The Barriers and Facilitators to Supporting, Commissioning and Working with Lived Experience Recovery Organisations in Systems of Care in England

Why It Matters

Clarifying LERO roles and securing stable funding will enable these peer‑led groups to complement clinical services, improving outcomes for people with substance‑use challenges and advancing UK drug‑policy goals.

Key Takeaways

• Only one‑third of English local areas have a recognised LERO.
• Funding cycles are short, causing instability for LEROs.
• Clear LERO definition needed to improve stakeholder collaboration.
• Embedding LERO in governance boosts strategic influence and funding.
• Grassroots LEROs benefit from targeted start‑up support and space.

Pulse Analysis

The United Kingdom’s recovery‑oriented systems of care have increasingly highlighted lived‑experience recovery organisations (LEROs) as essential partners for people who use alcohol or other drugs. These peer‑led groups, run by individuals with personal recovery experience, provide direct support that complements clinical services. Yet a RAND Europe study finds that, at the time of data collection, only about one‑third of English local authorities recognised a LERO, indicating a substantial gap between policy ambition and on‑the‑ground implementation. Understanding why this gap persists is crucial for policymakers aiming to meet the 10‑year drug strategy targets.

The study pinpoints three interrelated barriers. First, there is no shared definition of a LERO, leaving commissioners, treatment providers and local partners uncertain about the organisation’s role. Second, funding structures are fragmented: short‑term grants and ad‑hoc allocations undermine organisational stability and limit strategic influence. Third, inclusion in formal governance bodies such as multi‑agency forums is uneven, restricting LEROs’ ability to shape funding priorities. These obstacles vary across four development models—absent, grassroots, commissioner‑initiated, and treatment‑service‑initiated—each with distinct facilitators and constraints.

Recommendations focus on standardising terminology, extending multi‑year funding, and embedding LEROs in decision‑making structures. Central government, in partnership with the College of Lived Experience Recovery Organisations, should issue clear guidance on what constitutes a LERO and the services it can deliver. Local authorities can accelerate grassroots formation by providing start‑up capital, physical space and governance templates. When LEROs sit at the table in strategic planning, they can document outcomes, demonstrate value, and attract sustainable investment, ultimately strengthening the recovery‑oriented care ecosystem across England.