Dr. Peter Kelly:

A lot of the services need guaranteed funding over long-term cycles as opposed having to apply for funding year on year. Strategic workforce development was looking at population needs. A little work has been done on that. One of the strategic groups of the national oversight committee looked at population needs and resources, and the longitudinal evaluation of what workforce will meet the needs of that specific population, looking at changing drug trends, demographics, etc. I have already said security of tenure, supervision and exploration of workloads. A big piece of research has been done in nursing called the RN forecast and it looked at general hospital settings. It looked at the ratio of nurses to patients and mapped that onto outcomes. There is a lot of evidence to say that the more highly qualified nurses and other healthcare professionals you have, the lower the mortality rates. There are particular ratios that change those outcomes. There is not any research like that done in community addiction treatment services. It is probably hard to do and is expensive. However, there is no reason we could not extrapolate from that research to say if you have happy, well-supported staff you will have happy service users. There is lots of evidence to support that where there are high levels of burnout and less educated staff who feel less autonomous, then the outcomes for service users are worse. It is about examining those things and then creating a strategy that recognises those.