Chamber and committees

No information is held on the costs to the NHS of knife crime.

To allow progress to be measured in relation to the immediacy and speed with which offenders commence and complete their orders, we are currently conducting an audit of activity across Scotland. We will apply the findings of the audit to inform and reinforce our work with partner agencies to improve the delivery of Community Payback Orders. The results of a previous audit were lodged with the Scottish Parliament Information Centre on 24 April 2009 (Bib. number 47783).

The Scottish Crime Campus will provide purpose built accommodation for the Scottish Crime and Drug Enforcement Agency and its partner agencies responsible for tackling serious organised crime in Scotland. It will enable closer and more joined up working in the fight against Serious Organised Crime. The Scottish Intelligence and Co-ordination Unit is an integral part of SCDEA.

The use of test purchasing is an operational decision for each police force. We understand that test purchasing is intelligence-led and deployed in premises with a perceived problem of sales of alcohol to those under the age of 18.

The following table provides information on test purchases carried out in off-sales and on-sales obtained from the police based on the latest available returns.

Police Force Area	Off Sales Tested	Off Sales 1st Failure	Off Sales 2nd Failure	On Sales Tested	On Sales 1st Failure	On Sales 2nd Failure
Central	4	0	0	1	0	0
Fife	118	17	0	0	0	0
Grampian	41	6	1	10	8	1
Lothian and Borders	166	19	0	0	0	0
Northern	40	4	0	0	0	0
Strathclyde	363	43	0	3	0	0

Note: Figures are not available for Dumfries and Galloway and Tayside Police Forces.

Subject to contract the first agency is expected to move into the Scottish Crime Campus during 2012 with full occupation expected by mid 2013. The order in which agencies move in has not yet been determined.

The SICU is presently located in a building owned by Lothian and Borders Police. The annual cost of this accommodation inclusive of rent, rates, utilities, cleaning, repairs, general maintenance and secure parking is £100,000. In addition approximately £200,000 was spent on refurbishing the building.

The investigation of homicides is an operational matter for chief constables. Information on the costs of investigations is not held centrally.

The deployment of police officers is an operational matter for chief constables. Information on the time police officers spend on individual tasks is not held centrally.

Information on the number of methadone defined daily doses for financial years ending 31 March 2005-2009 inclusive, by NHS board is shown in the following table. Although methadone oral solution prescribing rates have risen 2004-05 to 2008-09, the figure has remained stable at 96 methadone prescriptions per 1,000 population over the last three years.

It should be noted that this information is a statistical measure and as such does not tell us about the number of people who are prescribed methadone in Scotland. Assumed average maintenance dose based upon guidelines at the following link:

http://www.whocc.no/ddd/definition_and_general_considera/.

I refer the member to the answer to question S3W-31785 on 11 March 2010. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at the following link: http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The information in the following table is derived from prescriptions dispensed in the community in Scotland each month. The prescribing team at ISD Scotland scan prescriptions that are dispensed in the community (some eight million prescriptions each month) and calculate defined daily doses using data derived from prescriptions plus local information. Individuals may have more than one prescription and therefore the number of prescriptions is not indicative of the number of individuals.

Number of Defined Daily Doses for Methadone by NHS Board 2004-05 to 2008-09

Dispensing NHS Board1	Financial Year
	2004-05	2005-06	2006-07	2007-08	2008-09
NHSscotland2	14,995,485	17,440,492	19,359,311	21,410,688	23,209,441
NHS Ayrshire and Arran	1,131,478	1,388,218	1,625,850	1,847,091	2,036,536
NHS Borders	41,857	53,098	83,531	92,303	116,259
NHS Dumfries and Galloway	246,589	273,125	315,450	362,189	401,011
NHS Fife	417,067	494,904	667,397	1,050,983	1,407,307
NHS Forth Valley	387,238	432,549	532,629	648,840	697,605
NHS Grampian	897,579	1,079,209	1,316,876	1,632,252	1,918,198
NHS Greater Glasgow and Clyde	7,235,211	8,170,408	8,759,282	9,206,738	9,498,299
NHS Highland	198,007	271,440	298,546	349,309	414,430
NHS Lanarkshire	996,124	1,176,836	1,223,077	1,224,961	1,330,647
NHS Lothian	2,646,008	3,305,785	3,733,667	4,063,151	4,227,491
NHS Orkney	721	598	1,131	2,358	1,521
NHS Shetland	8,350	15,414	25,987	26,045	23,851
NHS Tayside	789,060	778,800	775,419	904,389	1,136,249
NHS Western isles	196	108	469	80	36

Source: Prescribing Information System, ISD Scotland, IR2010-00467.

