Publication - Minutes

Drug Deaths Taskforce meeting: January 2020

Published: 11 Mar 2020
Date of meeting: 15 Jan 2020
Location: The Cairn Centre,2 Rattray Street, Dundee DD1 1NA

Minutes and supporting papers from the second meeting of the taskforce, held on 15 January 2020.

Published:
11 Mar 2020
Drug Deaths Taskforce meeting: January 2020

Attendees and apologies

Taskforce members:

  • Prof. Catriona Matheson (Chair), University of Stirling
  • Neil Richardson (Vice Chair), Turning Point Scotland
  • Dr Catherine Calderwood, Chief Medical Officer for Scotland
  • Iona Colvin, Chief Social Work Adviser
  • Fiona Doig, Boarders ADP and Health Improvement
  • Dr Ahmed Khan, Royal College of Psychiatrists
  • Jean B. Logan, Royal Pharmaceutical Society of Great Britain (Scotland)
  • Phil Mackie, Scottish Public Health Network
  • Dr Duncan McCormick, Public Health Medicine  
  • Karyn McCluskey, Community Justice Scotland 
  • Anthony McGeehan, Crown Office and Procurator Fiscal Service
  • Susanne Millar, Glasgow City Health and Social Care Partnership
  • Dr Tessa Parkes, Drugs Research Network Scotland
  • Dr Robert Peat, Dundee Drugs Commission
  • Allan Houston, Lived/Living Experience Representative  
  • Cameron Stewart, Scottish Courts and Tribunal Services 
  • Richard Watson, Recovery Community Lived Experience Representative
  • Rebecca Wood, Lived/Living Experience Representative 

Attendees: 

  • Caroline Butler, Families Lived Experience Representative  
  • Michael Crook, Scottish Government: Drug Death and Harm Prevention 
  • Julie da Costa, Scottish Government: Drug Death and Harm Prevention
  • Frank Dixon, National Records Scotland  
  • William Doyle, Scottish Government: Drug Law and Health Harm
  • CS David Duncan, Police Scotland
  • Andy Parker, Scottish Ambulance Service 
  • Joe FitzPatrick MSP, Minister for Public Health, Sport and Wellbeing
  • Orlando Heijmer-Mason, Scottish Government: Health and Justice Collaboration 
  • Kirsten Horsburgh, Scottish Drugs Forum 
  • Millie Lewis, Scottish Government: Drug Law and Health Harm
  • Suzi Mair, Scottish Government: Communications Division: News 
  • PI Claire Miller, Police Scotland 
  • Justina Murray, Scottish Families Affected by Drugs and Alcohol
  • Maggie Page, Scottish Government: Analytical Services
  • Liz Sadler, Scottish Government: DD Health Improvement Division 
  • Jardine Simpson, Scottish Recovery Consortium 
  • Nick Smith, Scottish Government: Alcohol and Drug National Support Team 

Apologies:

  • Adam Coldwells, Aberdeenshire’s Health and Social Care Partnership
  • Beverley Francis, Scottish Government: Drug Law and Health Harm
  • Paul Gowan, Scottish Ambulance Service
  • Hannah Snow, Lived/Living Experience Representative 
  • Carey Lunan, Royal College General Practitioners in Scotland
  • ACC Gary Ritchie, Police Scotland
  • Cameron Stewart, Scottish Courts and Tribunal Services
  • David Williams, Glasgow City Health and Social Care Partnership  
  • Colin Hutcheon, Families Lived Experience Representative
  • Lesley McDowall, Scottish Prison Service 
  • John Wood, Convention of Scottish Local Authorities 

Items and actions

Introduction

The Chair welcomed members to the third meeting of the Taskforce, noting the importance of Dundee for the work of the group.

The minutes from the last meeting were accepted and Michael read out the actions from the last meeting and updated the group on the progress of each one. 

