Treatment services need to be ambitious for their clients, provide best value for money and respond to changing patterns of drug use, Paul Hayes, NTA chief executive, said today.

Speaking to treatment providers, he set out a challenging agenda for the next 18 months in the run-up to the establishment of a new Public Health Service responsible for drug and alcohol treatment.  

In a speech to the EATA conference, Mr Hayes said commissioners and providers should focus on what works in straitened financial times. The Government had threatened spending cuts that would be "tough but fair" but he was convinced there were efficiencies to be gained in the system.

"People come into treatment wanting to get better. Month by month, more people are successfully overcoming their addiction.  We are moving in the right direction, but there is more we could do to engender hope in the treatment system and ensure more clients are on the road to recovery," said Mr Hayes.

Mr Hayes was speaking after a keynote address by Anne Milton, the public health minister, to the London conference on the theme of Aiming high for drug and alcohol treatment.

Mr Hayes said the drug treatment system is well-placed to take advantage of the Prime Minister's vision for a Big Society, because mutual aid networks, peer support groups, and the grassroots movement around recovery communities were all in tune with that ethos.

He said annual treatment statistics last week showed the system needed to respond to changing treatment demand. As the numbers seeking treatment for heroin and cocaine started to fall, demand was rising for cannabis services which in the past had been squeezed out because of the priority given to Class A drugs.  

But Mr Hayes said the ambition to get people through treatment swiftly must always be balanced with the need to do so safely.

"Medical experts tell us it can take several years for heroin addicts to overcome their dependency. So it is hardly surprising that a large proportion of those in treatment - about 95,000 at the last count – were on prescribing for longer than a year, one-third of them for more than four years," he said.

"We know that some vulnerable individuals will always need long-term support, but we also suspect that many others could be helped towards recovery sooner. What are the right proportions, who is ready to move on safely and when, and how we ensure substitute prescribing does not become a default option, are issues we want Prof John Strang and his expert clinical group to consider."

The EATA conference also heard from Dr David Best, of the University of Western Scotland, who is leading another project for the NTA to help commissioners place patients in the most appropriate treatment settings.