatment providers' ability to support people who take drugs. One of the key changes has been the monopolisation of the sector by large providers at the expense of smaller, community rooted organisations who fail to compete on price. A small but growing body of literature has examined the impact of these changes on service provision but there is scant research exploring the impact of these developments on womens access to treatment. 

Adopting a trauma informed approach, this research proposes a comparative case study design using two sites in England; a single provider model and a community rooted harm reduction service. The aim is to explore the experiences of service provision in areas with with a single provider model and those that have maintained a more local community focused approach with multiple small to medium providers. Women who are accessing harm reduction provision and those who would benefit but are but are not accessing will be recruited in each area to co-design and produce the research. 

The research will provide evidence of the impact of these gender blind changes on women who use and need these services, filling a significant gap in the literature. The recommendations will be used to influence policy around commissioning and to encourage the large national charities to work in a more collabroative way with the remaining smaller, community rooted organisaitons for the benefit of women who use their harm reduction services.