Julia Sinclair

Julia Sinclair is Professor of Addiction Psychiatry in the Faculty of Medicine at the University of Southampton, and honorary consultant in alcohol liaison at University Hospital Southampton.

Her priority is to improve outcomes for patients with alcohol use disorders and co-morbid physical and mental health conditions by research, teaching, policy, and clinical practice.

Her clinical roles include developing an integrated alcohol strategy across local services and offering direct clinical care. Since April 2020, she has also been the National Specialty Advisor for Alcohol Dependence to NHS England.

Her primary research aim is to conduct clinically relevant research into the harms of alcohol use, specifically the impact on clinical outcomes in terms of prevention, engagement and response to treatment.

She currently co-leads the NIHR funded programme to build the evidence base for alcohol care teams (ProACTIVE). She also has a long track record of teaching and training health professionals and is currently leading the work to implement the change to the GMC curriculum that requires all trainee psychiatrist to demonstrate competence in the assessment and management of addictions.

Improving addiction competencies in the UK

Changes in Government Policy in 2012 which led to commissioning of addiction services to be moved out of the NHS into local authorities have had devastating consequences on the provision of specialist training in addictions. Training places for psychiatrists have fallen by over 60% and opportunities for specialist addiction nurses, psychologists and social workers have been similarly affected.

The loss of a critical mass of addiction specialists in the UK has had systemic effects across the healthcare system, by reducing the strategic input in decision making as well as prioritisation of limited resource within mental health systems. This can be considered as a ‘wicked’ problem which will require a patchwork of solutions to reverse the decline. These include ensuring addiction experience is mandated within the core curriculum for psychiatrists, setting up a national tutor network of addiction specialists to facilitate this, and developing innovative solutions to higher training. Making training accessible for non-specialist to up-skill is also part of the solution as well as co-production with people with lived experience to reduce stigmatising attitudes towards addiction that currently overshadows their care.

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