National Mission Oversight Group minutes: September 2023

Attendees and apologies

• David Strang, NMOG Chair
• Professor Andrew McAuley, Glasgow Caledonian University
• Sally Amor, LLE Representative
• Iain Smith, Keegan Smith Law
• Kirsten Horsburgh, SDF
• Emma Crawshaw, CREW 2000
• Stephen McCutcheon, LLE Representative
• Chris Williams, Royal College of GPs
• Justina Murray, SFAD
• Laura Wilson, Royal Pharmaceutical Society
• Professor Tessa Parkes, University of Stirling / DRNS
• Nicholas Phin, Public Health Scotland
• Mark O'Donnell, SRC
• Belinda Phipps, With You
• Lorraine McGrath, Simon Community Scotland

 

Also attended

• Tracey Clusker, Public Health Scotland
• Orlando Heijmer-Mason, Scottish Government
• Maggie Page, Scottish Government
• Morris Fraser, Scottish Government
• Alison Crocket, Scottish Government
• Alice Burling-Brown, Scottish Government
• Joshua Bird, Scottish Government

 

Apologies

• Ms Whitham, Minister for Drugs and Alcohol Policy
• Billy Watson, SAMH
• Sandra Holmes, LLE Representative
• ACC Faroque Hussain, Police Scotland
• Susanna Galea-Singer, Royal College of Psychiatrists
• Eddie Follan, COSLA

 

Observers

• Aime Jaffeno, Scottish Government
• Lauren Ross, Scottish Government
• Maisie Bennett, Scottish Government

Items and actions

Welcome and board governance

The chair welcomed members and attendees to the sixth meeting of the national mission oversight group (NMOG). Apologies were noted.

The chair updated the group on the continued engagement of the international experts. It was agreed with the three experts, the Minister for Drugs and Alcohol Policy and the Chair of the NMOG that the international experts would form a small subgroup to the NMOG, to meet on an ad-hoc basis, when suits policy needs, to allow them to share information and best practice from overseas. They will no longer attend the NMOG meetings but will receive all the papers and be able to provide comments or opinions. They will be invited to participate in sessions with the NMOG on their areas of expertise when suits policy needs. Secretariat are currently in discussions with them about arranging for them to deliver a session on their experience and knowledge of fentanyl and new synthetic opioids.

The chair reiterated the purpose of the national mission is to save and improve lives through fast and appropriate access to treatment and support through all services. The NMOG role is to challenge, provide scrutiny, challenge, and advice to Scottish Government (SG).

The minute of the previous meeting on 22 June 2023 was formally approved. The summary minute for this meeting has been published on the website.

The actions and advice trackers were reviewed, there were two outstanding action points. The chair encouraged members who have not done so, to send a copy of their NMOG evaluation form to the secretariat.

Drug related death statistics

JB, a Scottish Government analyst, attended the meeting to provide the NMOG members with a presentation on the latest drug related death statistics, which were published on 22 August 2023.

SG Update

OHM referenced the SG update paper and RAG status report (NMOG 06/23-03) which was provided in advance of the meeting, highlighting preference to discuss and take any questions and summarised content. The key areas included:

•    achievements since the last meeting
•    actions for the coming months
•    cross government update

The Chair welcomed comments and discussion on the SG update and the Drug Related Death Statistics presentation.

Discussion

The group highlighted the importance and need for data to be split on race and gender, they discussed existing gaps and challenges, but agreed it should be prioritised. 

The update on safer drug consumption facilities was welcomed but brought discussion around the need to review and pilot different models across the country particularly in rural areas that will not be able to replicate a Glasgow model of delivery. The group discussed looking at new and existing models, and how service models such as “high tolerance” accommodation might be encouraged and evaluated, and encouraged SG and Glasgow to be considerate of the impact on women when establishing the feasibility and impact of certain pilots. 

NDDIMT Update

NP provided the group with an update from the latest NDDIMT meeting, which took place on 15 September 2023. Key areas included:

•    epidemiology and surveillance
•    MAT standards
•    drug special interest group
•    toxicology delays

MAT standards 6-10

TC from MIST attended the meeting to present outline plans for supporting local services to adopt MAT standards 6-10 by April 2025. Key areas included:

•    key recommendations were to merge MAT 6 and 10 for evidence collection, including 3rd sector involvement
•    the process for previous and future evidence collection for 7,8 and 9 and highlighted that a steering group has been formed between MH and substance use. HIS are supporting some areas to develop a relevant pathway. MIST working closely with HIS on this standard. Details of consultation group shows wide range of stakeholders
•    confirmed that MIST is going to collect data on the percentage of mental health (MH) patients screened for drug disorders, diagnosed as having a drug disorder, Substance Use (SU) patients screened for MH disorder and diagnosed as having MH disorder. This will confirm if care pathways are met, and both MH teams and SU teams would be responsible for collating own relevant data. Wide engagement with MH teams is planned over next few months 

The chair welcomed discussion on the points raised in TCs presentation.

Discussion

The group highlighted the frequency of the mention of third sector with regards to MAT implementation. Being clear that any gaps in delivery of services should not just be an expectation that third sector will fill those gaps. 

The breadth of skills and experience that goes into mental health care was highlighted. The group discussed the difference between care and services, and the need to recognise mental health skills and training available within the third sector and not just statutory services. 

The group reflected that the slow progress on meaningful implementation is disappointing. They discussed challenges causing this including NHS being slow to change. 

It was agreed that NHS and PHS should look to the third sector for examples of good practice when it comes to implementing standards 6-10. The third sector has skills and knowledge in areas to deliver a fully holistic approach which can take the pressure off the NHS, especially with regards to mental health care. 

The commissioning model in Scotland was discussed with comparisons made to models used in England which call for partnership and service level agreements. It was noted that in Scotland ADPs have become “mini commissioners” and that strategic oversight is needed from public health scotland to be more collaborative. 

Any other business and close

The chair thanked attendees for coming to today’s meeting.

The chair reminded attendees that, should they have any items they would like to add to the agenda for future meetings, they should let the steering group know.

The next meeting is scheduled to take place on Thursday 14 December at 14:00 in St Andrew’s House, Edinburgh. The proposed focus will be on stigma and the delivery of the stigma action plan. The proposal for the March 2024 meeting is to have a focus on the national collaborative and LLE.

The chair advised that the secretariat will be in touch in due course with the dates for the 2024 meetings.