Drug Deaths Taskforce response: cross government approach

10. Leadership and accountability

Taskforce Recommendation: Clear, decisive and accountable leadership is needed to deliver the Taskforce recommendations and ensure that the National Mission is effective in improving and saving lives. While the First Minister and Minister for Drugs Policy are rightly accountable at national level for drug-related deaths and harms, there is a need for clear lines of accountability at local level, with chief officers from the local Chief Officers Group ultimately assuming similar accountability locally. Chief executives of organisations in alcohol and drug partnerships (ADPs) must be responsible for their organisation's engagement and delivery.

Too often the experience of people seeking support locally, does not match the expectations or written policies. Leadership and accountability at all levels are vital to ensuring that this disconnect is resolved.

Within local systems for alcohol and drug services, we are working with local services to implement eight recommendations agreed with COSLA to improve lines of accountability for services and interventions commissioned through ADPs. These focus on improving financial governance, accountability arrangements as well as improving strategic planning. A toolkit has been issued to improve local governance which will be open to peer and external validation. Requirements have also been set with templates to be issued to improve local strategic planning.

Fully implementing the MAT Standards is core to our National Mission and will have a significant impact on saving and improving lives. While we recognise the challenges with implementation, the Minister for Drugs Policy has been clear that the speed of implementation has not been good enough. As a result, Ministers issued a Direction to Integration Authorities for Health and Social Care to implement the MAT Standards; this will require Chief Officers to provide leadership to enable and oversee this work. All Integration Authorities have submitted implementation plans and are now providing regular reports to Scottish Government on progress towards implementation.

The work being done to support local areas implement the standards fully has thrown some of the challenges we need to overcome into sharp relief. In light of the scale of some of those, particularly in justice settings, we accept the timescales for full implementation in community and justice settings as recommended by Public Health Scotland in its Benchmarking Report of June 2022. Implementation plans locally have focused on what can be done by April 2025 at the latest.

In the longer-term there could be a more formal, single framework of accountability for services provided through the National Care Service and alcohol and drug services would form part of that.

Nationally, ministers are accountable for drug misuse deaths and harms with the Minister for Drugs Policy reporting directly to the First Minister. In order to enhance independent scrutiny, challenge and advice of the National Mission, the National Mission Oversight Group was launched in June 2022. The Group is chaired by David Strang CBE QPM, following the conclusion of the Drug Deaths Taskforce in July 2022, and brings together a broad range of Scottish and International experts to provide challenge to ministers and the wider system, identify gaps in the National Mission plan and highlight examples of world-leading approaches from other countries.