In discussion, the following points were made: 

  • with reference to the Taskforce’s commitment to use ‘People First’ language, it was reinforced that members should implement this in their organisations
  • in relation to the update on the position of the University of Glasgow’s toxicology service, the Crown Office and Procurator Fiscal Service reported on the delay in reporting. COPFS have allocated £300,000 to assist in clearing the backlog and to allow for increased staffing and external resources to help minimise delays. There is not yet a timeline for the improvement plan but the need to address the backlog as soon as possible was reinforced
  • Glasgow City Health and Social Care Partnership reported an additional bid by the Glasgow City Alcohol and Drug Partnership to provide the University of Glasgow with specialist equipment to help minimise the delay to toxicology reporting
  • in relation to the Taskforce’s blog page, it was noted that the secretariat should notify the author if a comment is received on their post to allow for a timely response

Actions:

  • further to the request that Taskforce members implement ‘People First’ language in their organisations, Fiona had agreed to speak with anyone who was looking for advice about how to go about this
  • the Taskforce members to report on what progress has been made in their individual organisations to tackle stigma and use ‘People First’ language, including the challenges to the uptake
  • Scottish Government secretariat to notify blog authors on any comments they receive on their posts 

Round table updates

David Duncan provided the Taskforce with an update on new approaches Police Scotland are taking to drugs, including the implementation of a new ‘Drugs Strategy’. The Police Scotland Short Life Working Group on naloxone has provided a paper, setting out a proposed pilot in the West of Scotland for officers to carry naloxone, to the Chief Constable, however there remain concerns within Police Scotland about all officers carrying naloxone. A decision will be made at the Leadership Board at the end of the month (January).

Tessa provided an update on the current thinking and actions regarding a proposal for a nationally supported, city-based, drug checking project in Dundee. She noted that the work on this scheme is ongoing and the next stage will be to devise, and cost, a model which local partners are supportive of. Tessa mentioned a paper which she has developed and which can be shared amongst the group for more information. David Duncan agreed to feedback to Gary Ritchie on this work and agreed the need for Police Scotland to work with Tessa as this develops. It was also agreed that Anthony will meet with Tessa to consider how the Crown can be involved in this work from an early stage.

Andy Parker (on behalf of Paul Gowan), provided an update on the development of an ambulance naloxone pilot in a paramedic response unit team in Springburn. The Scottish Ambulance Service are in the process of procuring naloxone and completing paramedic training with Scottish Drugs Forum. 

Michael fed back to the Taskforce on the progress of plans for a drugs summit in Glasgow in March. The Home Office have been invited to engage and the summit will showcase innovative responses to drugs deaths from across the UK. 

Catriona, and Neil fed back to the Taskforce a proposal to develop an out-of-hours service to provide wrap-around service at the point of crisis. The Taskforce supported the proposals but acknowledged that further refinement was necessary. This will take place out with the main meetings and a smaller group can examine the revised proposal.

In discussion, the following points were made: 

  • in relation to the proposal for an out-of-hours service, there was a need to ensure individuals are re-integrated into the health and social care system as well as gaining out-of-hours support
  • out-of-hours proposals need to be linked to assertive outreach and extend beyond the four cities

Actions:

  • Secretariat to circulate Tessa’s paper on scoping a drug checking project
  • David Duncan to discuss drug checking work with Gary Ritchie
  • Tessa to meet with Police Scotland, COPFS and Anthony to discuss Crown involvement in drug checking work
  • Neil will work with the Frontline Workers group to update the proposal and bring it back to a sub-group of the Taskforce for final signoff

Dundee Drugs Commission – recommendations and implementation

Robert introduced Andrew Fraser and Andy Perkins who presented on ‘How the Taskforce could assist in implementing the recommendations of the Dundee Drugs Commission’. The presentation included a number of national considerations developed by the commission for the Taskforce to review. 

Simon Little (Independent Chair, Dundee Alcohol and Drug Partnership) presented on the changes the ADP has made in response to the commission’s recommendations. This included the work done to agree an action plan and also develop a test of change around non-fatal overdoses taking a multi-agency approach. 

Dianne McCullough (Chief Social Work Officer, Dundee City Integration Joint Board) presented on ongoing work around same-day prescribing. She noted the importance of the role of General Practitioners in addiction support and proactive engagement with primary care.

David Barrie (Addaction) presented on the developments in multi-agency locality working in Dundee, in particular the implementation of a hub model in areas of most need. 