Notes:

1. The data refers to items dispensed in Scotland (by community pharmacists or dispensing doctors anywhere in the UK). This excludes the direct supply of medicines to patients from hospitals or clinics and excludes items dispensed in England.

2. It is important to note that these figures do not provide information about the number of people in Scotland on methadone prescriptions.

3. Defined daily doses for medicines is based upon the assumed average maintenance dose per day in adults according to the World Health Organization (WHO):

http://www.whocc.no/ddd/definition_and_general_considera/.

Please note that use of Defined Daily Doses (DDDs) allows standardisation of a drug utilisation metric to enable comparisons of drug use between countries, regions, and other health care settings, and to examine trends in drug use over time and in different settings. The DDD is a technical drug use metric generated by the WHO, and the basic definition is: The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.

Drug consumption data presented in DDDs only give a rough estimate of consumption and not an exact picture of actual use. The DDD provides a fixed unit of measurement independent of price and dosage form (e.g. tablet strength) enabling assessment of trends in drug consumption and to perform comparisons between population groups.

The DDD is nearly always a compromise based on a review of the available information including doses used in various countries when this information is available. The DDD is a dose that is rarely, if ever, prescribed, because it is an average of two or more commonly used dose sizes.

The current WHO DDD for Methadone usage in substance dependence is 25mg orally.

An example of how DDDs are used in practice:

Patient A gets a prescription for 175ml of Methadone 1mg/ml, 25mg/day for seven days.

Patient B gets a prescription for 525ml of Methadone 1mg/ml, 75mg/day for seven days.

Patient A''s prescription contains 1(25mg) x 7 = 7 DDDs.

Patient B''s prescription contains 3(75mg) x 7 = 21 DDDs.

ISD calculates DDDs as follows:

                        Total Quantity of product x Strength of product

                                                WHO DDD for drug

In considering costs of supervised dispensing of methadone, it is important to note that the Gross Ingredient Cost (GIC) of 500mls of methadone changed from £7.59 in April 2006, £7.37 in April 2007, with a large increase to £9.54 in April 2008. These price changes mean that care must be taken when considering the cost data provided over time (2004-05 to 2008-09).

In addition to this, variations in the fees for methadone dispensing and supervision and in the manner in which methadone information is collected and reported mean that we do not have complete coverage across Scotland and cannot compare data across time.

The methadone dispensing fee is a payment that covers the actual act of dispensing the Methadone Oral Solution. This is a multi-stage process that starts with unequivocal identification of the patient and confirmation that the prescription meets the legal requirement. The main process would include measuring the volume required, and placing into a suitable container, labelling the container, handing the finished product to the patient, and at some stage also making the appropriate register entry required for the Schedule 2 Controlled Drug and also annotation of the prescription for the act of dispensing. The fee is paid for each act of dispensing. Methadone dispensing fees are not included in the transitional arrangements for implementation of the new pharmacy contract. The fee can be negotiated locally, and in some boards is in excess of the default payment of 175p (as stated in page 24 of the Scottish Drug Tariff, March 2007) up to £2.65.

The methadone supervision fee is a locally agreed facility, which is not identified specifically in the Scottish Drug Tariff. The fee is paid on the occasion where the contractor hands the methadone to the patient, who administers the medicine in the presence of the contractor. (Methadone is long-acting, and a single dose would give the patient twenty-four hours'' cover.) There may be local standards applied to ensure patient compliance before the fee is claimed to ensure probity of process. The costs to the process may include reuse of the vessel used to measure and administer the methadone, plus a possible place of privacy such that administration does not take place in front of other patients in the pharmacy.

Methadone supervision fees are locally negotiated, and where collected centrally, rates range from £3.10 to £4.06. Any other methadone/supervision fees are not captured centrally. Some NHS boards inform NSS of the fee values in place, and also the number of claims made, and this data can be collected. Other NHS boards prefer to collect the data locally, and this data is not normally shared with NSS. This appears to be a local choice made at board level.

