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The Royal College of Psychiatrists Improving the lives of people with mental illness

CR173. Delivering Quality Care for Drug and Alcohol Users: the Roles and Competencies of Doctors

Price: £0.00

Approved: Mar 2012

Published: Sep 2012

Status: current

Number of pages: 36

Review by: 2022

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This report is only available online – there are no printed copies available to buy.

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Since 2005 there have been major changes affecting both the commissioning and provision of services for people who use drugs and alcohol. There has been a growing emphasis on recovery, with provision increasingly oriented towards outcome measurement and third sector involvement. Drug and alcohol treatment have a very significant place within the evolving new arrangements for improving public health. All of this is taking place in the context of the wider health reforms in the Health and Social Care Act 2012.

At the same time, the profile of drug use has changed. Heroin and cocaine use is stable or in decline, whereas new drugs such as ‘legal highs’ are emerging. Increasing numbers of young people are using alcohol and stimulants, and long-term drug and alcohol use by older people is becoming more significant.

It is therefore timely to look again at the roles, responsibilities and competencies of the various types of doctors involved in helping people recover from drug and alcohol use. This report – which constitutes official guidance from the Royal College of Psychiatrists and the Royal College of General Practitioners – will help commissioners, providers, regulators, policy makers, doctors and those seeking recovery from drug or alcohol use to ensure that drug and alcohol services make the best use of resources to deliver the highest possible standard of care across the entire pathway and that all doctors working with people using drugs and alcohol have the right level of competency for the roles and responsibilities they undertake.

This report replaces CR131: Roles and Responsibilities of Doctors in the Provision of Treatment for Drug and Alcohol Misusers from 2005.  In 2017 the currency period for this report was extended to 2022. 


  • Working Group
  • Foreword
  • Executive summary
  • Introduction: aims and structure of this report
  1. The diversity of doctors working with drug and alcohol users
  2. Roles and responsibilities of doctors working with drug and alcohol users
  3. The three levels of competency for doctors working with drug and alcohol users
  4. Training, qualifications and supervision arrangements for doctors working with drug and alcohol users
  5. Principles for service design
  • References
  • Further reading

Chapter 1 describes the recovery context, the range of doctors working with drug and alcohol users, and the regulatory requirements regarding their roles and competencies.

Chapter 2 delineates the main distinctive roles and responsibilities carried out by doctors working with drug and alcohol users, and outlines their importance in delivering high-quality, effective care and support.

Chapter 3 defines three levels of competency for doctors in this field – specialist, intermediate and generalist – based on these roles and responsibilities. It also gives examples of the background and training of the kinds of doctors usually found working at each of these levels of competency in practice.

Chapter 4 provides further information on the training, qualifications and supervision arrangements currently available for doctors in this field. It sets out the Working Group’s recommendations for the training, qualifications and supervision requirements that should be expected of doctors at each level of competency. The Working Group expects that following these recommendations should normally be sufficient to ensure that regulatory requirements are met.

Chapter 5 uses the roles, responsibilities and competencies of doctors in this field to propose a number of broad principles for commissioning drug and alcohol services.

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