Coronavirus (COVID-19) residential rehabilitation - testing, vaccination and infection control: status report

1. Background

Tackling the high level of drugs deaths in Scotland is a priority for the Scottish Government. The First Minister made a statement to parliament on 20 January 2021 which set out a National Mission to save and improve lives. One of the priorities is to ensure individuals have access to and remain in residential rehabilitation during the ongoing COVID-19 pandemic.

As part of the COVID-19 Testing Strategy, the Scottish Government has committed to using testing and vaccination to protect the vulnerable. People recovering from drug addiction often have a range of complex health needs which mean they may be at increased risk from COVID-19^[1],[2]. In residential settings in particular, regular testing would likely reduce the risk of transmission between vulnerable residents^[3], and so it is important to understand current practices across the different services. People entering residential rehabilitation may already have been vaccinated through the Joint Committee on Vaccination and Immunisation prioritisation process. However, some of those entering residential rehab, especially those coming to rehab from temporary accommodation, may have not been able to access their vaccine. It is important to ensure that the vaccine is offered to all people as part of their pathway into residential rehabilitation.

Previously, the working group on residential rehab, chaired by David McCartney, published a mapping report which set out to better understand the current residential rehab landscape in Scotland. This was followed by a report on capacity which found that there were least 418 residential rehab beds/ placements available in Scotland, across the 20 facilities surveyed. These reports served primarily as scene setting exercises, to inform the work of the working group and did not explore the efforts made by providers to adapt to the ongoing pandemic. A short-life working group on Drug and Alcohol Rehabilitation COVID-19 Testing and Vaccination Pathways (SLWG) has been established to design, implement, monitor and support pathways for vaccination and testing for people receiving residential treatment for problematic alcohol and drug use. After consultation with health boards and liaison with the Recovery and Residential Providers Group, the SLWG recommended that research should be conducted to better understand current practices around the ongoing COVID-19 pandemic.

This report aims to provide an improved estimate of current COVID-19 testing and vaccination in residential rehab settings in Scotland and to better understand how services are adapting to minimise the risk of infection within their service. This report will also inform the guidance on vaccination and testing produced by the SLWG, which will help support residential rehab providers create a safe environment for their residents during the time of the pandemic.