Prior to Road to Recovery, the most recent Scottish Drug Strategy was Tackling Drugs in Scotland: Action in Partnership and can be found at the following link:

http://www.scotland.gov.uk/library/documents-w7/tdis-00.htm.

One of the four pillars was based on treatment and targets included the following:

Increase the number of drug misusers in contact with drug treatment and care services in the community by at least 10% every year

This government''s recovery-focused policy on tackling problem drug use goes further and recognises the importance of providing person-centred care and treatment opportunities that suit individual circumstances and needs (The Road to Recovery, 2008 which can be found at the following link http://www.scotland.gov.uk/Resource/Doc/224480/0060586.pdf).

For those who are addicted, this means that a full range of services must be available to them when they need it so that people can progress to recovery through individually tailored treatment and support.

International evidence shows that methadone works as a treatment for heroin dependence and in the Scottish context it is appropriate for methadone to be used as a treatment for substance misuse.

Reducing Harm and Promoting Recovery, 2007 which can be found at the following link: http://www.scotland.gov.uk/Resource/Doc/180417/0051271.pdf.

The annual ISD Scotland Drug Misuse Statistics Scotland publication shows that:

In 2008-09, 11,955 new individuals engaged with treatment services “ the majority of these individuals (64% or 5,955 individuals) reported heroin use and can be found at the following link:

http://www.drugmisuse.isdscotland.org/publications/09dmss/09dmss-026.htm.

Information from the ISD Drug Treatment Waiting Times Framework for the last four quarters (December 2008 to September 2009) shows a:

19% rise in the number of clients offered a date for any intervention and can be found at the following link:

http://www.drugmisuse.isdscotland.org/wtpilot/reports_revised_julsep09.pdf.

Regarding treatment types, there is a:

13% rise in the number of clients offered a date for prescribed drug treatment which is lower in relative terms when compared with the

20% rise in the number of clients offered structured preparatory interventions, and

19% rise in the number of clients offered community based support/rehabilitation.

This indicates that a range of treatment interventions are being offered, and in increasing numbers. This would be consistent with the aims of the drugs strategy and would seem consistent with the increased numbers of people being accepted into treatment.

Data on supervised methadone dispensing for financial years 2004-05 to 2008-09 are displayed in the following tables. As noted above, information on methadone dispensing and supervision fees is not available centrally for all NHS health boards in each of the time periods under question. As a result, methadone dispensing and supervision cost information in tables 1 to 5 may not provide the complete picture across Scotland and comparisons over time must be treated with caution.

Please note that the data in tables 1 to 5 cover methadone and supervision fees paid centrally and exclude the supply of medicines to patients treated within hospitals and clinics.

Table 1: Total Drug Costs and Fees for Methadone Mixture: Items Dispensed in Scotland by NHS Board¹

Dispensing NHS Board Financial year: 2004-05	Gross Ingredient Cost (£)2	Methadone Fees (£)3	Supervision Fees (£)4	Total Cost (£)
Ayrshire and Arran	425,084.39	656,600.15	-	1,081,684.54
Borders	15,542.77	20,067.25	-	35,610.02
Dumfries and Galloway	92,222.60	100,156.79	164,853.04	357,232.43
Fife	157,121.28	246,361.50	-	403,482.78
Forth Valley	146,248.09	337,584.77	-	483,832.86
Grampian	339,562.50	195,923.00	664,308.36	1,199,793.86
Greater Glasgow and Clyde	2,678,588.05	3,829,664.68	1,127,001.11	7,635,253.84
Highland	73,085.53	87,700.51	67,416.17	228,202.21
Lanarkshire	364,832.26	503,917.75	-	868,750.01
Lothian	986,191.59	1,027,048.08	-	2,013,239.67
Orkney	146.21	35.00	6.40	187.61
Shetland	3,156.26	7,175.00	-	10,331.26
Tayside	295,895.16	325,081.05	369,560.30	990,536.51
Western Isles	74.54	94.50	-	169.04
Scotland	5,577,751.23	7,337,410.03	2,393,145.38	15,308,306.64

Source: Information Services Division: IR2010-00466.

Notes:

1. Data relates to methadone mixture and solution, 1mg/ml which are recognised as being the standard products for methadone programmes.

