CONTEXT

Since the Drug Deaths Taskforce held its first meeting in September 2019 it has been working to draw together the evidence that will enable it to fulfil its task to identify the tailored strategy to tackle the public health crisis in Scotland’s rising Drug-Related Deaths (DRDs).


Whilst the progress of some of this work has been interrupted by the impact of Covid19, the urgency underlying this work has not. The Taskforce now sets out its high-level plan for the first time. It does so for the following reasons:

Forward Plan 2021/22 Cover Download the Forward Plan (PDF: 2MB)
  • The Taskforce is committed to being open and transparent, and seeks to give clarity on the what, how and when it expects its intended actions to positively impact DRD’s, promoting the widest possible understanding of what we are trying to achieve.
  • It seeks to do so in an accessible way through channels such as its website, social media and mainstream media dialogue; whilst the nature of its work often involves experts exchanging in expert language, Drug-Related-Deaths are a national issue affecting all of Scotland and its communities. It must present its intentions accordingly.
  • Scotland faces a unique, multi-faceted challenge, which demands a unique multi-faceted response. It is only right that this should be open to scrutiny, but any benefit we can gain from debate and exchange around this is maximised if this is forward-focussed and informed, fixing on the best form of actions for the future rather than revisiting perceived past failures. Our plan is offered as such.
  • We have reached a critical point in our response to this particular health emergency. We are now working with a full range of public agencies and organisations to establish and rapidly implement best practice across all touchpoints of the issue. A transformation across Scotland is required, and we need the understanding and support from all Scotland to achieve it.

DRUG DEATHS TASKFORCE MISSION AND VISION

The Taskforce was formed to identify and advise on an evidence-based strategy, and its component parts, that can successfully tackle Scotland’s unique challenge. Inherent within this is the need to source the evidence which informs that strategy.

Whilst some of this is provided by the expert volunteers that make up the Taskforce, a programme of commissioning Tests of Change (TOC’s) to provide evidence is now well underway, with these scheduled to provide vital learning over the next 2-3 years. Our plan gives proposed timelines for the collation and consolidation of the evidence together with the broad categorisation or work.

The Taskforce recognises that the nature of the challenge facing us means we cannot simply wait for all evidence to emerge in its complete, collated form; we must seek to save lives as we do so. This means:

  • Supporting TOC’s which have potential to save lives as well as inform future strategy to reduce DRDs
  • Rapid implementation of learning across all relevant agencies whenever these are iden tified as capable of immediate impact – Evidence In Action

At the highest level, Evidence In Action and embracing the dual nature of our mission – Identifying strategy and making every effort to save lives as we do so – are the core of the plan being presented.

The ‘Plan on a Page’ Schematic gives detail on the planned actions and TOC’s around the Taskforce’s six identified strategies including addressing stigma. It also identifies where each action sits in relation to the Taskforce’s high-level areas of focus detailed below.

TIMELINES

The ‘Plan on a Page’ Schematic highlights planned actions between now and the end of 2022, the deadline by which the Taskforce intends to deliver its final report detailing the evidence-based strategy needed to tackle Scotland’s unique challenge.

A key milestone is the delivery of an Interim Report in June 2021 which will detail progress against actions. It is intended to deliver this, so that an incoming government in summer 2021 can consider our proposed next steps as part of any new policy approach to DRDs.

Assuming Government approval on a way forward, the Taskforce will develop a further progress report June 2022 and seek stakeholder feedback.

The final full report will be presented by the end of 2022 when the Taskforce envisages completion of its mission.

STRATEGIC EVIDENCE BASED APPROACH

TASKFORCE PLAN: HIGH LEVEL AREAS OF FOCUS

The previously mentioned six identified strategies themselves can be categorised into the areas of focus this plan will refer to in order to provide clarity on which element in our multi-faceted challenge they address, and when we expect each to impact positively on DRD’s.

The Taskforce recognises that whilst the challenge is complex and unique, at the highest level there are only three ways to prevent lives being lost:

  • Maximising capacity and capability of emergency services, families and friends and agencies to deal with a potentially fatal overdose by being properly equipped and trained.
  •  Maximising the support, access, and range of practical and appropriate choices of pathways for anyone with high risk drug use.
  • Addressing issues that can pre-dispose the vulnerable to move into higher risk use of drugs through relevant key agencies and reducing the associated impact on wider communities.

