National Mission on Drugs: annual report 2021 to 2022

9. Monitoring and Evaluation

9.1 Governance

The National Mission Implementation Group^[69] was established in June 2021 as a forum for ensuring that the necessary actions and changes are being driven across all parts of government and services and was chaired by the Minister for Drugs Policy. Following discussion with the group and the Minister, the decision was taken to enhance independent scrutiny, challenge and advice of the National Mission. This led to the establishment of the National Mission Oversight Group which 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.

The Group will meet every three months and to ensure independence from government, a steering board of members has been nominated to co-ordinate the agenda for Oversight Group meetings.

9.1.1 Additional groups and governance

The National Mission benefits from expertise across a wide range of fields, including clinical advice, lived and living experience, and expertise on residential rehab and MAT standards. This is work which is commissioned so is not formally part of the governance of the National Mission. However it is highlighted in sections 2.2.1 and section 5.2.1 as detailed above. To ensure the mission is impactful and has a holistic approach, several topic specific groups meet regularly in addition to the Oversight Group. Figure 14 sets out the groups facilitated by the Drugs Policy Division.

9.2 Accountability

Scottish Government Ministers are accountable at national level for drug-related deaths and harms, there is a need for clear lines of accountability at local level.

Integration Authorities for Health and Social Care are responsible for the planning and delivery of alcohol and drug services. In practice, Integration Authorities need to work in partnership through Alcohol and Drug Partnerships to develop and deliver services which meet the diverse needs of people who experience problematic drug use and their families.

Local accountability for the provision of drug treatment services sits with Integration Authorities as set out in the partnership delivery framework.

We have agreed eight recommendations with COSLA to improve the accountability within the local system. 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.

The new oversight arrangements for implementing MAT Standards will also strengthen accountability to communities, through the involvement of lived and living experience in the required quarterly or monthly reporting.

Further powers to intervene through the implementation of the National Care Service, which will introduce a more formal, single framework of accountability will be considered, if necessary.

Figure 15: Accountability of local performance of drug services

National Level

• Scottish Government Ministers

Local Level

• Integration Joint Boards (IJBs)
  • Integration Authorties
  • ADPs

9.3 Future Evaluation

Delivering evidenced based policy requires on effective evaluation.

The National Drugs Mission will be evaluated by Public Health Scotland (PHS), ensuring that the evidence is considered in a balanced and objective way.

9.3.1 Measuring progress against outcomes

The outcomes framework will inform the development of a more detailed and comprehensive evaluation framework designed by PHS. This will expand on, and set out, the key research questions the evaluation will aim to answer, establish which data can be used to answer these questions, and the best and most appropriate way to capture this. Lived and living experience will be consulted throughout the evaluation process from the outset, including consultation on the design, data collection and oversight perspectives. Lived and living expertise will also be sought as an integral part of the overall evidence base for the evaluation.

9.3.2 Programme specific evaluation plans

As well as an overarching evaluation, we have commissioned individual evaluation of key policy areas which will also be led by PHS. Residential rehabilitation is one of these areas of focus and evaluation will specifically monitor and assess the impact of National Mission funding on access to residential rehabilitation services and recovery outcomes for individuals. This work will establish a solid evidence base around the range of residential rehabilitation treatment models and establish what works best for whom.

Other independent programmes of evaluation include evaluation of the Medication Assisted Treatment (MAT) Standards implementation, a programme of evaluation around the National Collaborative, and evaluation of Heroin Assisted Treatment (HAT). The evaluation of the National Mission will also draw on external evaluation projects carried out by academic groups or other stakeholders. These include evaluation projects on specific services or localities such as naloxone and primary care.