2. Total drug cost is the paid Gross Ingredient Cost (GIC).

3. Fees paid for dispensing methadone.

4. Fees paid for the supervision of methadone.

- = zero value.

Table 2: Total Drug Costs and Fees for Methadone Mixture: Items Dispensed in Scotland by NHS Board¹

Dispensing NHS Board Financial year: 2005-06	Gross Ingredient Cost (£)2	Methadone Fees (£)3	Supervision Fees (£)4	Total Cost (£)
Ayrshire and Arran	522,929.73	796,176.01	-	1,319,105.74
Borders	19,189.13	23,726.50	-	42,915.63
Dumfries and Galloway	100,707.56	106,622.01	197,878.98	405,208.55
Fife	185,806.48	270,868.50	-	456,674.98
Forth Valley	163,857.26	374,747.28	-	538,604.54
Grampian	406,887.75	172,329.50	839,370.70	1,418,587.95
Greater Glasgow and Clyde	3,034,961.61	1,810,602.32	4,666,449.17	9,512,013.10
Highland	99,571.31	115,357.68	88,888.90	303,817.89
Lanarkshire	428,893.35	519,806.00	-	948,699.35
Lothian	1,237,518.92	1,230,314.85	-	2,467,833.77
Orkney	225.18	88.20	19.20	332.58
Shetland	5,821.88	8,622.25	-	14,444.13
Tayside	294,655.78	247,724.16	526,019.21	1,068,399.15
Western Isles	39.23	42.00	-	81.23
Scotland	6,501,065.17	5,677,027.26	6,318,626.16	18,496,718.59

Source: Information Services Division: IR2010-00466.

Notes:

1. Data relates to methadone mixture and solution, 1mg/ml which are recognised as being the standard products for methadone programmes.

2. Total drug cost is the paid Gross Ingredient Cost (GIC).

3. Fees paid for dispensing methadone.

4. Fees paid for the supervision of methadone.

- = zero value.

Table 3: Total Drug Costs and Fees for Methadone Mixture: Items Dispensed in Scotland by NHS Board¹

Dispensing NHS Board Financial year: 2006-07	Gross Ingredient Cost (£)2	Methadone fees (£)3	Supervision fees (£)4	Total Cost (£)
Ayrshire and Arran	610,785.15	899,155.30	-	1,509,940.45
Borders	30,772.36	16,789.50	45,315.24	92,877.10
Dumfries and Galloway	116,275.33	150,361.35	236,756.66	503,393.34
Fife	251,247.31	333,957.75	-	585,205.06
Forth Valley	200,518.05	246,817.28	298,958.10	746,293.43
Grampian	492,155.30	191,345.00	977,989.40	1,661,489.70
Greater Glasgow and Clyde	3,258,335.19	1,403,993.44	5,570,319.78	10,232,648.41
Highland	110,047.58	60,524.22	196,543.09	367,114.89
Lanarkshire	445,606.24	523,129.25	-	968,735.49
Lothian	1,388,292.56	1,399,650.00	-	2,787,942.56
Orkney	412.58	71.40	403.20	887.18
Shetland	9,815.16	12,015.50	-	21,830.66
Tayside	291,925.94	217,054.08	566,920.42	1,075,900.44
Western Isles	176.57	119.00	-	295.57
Scotland	7,206,365.32	5,454,983.07	7,893,205.89	20,554,554.28

Source: Information Services Division: IR2010-00466.

Notes:

1. Data relates to methadone mixture and solution, 1mg/ml which are recognised as being the standard products for methadone programmes.

2. Total drug cost is the paid Gross Ingredient Cost (GIC).

3. Fees paid for dispensing methadone.

4. Fees paid for the supervision of methadone.

- = zero value.

