Chamber and committees

In Scotland the responsibility for the planning, designing and commissioning of alcohol and drug services is delegated to Integration Authorities. Integration Authorities issue directions to NHS Boards and Local Authorities as providers and purchasers of alcohol and drug services setting out the intention and required delivery of the function, financial resource attached and the intended outcome. Directions should specify in some detail what the Health Board, the Local Authority or both are to do in relation to carrying out a particular function to deliver services. The Integration Authority is required to review the delivery of directions as a part of its approach to performance management, scrutiny and audit. Further information is available here https://www.gov.scot/publications/statutory-guidance-directions-integration-authorities-health-boards-local-authorities/#:~:text=Directions%20should%20include%20detail%20on%20the%20required%20delivery,in%20the%20same%20report%2C%20using%20a%20standard%20format.

NHS Boards and Local Authorities can also act as purchasers of services and hold legally binding contracts with third sector providers of alcohol and services. These contracts enable these public sector organisations to hold third sector services to account and include expectations over governance as well as measures or targets relating to performance and outcome delivery.

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.

2020-21 funding from the Drug Deaths Taskforce was allocated through 3 methods:

• £3 million was allocated to Scotland’s Alcohol and Drug Partnerships;
• £5 million was allocated to the DDTF and its sub-groups for an Innovation and National Developments funding programme; and
• £1 million was allocated to a specific research programme.

Of the organisations represented on the Drug Deaths Taskforce, those who have received support in terms of funding allocated to the Taskforce are as follows:

• Borders Alcohol and Drugs Partnership
• Police Scotland
• Scottish Ambulance Service
• Turning Point Scotland
• University of Stirling

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.

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/ ).

We have invested around £895 million in services to tackle alcohol and drug use since 2008. The total financial resource is higher than Scottish Government funding and includes contributions from NHS and other statutory partners.

Details of funding to NHS Boards can be found https://www.gov.scot/publications/alcohol-and-drug-partnerships-funding-allocations/

Annual information on unplanned discharges from drug treatment is published by Public Health Scotland. The most recent publication is available here https://beta.isdscotland.org/media/3879/2020-03-03-sdmd-tables.xlsx .

Equivalent information on unplanned discharges from alcohol treatment is not available. This will be collected on the DAISy system which will start to go live from 1 December 2020, and so this information will be available for future years.

At present NHS Boards, including NHS Lothian, have sufficient acute capacity to meet the current demand from COVID-19 patients.

Following these assessments, at present the NHS Louisa Jordan is not required to support high dependency level care, as the NHS in Scotland has been equipped to quadruple ICU capacity if necessary.

However, should the NHS Louisa Jordan be required, the facility stands ready to support management of any additional demand COVID-19 presents to hospital capacity. This support will be for patients who are in a stable condition.

The Scottish Government will continue to work closely with health boards to ensure they have robust plans in place to deal with a range of pressures on capacity in the coming weeks and months, including COVID-19.

Since the start of the pandemic our priority has been to save lives and we have always placed the upholding of human rights at the heart of our approach.

COVID-19 presents an unprecedented public health challenge and the actions we have taken in responding to that challenge have been, and continue to be, carefully monitored to ensure that they are fully compliant with the European Convention on Human Rights (ECHR) and with the wider international human rights obligations.

However, we recognise the challenges faced by many older people during the pandemic and have worked hard to ensure they are supported. We have provided a range of support including the national helpline and the £350 million funding package to support communities affected by the pandemic.

The Scottish Ambulance Service does not have a ratings score system.

The decision to admit patients to hospital is made by either the Emergency Department or Primary Care, not the ambulance service.

In terms of categorisation of calls, these have not changed during 2020.