The three areas of focus above create the three broad categories of Taskforce focus – emergency response, reducing risk, and reducing vulnerability, with associated impact timescales of short-term, medium-term and longer-term respectively.

The three areas of focus extend to the indicators to benchmark the Taskforce’s progress towards its mission and vision. Our approach operates within the context of the Rights, Respect and Recovery framework established by Scottish Government.

DDTF PLAN ON A PAGE

2020

2021

2022

Timeline

DEC

JUNE

JULY

DEC

JUNE

DEC

New DRD Figures for 2019 published

Forward Plan published

Interim Report

Progress identifying strategies

New Govt response to interim report

Progress strategies

Interim Report

Final Report

Recommended Strategy

Implementation guide

Impact on DTFF and DRDs

Three Focus Areas

Emergency Response

Naloxone-Police & Ambulance TOCs

TOCs Naloxone Distribution & training

Pathways - Non-fatal O/D response TOCs

Other Pathways TOCs

Implementation of learnings

Future Pathways

Reducing Risk

MAT Standards Adoption & Implementation

MAT Standards Adoption & Implementation

Consistency of offering across all of Scotland

Development of tests of change for multiple complex needs

Implementation across test sites


Evaluation & shared learning

Reducing Vulnerability

Criminal Justice, Legislation & Practice change consultation

Criminal Justice, Legislation & Practice change consultation

Criminal Justice – Diversion test of approach implementation

Stigma Charter Development & Launch

Stigma Charter Implementation

Public Health Surveillance (Initiation, scoping etc.)

Public Health Surveillance established

INDICATORS AND BENCHMARKS

Plan progress is intended to be monitored as follows:

CATEGORY OF DDTF FOCUS STRATEGIES DDTF ESTIMATED TIMELINE IMPACT POTENTIAL HIGH LEVEL INDICATORS?
EMERGENCY RESPONSE NALOXONE SHORT TERM
  • Reach into at risk population across ADP areas.
  • Number of additional orgs & outlets carrying Naloxone
EMERGENCY RESPONSE Non-fatal O/D Immediate Response Pathways SHORT/MEDIUM TERM
  • Numbers of ADPs with non-fatal OD pathway
  • Cases through tests of change immediate pathways
REDUCING RISK CRIMINAL JUSTICE SHORT/MEDIUM TERM
  • Pathways for people intersecting with the criminal justice system being referred to services
  • People taking up pathfinder services
  • Naloxone distribution to prisoners upon release
REDUCING RISK MEDICATION ASSISTED TREATMENT SHORT/MEDIUM TERM
  • Numbers of people on OST
  • No of ADP’s adopting MAT standards
  • No of ADPs offering treatment choice on drug formularies
REDUCING RISK TARGETING THOSE MOST AT RISK (MCN)
including multiple complex needs
MEDIUM/LONG
  • Social Care review takes account of needs of PWUD
  • Outcomes from individual MCN Tests of Change e.g. Measures of co-morbidity, mental health, quality of life, recovery, treatment satisfaction
  • Awareness in ADP’s of MCN dimension
REDUCING VULNERABILITY STIGMA STRATEGY LONG
  • Stigma strategy recommendations adopted including Scottish Govt response
  • Adoption of Stigma Charter across a range of Scottish public organisations
  • Surveys of stakeholders – awareness/action on Stigma
REDUCING VULNERABILITY Drug law reform (part of Criminal Justice strategy) LONG
  • Published recommendations
  • Greater public discussion/debate
ALL OPTIMISING PUBLIC HEALTH SURVEILLANCE MEDIUM/LONG
  • Multi-agency progress towards plan

FUNDING & FURTHER TESTS OF CHANGE (TOCs)

This website contains detail on Taskforce funding , together with detail on TOC’s which have been approved for funding to date, and an explanation of the selection process by which future TOC’s will be chosen in future funding years.  A list of current funded initiatives is provided in the appendix.

NEXT STEPS

  • Preparation of reports as per Plan timelines
  • Indicators and benchmarks to populate Taskforce website as they become available
  • Further TOC’s commissioned, evidenced, Evidence In Action as per high level strategy
  • Publication of reports as per plan timelines

APPENDIX ONE: SPECIFIC WORK BEING UNDERTAKEN

The Taskforce has supported a wide range of projects and tests of change. These projects are ongoing and are required to provide regular feedback to the Taskforce as well as a final report.

Last Updated: 11 December 2020