Karen Melville provided an update to the group on a multi-agency public health modelling test of change in operation in Dundee to address non-fatal overdoses (NFOs) and provide support to those individuals. She flagged how previously it could take up to eight weeks for information to make its way to those services who could act on it. There is now a daily phone call, involving members of key agencies, to provide rapid assertive outreach responses to non-fatal overdose victims, they have set a standard of 72 hours for this group to meet and for contact to be made with the individual. In the first six weeks they received details of 92 NFOs.

Dr Emma Fletcher (Chair, Tayside Drugs Deaths Review Group) presented on the need to make strategic changes and identify emerging trends to tackle rising drug related deaths. 

In discussion, the following points were raised: 

  • the Crown Office and Procurator Fiscal Service provided an update to the Commission and Partnership members on the delays in the University of Glasgow’s toxicology reporting
  • the possibility of work surrounding anticipatory care and non-fatal overdose responses working in collaboration
  • the children and families work stream of the Dundee Alcohol and Drug Partnership
  • the links between mental health and substance use. The integration of services was identified as an area for improvement, in particular the integration of health and social work

Sub group updates

Neil Richardson fed back to the Taskforce on the progress of the criminal justice and the law sub group. The group has produced a process map of the pathway of a 5(2) possession case and identified two tests of change which will be developed further. The groups remit has expanded to include through care and work on this area is ongoing. 

Duncan reported on the progress of the medicated assisted treatment group (MAT). The group has produced service standards for MAT which focuses on same day treatment and sustainable case-load management. These standards are currently being discussed with clinicians and nurses as part of a consultation exercise being led by Tracey Clusker and Joe Tay, so far they have visited seven areas with more forthcoming.

Phil updated the Taskforce on the progress of the public health surveillance sub group (PHS). The group has immediate objectives to scope what a public health network would look like, taking on learning from Dundee, and long term goals on how to resource a surveillance system. 

Robert fed back to the Taskforce on the progress of the multiple complex needs sub group. The group’s initial work stream is examining what recommendations have been made for people with multiple complex needs and if they are being implemented by services.

In discussion, the following points were made: 

  • in relation to Neil Richardson’s update, there was a discussion surrounding connections with the work stream on through care and the ongoing work of the Health and Social Care in Prisons Programme
  • the necessity of a workforce sub group was discussed in relation to Duncan’s update. It was noted that responsibility for this issue should not fall to one of the sub groups, but should be dealt with independently by the Taskforce. Catriona suggested that workforce development is beyond the remit of the Taskforce and made a recommendation to Scottish Government that a workforce review was required
  • the need for achievable measures was discussed in relation to the update of the MAT sub group. The current measure were seen as misleading and there is a need to consider wider use of electronic reporting systems

Actions: 

  • Taskforce members to send feedback on MAT standards to Scottish government secretariat
  • the Taskforce will formally ask the Scottish Government to undertake a workforce review of drug and alcohol services

Taskforce admin

Catriona presented an evidence-based strategic document to the Taskforce which outlines the six key strategies which are central responses to the drug deaths crisis. The document will be used to focus the group on the aim of reducing drug-related deaths and outlines what strategies the Taskforce expects integration authorities and ADPs to consider implementing. 

Catriona outlined the financial planning for the Taskforce. It is expected that sub groups, and outside parties will have proposals for funding. Criteria for funding is in development and will be shared with members for agreement. 

Finally, Catriona noted the need for pro-active communications planning for the Taskforce. There should be a platform to share the good work that has been going on as part of the Taskforce. 

In discussion, the following points were made: 

  • in relation to the strategic document, the integration authorities and ADPs can be acting now in local areas to implement the recommended strategies

Action:

  • Scottish Government secretariat to circulate draft criteria for funding

Drug deaths statistics 

Catriona introduced Frank Dixon (National Records Scotland) and Maggie Page to present on the annual National Records of Scotland statistics of drug-related deaths. The presentation focused on how the statistics are produced and how delays to toxicology reporting impacts NRS’s ability to publish these statistics on time.

In discussion, the following points were made: 

  • the robustness of the data in relation to improved case ascertainment. It was determined that the increase in figures is so great that is cannot result from improvements in the way doctors state the cause of death
  • the support which the Taskforce could provide to National Records of Scotland. It was noted that the Taskforce should be open and recognise the reality of the figures

Any other business and date of next meeting

The Chair concluded the meeting and confirmed the date for the next meeting is 19th March 2020 in Kilmarnock.