Table 4: Total Drug Costs and Fees for Methadone Mixture: Items Dispensed in Scotland by NHS Board¹

Dispensing NHS Board Financial year: 2007-08	Gross Ingredient Cost (£)2	Methadone Fees (£)3	Supervision Fees (£)4	Total Cost (£)
Ayrshire and Arran	853,822.25	630,730.28	571,472.40	2,056,024.93
Borders	42,938.27	13,375.44	56,401.08	112,714.79
Dumfries and Galloway	165,454.62	163,507.20	278,866.30	607,828.12
Fife	489,001.80	221,102.00	424,846.08	1,134,949.88
Forth Valley	299,212.89	205,239.65	486,129.85	990,582.39
Grampian	753,978.26	222,001.50	1,124,150.23	2,100,129.99
Greater Glasgow and Clyde	4,202,404.02	1,600,138.46	5,740,005.54	11,542,548.02
Highland	161,204.72	80,443.20	211,443.66	453,091.58
Lanarkshire	563,373.64	515,557.00	-	1,078,930.64
Lothian	1,870,567.91	1,493,739.18	-	3,364,307.09
Orkney	1,101.09	172.20	937.60	2,210.89
Shetland	12,084.79	10,606.75	-	22,691.54
Tayside	420,718.47	209,738.16	663,453.01	1,293,909.64
Western Isles	37.83	10.50	-	48.33
Scotland	9,835,900.56	5,366,361.52	9,557,705.75	24,759,967.83

Source: Information Services Division: IR2010-00466.

Notes:

1. Data relates to methadone mixture and solution, 1mg/ml which are recognised as being the standard products for methadone programmes.

2. Total drug cost is the paid Gross Ingredient Cost (GIC).

3. Fees paid for dispensing methadone.

4. Fees paid for the supervision of methadone.

- =zero value.

Table 5: Total Drug Costs and Fees for Methadone Mixture: Items Dispensed in Scotland by NHS Board¹

Dispensing NHS Board Financial year: 2008-09	Gross Ingredient Cost (£)2	Methadone Fees (£)3	Supervision Fees (£)4	Total Cost (£)
Ayrshire and Arran	970,834.31	471,041.41	952,100.85	2,393,976.57
Borders	55,785.19	10,978.42	74,800.86	141,564.47
Dumfries and Galloway	189,192.63	170,377.04	281,269.06	640,838.73
Fife	664,198.00	190,018.50	611,792.67	1,466,009.17
Forth Valley	325,814.14	210,720.21	527,607.63	1,064,141.98
Grampian	912,384.80	257,855.50	1,214,841.12	2,385,081.42
Greater Glasgow and Clyde	4,441,871.00	1,726,017.10	6,169,470.96	12,337,359.06
Highland	195,240.70	97,652.64	243,506.79	536,400.13
Lanarkshire	638,809.66	570,914.75	-	1,209,724.41
Lothian	2,007,952.46	1,090,313.58	692,069.94	3,790,335.98
Orkney	747.56	130.20	550.40	1,428.16
Shetland	11,574.93	8,772.75	-	20,347.68
Tayside	535,282.50	290,498.40	774,327.84	1,600,108.74
Western Isles	17.47	7.00	-	24.47
Scotland	10,949,705.35	5,095,297.50	11,542,338.12	27,587,340.97

Source: Information Services Division: IR2010-00466.

Notes:

1. Data relates to methadone mixture and solution, 1mg/ml which are recognised as being the standard products for methadone programmes.

2. Total drug cost is the paid Gross Ingredient Cost (GIC).

3. Fees paid for dispensing methadone.

4. Fees paid for the supervision of methadone.

- = zero value.

The Scottish Crime and Drug Enforcement Agency was placed on a legal footing by the Police, Public Order and Criminal Justice (Scotland) Act 2006 and was formally established in April 2007.

The SCDEA does not currently employ any police officers and detailed information on seconded officers was not held centrally from 2001 to 2009. The following information on seconded officers is accurate as of 15 March 2010.

	Deputy CC	Assistant CC	Chief Superintendent	Superintendent	Chief Inspector
Central			1
Dumfries and Galloway
Fife
Grampian				1
Lothian and Borders				1	2
Northern
Strathclyde	1	1	1	2	5
Tayside
British Transport Police

 

	Inspector	Sergeant	Constable	Total
Central	1		4	6
Dumfries and Galloway			7	7
Fife	1	1	6	8
Grampian		4	15	20
Lothian and Borders	2	8	24	37
Northern	1		7	8
Strathclyde	8	22	69	109
Tayside		1	7	8
British Transport Police			1	1

 

 

Total number of seconded officers at SDEA and SCDEA from 2001 to 2010. Numbers taken on 31 March each year, except 15 March for 2010:

Year	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010
Total Secondees	107	130	161	194	200	209	197	207	202	204