Drug Deaths Taskforce response: cross government approach

8. Workforce Action Plan

Taskforce Recommendation: The Scottish Government should develop and rapidly implement a workforce action plan for the drug and alcohol sector to ensure the workforce is supported, well-trained and well-resourced.

8.1 A workforce action plan

We recognise the importance of having a well-supported, trained and resourced workforce to meet the needs of the drug and alcohol sector. A Workforce Expert Delivery Group has been established to consider critical workforce challenges. This group is comprised of sector experts and those delivering front line services, best placed to know how these specific challenges should be overcome.

In the short term, the group has begun progressing actions to drive workforce development at a pace commensurate with the ongoing public health emergency. The group is also considering the medium and longer term actions required and these will be detailed in a workforce action plan.

The workforce action plan will build on the National Workforce Strategy for Health and Social care in Scotland which sets out a framework to shape Scotland's health and social care workforce over the next decade, placing training, wellbeing, job satisfaction and the principles of Fair Work at its heart.

The plan will outline the core skills, knowledge, and values that all drug workers should possess. The plan will also detail mandatory workforce training requirements. The expert group has already begun work to develop a platform which will bring together all training resources in to one location, ensuring improved access and support for the entire workforce.

As expressed throughout this plan, we are committed to ensuring that people with lived experience are at the heart of everything we do. We are committed to ensuring that people with lived experience are supported to establish careers within the sector and play a more active role in the design and delivery of services.

We recognise that more needs to be done to ensure those with such a valuable insight have access to appropriate training and pathways to enter the workforce and develop their careers. Scottish Government will seek to identify any solutions which can provide more efficient career entry. Work is already underway through the expert group to develop guidance which will improve pathways for those with Lived and Living Experience to enter the workforce.

Recruitment, retention, and service remain significant challenges for the drug and alcohol sector and addressing this challenge is of critical focus to workforce development plans. Work is already underway to improve workforce data capture to facilitate improved planning. Cross government work is also being progressed to provide employment support to people who use drugs through the No One Left Behind strategy.

Key actions

• Scottish Drugs Forum's Addiction Workers Training Programme (AWTP) continues to successfully recruit and provide a programme of paid work placements, specialist training and vocational learning for people with a history of drug use. Trainees are supported into further employment upon completion of the project. We will support the additional recruitment of up to 20 additional trainees per year through investment of £480,000 per year.
• Scottish Government has brought together the aforementioned Workforce Expert Delivery Group, to consider workforce challenges specific to the sector. These experts have been tasked with identifying workable solutions to help achieve sustainable improvements. In doing so the Group will plan, develop, oversee, and report on activity to develop a workforce action plan. The plan will set out the longer-term actions required to deliver a sustainable, trauma informed, skilled workforce, which is valued for the work it does.
• We will invest funding of £500,000 per year to support workforce development activity identified in this plan.

8.2 Developing a trauma-informed and responsive workforce and services

Abuse, neglect, and other traumatic and adverse experiences, particularly those experienced in childhood, can have devastating and long-lasting effects on people's lives and can lead to people developing negative self-coping strategies including substance use. This can be compounded by trauma experienced in later life as a result of substance use.

The experience(s) and the impacts of trauma are often hidden. What has become increasingly recognised is that without the right support, trauma, and adverse childhood experiences, can result in poorer physical and mental health, and poorer educational, employment and justice outcomes and in some cases, disconnection from society and services. The impact is broadly felt and can result in inequalities in physical and mental health and wellbeing, employment prospects and access to services. However, people are resilient and with support they can and do recover from trauma.

It is crucial that we act on the learning from experts by experience and profession, and from research evidence, about what helps people to cope with and recover from such experiences; including the importance of relationships, positive childhood experiences, and trauma-informed care. Many experts by experience (people with lived experience of trauma) report that feelings of blame and shame can arise from the experiences of trauma and the responses of other people, including stigma. Progressing actions to better prevent and respond to trauma and adverse childhood experiences, and implement trauma-informed approaches, is as a profound shift from longstanding approaches of 'blame, shame and punishment' to approaches based on 'understanding, nurturing and healing'.

This shift in our culture requires a system-wide approach to reducing barriers to accessing services and preventing institutional discriminatory practices which negatively impact those affected by trauma. Scotland has paved the way in recognising that trauma-informed approaches are crucial to ensuring all children, young people and adults can lead healthy and fulfilled lives.

Since 2018, the Scottish Government has invested over £5 million in the National Trauma Training Programme (NTTP), delivered by NHS Education for Scotland (NES), including a total of £3.2 million funding distributed to all local authorities in 2021/22 and 2022/23 to work with community planning partners to further progress trauma-informed services, systems, and workforces. The NTTP provides freely available, evidence-based trauma training resources and support for implementation. This includes a new 'Trauma skilled' level e-learning module to support understanding on the links between psychological trauma and substance use which was published in summer 2022 and is available to all services and sectors via the National Trauma Training Programme website.

Key actions

• Two trauma-informed substance use pathfinder projects are currently underway in NHS Dumfries and Galloway and NHS Orkney, supported by the National Trauma Training Programme and funded through the Scottish Government Mental Health Recovery and Renewal Fund. The aim of the pathfinder project is to help strengthen the understanding of what support is needed within frontline services to implement and embed trauma informed practice.
• We have commissioned trauma specialists at NHS Education for Scotland to create a 'Knowledge and Skills' framework specifically to support the development of a trauma-informed workforce in the justice sector. The framework will be published shortly. Justice partners will be able to use it to identify the knowledge and skills required of each job role in their organisations, and to create or commission high quality training to meet the needs of their workforces.
• Trauma Responsive Social Work Services: A workplan has been developed with partners and sets out a framework to imbed trauma responsive practice into social work services across Scotland. Actions include:
  • Working with Higher Education Institutions, Social Work Education Partnership, and the Scottish Social services Council to embed trauma trainings into social work education and the NQSW supported programme.
  • Identifying and/or developing training materials suitable for the needs of the social work workforce (at minimum Enhanced Level), including a focus on worker wellbeing and reflective practice supervision to support the workforce.
  • Improving access to all appropriate levels of trauma training for social workers from NQSW to Advanced Practice.
  • Ensuring there are suitable train the trainers programmes and approaches for trainings relevant to social care workers and social workers.
  • Establishing an implementation support team to deliver a cohesive programme of workforce support, for operational, middle, and front-line social work leaders.
• Scottish Government is working with experts across the drugs sector to develop a platform to communicate and signpost available training opportunities to the entire drugs workforce. This will contribute to the delivery of a sustainable, trauma informed, skilled workforce, which is valued for the work it does.
• We will invest up to £1.1 million a year to expand the existing Transforming Psychological Trauma Implementation Coordination Network (TPTIC), and recruit a National Lead specialist post with experience in substance use and trauma informed practice. This will ensure that both specialist and generic services that people who use drugs may encounter, are trained and equipped in trauma informed practice to ensure appropriate responses and support is given.