Chamber and committees

On completion the Drug and Alcohol Intervention Service (DAISy) tool will have taken three years and six months to be developed The business case for the DAISy was approved by the Scottish Government and Information Services Division (now Public Health Scotland) in May 2016. The DAISy tool will be completed and implemented from 1 st December 2020.

The tool will collect a range of data on people who access treatment and recovery services, including demographic data, trends in relation to drug and alcohol use as well as service performance and individual outcomes. This will enable local areas to better understand the needs of people who access their services as well as the impact these services and improve responses accordingly.

Information on DAISy is available on the Public Health Scotland website https://www.isdscotland.org/Health-Topics/Drugs-and-Alcohol-Misuse/Drug-Alcohol-Information-System/

There is no research available which directly links funding for services as a causative factor in the rate of drug-related deaths. The reasons behind the rising number of drug-related deaths are complex and many-fold; the reasons being reflective of Scotland’s unique challenge when it comes to tackling problematic drug use. This is recognised by the work of the Drug Deaths Taskforce which draws its membership from a wide range of areas, sectors and expertise – including people with lived and living experience. The Taskforce has identified a range of initiatives to directly tackle drug deaths and is supporting a range of innovative programmes and research.

The Drug Deaths Taskforce (DDTF) published a report of its first years activity on 31 July (a copy can be accessed here - https://drugdeathstaskforce.scot/news-information/publications/reports/scottish-drug-deaths-taskforce-one-year-report/ ). This summarises it’s work to date and provides information on the specific areas it has focussed on.

Reducing drug related deaths and drug related harm is a priority of this government, however, we know that this is a long term objective and that actions taken now will take time to impact on the numbers of deaths. However, the DDTF identified six evidence based strategies to reduce levels of drug related deaths and this is where it has focussed its energies in its first year. These include such things as the targeted distribution of naloxone, optimising the use of medication-assisted treatment and the need for an immediate response pathway for non-fatal overdose. More information on these 6 strategies can be found here - https://drugdeathstaskforce.scot/our-work/ .

The DDTF is continuing to take action on these six strategies and is providing financial support to Scotland’s Alcohol and Drug Partnerships to do the same, as well as funding a range of innovative projects which will also have these strategies at their core (more information available here - https://drugdeathstaskforce.scot/about-the-taskforce/funding/ ).

The definition of an ageing cohort in relation to substance use, and in particular the identification of that ageing cohort starting at the age of 35, came from the report published by the Scottish Drugs Forum in June 2017 ( http://www.sdf.org.uk/wp-content/uploads/2017/06/Working-group-report-OPDPs-in-2017.pdf ).

That report states that ‘The challenges of responding to needs of older people with a drug problem (OPDP), defined in this report as over the age of 35, are significant and will increase considerably over the coming years. Among people with drug problems, those aged over 35 will become the main client group in specialist services for the foreseeable future.’ It goes on to say ‘over half of those with drug problems in Scotland are now aged 35 years or over and face ageing much sooner than the general population in terms of both morbidity and life expectancy. Drug use and social deprivation have led to older drug users having health problems generally associated with people in the general population who are fifteen years older (Vogt, 2009)’.

There are no other areas of healthcare where a person is considered to be part of an ageing cohort at age 35 but the information above sets out why this age has been used in relation to substance use.

Following the announcement of the national lockdown in Scotland in March 2020 all dental care in high street settings ceased, with treatment transferring to within the Urgent Dental Care Centres in each NHS Board area for the most urgent cases. Since that time we have implemented a phased return of NHS dental services to ensure that appropriate protections are in place for patients, practitioners and public health. It is the case that all dentists, whether they carry out NHS work or work privately, are subject to the same requirements to control the spread of coronavirus. The Health Protection (Coronavirus) (Restrictions and Requirements) (Scotland) Regulations 2020 require all healthcare providers to take all reasonable measures to ensure safe practice in the controlled environment in which they are currently operating.

The return of the full range of NHS dental treatments from 01 November is being safely delivered through the provision of PPE to NHS dental contractors and is supported by the clinical evidence and guidance. This will ensure that NHS dental patients in Scotland will have access to NHS treatment in the first instance. However, this is not a return to pre-COVID levels of patient volumes and when seeking an appointment patients should expect to be prioritised within the dental practice on their oral health needs.

