National Mission on Drugs: annual report 2022-2023

Monitoring and Evaluation

9.1 Governance

The delivery of the National Mission on Drugs is supported by multiple groups across all policy and objectives. The Scottish Government value the specialised and expert input that these groups can contribute to policy development and implementation and ensure that actions are done so based on frontline and lived and living experience. We have two main groups that provide scrutiny and input on the national mission as a whole: the National Drugs Mission Oversight Group and the Clinical Advisory Group.

9.1.1 National Mission Oversight Group

A National Drugs Mission Oversight Group was set up by the former Minister for Drugs, Angela Constance, meeting for the first time in June 2022, and reconvening every three months. The core of our national mission to improve and save lives is taking action based on what we know works to reduce harm, promote recovery and save lives.

The group meets every three months to:

• scrutinise the Scottish Government’s plan to deliver the national mission
• identify any gaps in the plan and share suggestions for how these may be addressed
• provide expert advice on policy areas and service delivery as requested by Scottish Ministers
• share best practice, including from other countries which have had success in reducing deaths and harms from drug use
• promote accountability in the system at a national and local level
• explore how recommendations from other governance groups could be implemented in the context of limited funding and resources.

Topics discussed to date:

Meeting 1 – Introduction to the NMOG and its purpose (National Drugs Mission Oversight Group minutes: June 2022 - gov.scot (www.gov.scot))

Meeting 2 – focus on Drug Related Death Stats and deep dive in to MAT (National Drugs Mission Oversight Group minutes: September 2022 - gov.scot (www.gov.scot))

Meeting 3 – Focus on the Taskforce Response with a deep dive in to Residential Rehabilitation (National Drugs Mission Oversight Group minutes: December 2022 - gov.scot (www.gov.scot))

Meeting 4 – Focus on Suspected Drug Death Stats with a deep dive on the Cross- Government Action Plan (National Mission Oversight Group minutes: March 2023 - gov.scot (www.gov.scot))

Meeting 5 – Focus on ADPs with presentations from ADP Chairs in Dumfries and Galloway and West Dunbartonshire (to be published)

See: National Drugs Mission Oversight Group - gov.scot (www.gov.scot)

9.1.2 National Mission Clinical Advisory Group (NMCAG)

The Scottish Government’s National Mission Clinical Advisory Group (NMCAG) is a reference group that provides clinical expertise to wider National Mission groups. The group was established on 26th April 2023 and held its proper meeting on 28th June 2023 and explored the topic of MAT 7/Primary Care. Meetings will be held quarterly, with ad hoc being sought as and when required across the year.

Membership includes Clinical Leads specific to all relevant conditions and wider areas such as general practice, pharmaceutical, mental health, third sector organisations and social work and will report to the Minister for Drugs and Alcohol Policy.

The CAG will:

• Provide clinical expertise to local and national policy and decision makers.
• Be champions of change, innovation, and research in response to Drug Deaths Task Force (DDTF), Medically Assisted Treatment (MAT), Residential Rehabilitation (RR) National Collaborative (NC).
• Explore and consider the data, views, and evidence from across Scotland and beyond and the best way to support those at highest risk, those with clinical priorities and/or those with long term conditions.
• Consider the data on the effectiveness of measures and advise where improvements should/could be made.
• Be mindful of the wider harms, practical and policy implications that the challenges of these measures may cause – including mental and physical health.
• Maintain links between the Oversight Group, Delivery Board, National Collaborative, MAT Implementation Support Team (MIST), Residential Rehabilitation Development Working Group (RRDWG), Drug-related Deaths Incident Management Team (DDIMT).

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.

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.

9.3 Evidence-based policy making

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

9.3.1 Understanding impact

The National Mission 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 is being consulted throughout the evaluation process, including consultation on the design, data collection and oversight perspectives. Lived and living expertise is also be sought as an integral part of the overall evidence base for the evaluation. The development of the evaluation framework is ongoing and baselining workstreams are underway.

9.3.2 Programme specific evaluation

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. Baselining workstreams for this evaluation are underway and a number are already completed. An evaluation baselining report is expected early 2024.