National Mission on Drugs: annual report

9. Governance

9.1 Overview

The delivery of the National Mission on Drugs is supported by stakeholders on a range of groups to support our policy objectives. The Scottish Government value the specialised and expert input that these groups can contribute to policy development and implementation and ensure that actions done are based on frontline and lived and living experience. We have one main group that provides scrutiny and input on the National Mission as a whole: the National Mission Oversight 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 reconvenes 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.

9.1.2 Other Key Groups

National Mission Clinical Advisory Group (NMCAG)

The Clinical Advisory Group, co-chaired by John Harden, the Deputy National Clinical Director, and Marion Bain, the Deputy Chief Medical Officer, was established in April 2023. It meets quarterly as a reference group to provide clinical expertise to wider National Mission groups.

The group meets every three months to:

• 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.

Residential Rehabilitation Development Working Group (RRDWG)

The Residential Rehabilitation Development Working Group (RRDWG), chaired by Dr David McCartney, former Clinical Lead of the Lothian and Edinburgh Abstinence Project, is the successor to the Residential Rehabilitation Working Group, which was established in June 2020 to advise Scottish Ministers on a programme of work to ensure the provision of drug and alcohol residential rehabilitation services across Scotland. The RRDWG vice-chair is Lyndsey Hague, former Director of Operations for Phoenix Futures Scotland.

The RRDWG meets every quarter and is used as a “critical friend” and sounding board for key developments on the three main residential rehabilitation workstreams (pathways development, capacity reporting and national commissioning) which are being delivered by Healthcare Improvement Scotland, Public Health Scotland, and Scotland Excel respectively on the Scottish Government’s behalf.

Workforce Expert Delivery Group (WEDG)

The Workforce Expert Delivery Group (WEDG), established in 2022, is chaired by Mark Kelly, Nursing Director for Dumfries and Galloway and reports to the Minister for Drugs and Alcohol Policy.

The WEDG brings together experts from across the drugs and alcohol sector to consider key workforce challenges and identify how these should be overcome. The WEDG played a pivotal role in development of the Scottish Government’s Drugs and Alcohol Workforce Action Plan 2023-2026 and provides critical oversight and advice at key stages in the delivery of those actions identified in that plan.

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