There is a wide range of data and research that analyse the impact of opioid substitution treatment on individuals. Much of this information shows that OST is an important treatment with a strong evidence base.

The use of OST as a treatment is in-line with the current ‘UK Guidelines on the Clinical Management of Drug Misuse and Dependence’ and the ‘Advisory Council on the Misuse of Drugs’ who state that methadone can be a very helpful part of treatment and recovery for heroin dependence. Its use was also reviewed by a Scottish Independent Group in 2013 who found that it remained an effective treatment and should remain as a significant element of the treatment options available.

The Drug Death Taskforce Medication Assisted Treatment sub-group is taking forward work that will define national standards for the consistent delivery of medication assisted treatment (which includes OST) in Scotland, and to help partners achieve it through a quality improvement approach. This work also involves establishing measures of success for people who use MAT.

To date the Drug Deaths Taskforce (DDTF) has allocated funding to a number of organisations, information on this can be found here - https://drugdeathstaskforce.scot/about-the-taskforce/funding/ .

This includes £1 million which was allocated through a call for research proposals to contribute to the evidence base on interventions to reduce drug-related deaths and overdose, the experience of people who are most at risk and the services which support them. In addition, a further £3 million was allocated to Scotland’s Alcohol and Drug Partnerships to allow them to address gaps in delivering the six evidence-based strategies for reducing drug related deaths set out by the DDTF.

Further work is ongoing through the Innovation and National Developments Funding Programme (a funding programme set up by the DDTF and administered on its behalf by the Corra Foundation) to allocate £5 million in 2020/21 to projects which would allow for testing of innovative or immediate responses to reduce drug related deaths. More information will be added to the DDTF website on this as allocations are made to successful applicants.

Further finding has also been allocated through the DDTF to the Scottish Ambulance Service (SAS) and to Police Scotland, both of which are progressing plans around naloxone. SAS are rolling out a national programme of naloxone distribution following non-fatal overdoses, while Police Scotland are developing a pilot around police carriage of naloxone. More information on both of these projects will be published in the next month.

Public Health Scotland have also received funding for specific posts which have been allocated to support the work of the DDTF and its sub-groups (specifically the Public Health Surveillance group, the Medication Assisted Treatment group and the Multiple Complex Needs group).

John Swinney; The Scottish Government’s approach to using testing alongside other measures to suppress COVID-19 outbreaks is set out in Scotland’s Strategic Framework, published on 23 October and available at https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/ . This approach is informed by the clinical and scientific review of our testing strategy, also published on 23 October and available at https://www.gov.scot/news/clinical-and-scientific-review-of-testing/ .

Testing is available to anyone who has symptoms of COVID-19, including school children and the education workforce. Testing is also available for asymptomatic staff in schools and early learning settings who are concerned they have been exposed to the risk of infection. In addition, Public Health Scotland have recently commenced recruitment of a sample of school staff who will undertake antibody tests as part of the enhanced Covid-19 surveillance being carried out within schools.

There are no plans to introduce temperature checks in schools at the current time. As referenced in S5W-32464 on 30 October 2020, there is not enough evidence to support the use of Infrared Thermal Imaging devices to detect potential COVID-19 cases. Employing it, even as a visible sign of caution to promote public confidence, could lead to over-confidence and reduction of compliance with other measures. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx .

The Scottish Intensive Care Society Audit Group (SICSAG) is part of the Scottish National Audit Programme (SNAP) within Public Health Scotland (PHS) and has the aim to improve the quality of care delivered to critical care patients in Scotland by monitoring and comparing activities and outcomes across Scottish critical care units.

The SICSAG database held within PHS focusses on patient information, and, therefore, this resource does not include data which would allow the monitoring of the number of empty beds within each unit. We do not therefore have the information to answer the PQ.

As part of the COVID response, NHS Boards worked to put in place the surge capacity to double and triple ICU capacity should it have been required.

In their June 2020 report, SICSAG said that the baseline capacity for the most complex level of ICU care (level 3 care) was exceeded from 31 March 2020 to 24 April 2020. This activity peaked at 46% above baseline on 09 April 2020.

URL: https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/scottish-intensive-care-society-audit-group-report-on-covid-19/3-june-2020/