Annex A - Partnership Delivery Framework To Reduce The Use of and Harm From Alcohol and Drugs
1. This document sets out the partnership arrangements needed to reduce the use of and harms from alcohol and drugs. It aims to ensure that all bodies involved are clear about the accountability arrangements and their responsibilities when working together in the identification, pursuit and achievement of agreed, shared outcomes.
2. The new framework is designed to be consistent with, and to build directly upon:
- The Scottish Government's Purpose and National Performance Framework;
- The high-level commitment between Ministers and CoSLA to work together in partnership;
- The established performance management arrangements between the Scottish Government and NHS Boards;
- Statutory duties for community planning, built around a purpose that local public services work together and with community bodies to improve outcomes and tackle inequalities;
- The Public Health Reform Programme, jointly led by Scottish Government and CoSLA, which aims to reduce health inequalities and improve life expectancy across the Scottish population. This includes the Public Health Priority:
Reduce the use of and harm from alcohol and drugs;
- Scotland's alcohol and drug strategy, Rights Respect Recovery and the Alcohol Framework 2018;
3. This Partnership Delivery Framework replaces three previously agreed memoranda of understanding (MoU) between the Scottish Government and CoSLA:
- A New Framework for Local Partnerships for Alcohol and Drugs (2009)
- Supporting the Development of Scotland's Alcohol and Drug Workforce (2010)
- Updated Guidance for Alcohol and Drug Partnerships on Planning and Reporting Arrangements 2015-18 (2014)
4. The Scottish Government and CoSLA undertake, and invite community
planning partners, to operate within the terms of this framework.
5. Much has been achieved to prevent and reduce the harms experienced by individuals, families and communities and support people in their recovery. However Scotland continues to experience significantly higher levels of harm and health inequalities than other parts of the UK and Europe. This is recognised in the Public Health Reform Programme which identified 'Priority 4: A Scotland where we reduce the use of and harm from alcohol, tobacco and other drugs', as one of the key Public Health Priorities for the country over the next decade.
Public Health Reform recognises that this will require a focus on prevention and reducing inequalities and is best delivered by adopting a whole system approach.
6. In 2018 the Scottish Government published two strategic documents to address alcohol and drug harms:
These documents set out a series of outcomes and priority actions for Scotland, supporting the delivery of the Public Health Priorities. This is summarised in the table below:
Rights, Respect and Recovery sets out the context for a Human Rights based approach. This requires 'rights bearers' and 'duty holders' work together to ensure that people's human rights are recognised and met. In the context of this strategy this means that people with experience of problem alcohol and drug use as well as those who are affected need to work with those involved in the planning, development and delivery of services to deliver shared outcomes.
7. The Audit Scotland Report, Alcohol and Drug Services – An update identifies six areas where progress will help the successful implementation of the strategy:
- Effective performance monitoring
- Clear actions and timescales
- Clear costings
- Spending and outcomes linked
- Public performance reporting
- Evaluating harm reduction programmes
The Partnership Delivery Framework
8. Alcohol and Drug Partnerships (ADPs) will continue to lead the development and delivery of a local comprehensive and evidence based strategy to deliver local outcomes. This should be achieved through applying a whole system approach to deliver sustainable change for the health and wellbeing of local populations.
9. Since 2009 the local delivery landscape has changed significantly. This includes the introduction of Community Justice Partnerships to replace Community Justice Authorities, and Integration Authorities have been created as a new public body to oversee the integration of health and social care services, including adult alcohol and drug services. The statutory requirements of key local partnerships and organisations in relation to strategic planning and annual reporting are summarised in Appendix 1.
10. The partnership delivery framework should include the following key features:
- A clear and collective understanding of the local system in particular its impact, how it is experienced by local communities, and how effectively it ensures human rights are met.
- Informed by the above, a locally agreed strategic plan, which sets out the long term measureable outcomes and priority actions for the local area, focussing on preventing and reducing the use of and harm from alcohol and drug use and the associated health inequalities.
- People with experience of problem alcohol/drug use and those affected are involved in the planning, development and delivery of services. This will require a shared understanding of the roles of duty holders and duty bearers in the context of a human rights based approach.
- A quality improvement approach to service planning and delivery is in place.
- Clear governance and oversight arrangements are in place which enable timely and effective decision making about service planning and delivery; and enable accountability to local communities.
- A recognition of the role played by the third sector and arrangements which ensure their involvement in the planning, development and delivery of services alongside their public sector partners.
11. Each ADP should publish agreed, measureable outcomes and priority actions to reduce the use of and harms from alcohol and drugs within a strategic plan. ADPs should use the outcomes and priority actions set out in Rights, Respect and Recovery and the Alcohol Framework 2018, as well as the associated monitoring and evaluation plans, to support the development of their local strategy.
12. Through the development and delivery of the local strategy the ADP should identify where there are shared outcomes and priorities with other local strategic partnerships. In these cases they should develop shared arrangements to support delivery. As a result minimum agreement to the strategic plan and arrangements for delivering should to come from:
- Community Justice Partnership
- Children's Partnership
- Integration Authority;
The relevant statutory requirements for the local strategic plans and reporting arrangements are set out in Appendix 1.
13. Community planning requires local public sector bodies to work together with community bodies, to improve outcomes on themes they determine are local priorities for collective action. Where reducing the use of and harms from alcohol and drugs feature in these priorities, local Community Planning partners should consider how co-operation with Alcohol and Drug Partnerships can support delivery.
14. The identification of priorities and delivery of strategic plans should be underpinned by needs assessment and action plans.
15. Public money must be used to maximum benefit to deliver outcomes for the local population. Investment in the delivery of outcomes will come from a range of sources, including the Local Authority, Health Board and the Integration Authority, as well as outside of the public sector. Effective and transparent governance arrangements must be in place to invest in partnership to deliver the shared outcomes and priority actions in the strategy. Financial arrangements should enable the ADP to:
- Establish a shared understanding of the total investment of resources in prevention of harm and reducing inequalities from alcohol and drugs across the local system.
- Make effective decisions to invest in the delivery of these outcomes.
- Ensure there is scrutiny over investments in third sector and public sector to deliver outcomes.
- Report to local governance structures on investment
- Report to the Scottish Government on specific alcohol and drug funding allocated to Health Boards for onward delegation to Integration authorities; and in line with financial reporting arrangements agreed with Integration Authorities.
16. The Scottish Government will work with local areas to develop an approach to quality improvement based on self-assessment and peer review. This approach will cover the breadth of Rights, Respect and Recovery, the Alcohol Framework 2018; it will apply to governance, investment plans, strategic planning and service delivery. These improvement arrangements need to complement the existing inspection frameworks applied to local areas.
17. The monitoring and evaluation plans for Rights, Respect and Recovery and the Alcohol Framework 2018 will enable the Scottish Government to identify progress in delivering the strategy as well as impact. The plans will identify national performance benchmarks which will identify progress at both the national and local level. This will be published on a regular basis and will inform the focus for quality improvement work.
Governance and oversight
18. Governance and oversight arrangements for the delivery of the strategic plan and the investment of resources needs to be consistent with local governance arrangements to meet other relevant local outcomes. In practice this means that the following members of the ADP will need to ensure that effective oversight arrangements are in place to deliver the local strategy:
- The Local Authority
- Police Scotland
- NHS Board
- Integration Authority
- Scottish Prison Service (where there is a prison within the geographical area)
- The third sector
- Community members
The relationship between the ADP and the Integration Authority
19. Alcohol and drug services are included within the Integration Authority scheme of delegation, alongside other adult health and social care services. Governance and oversight arrangements are needed which ensure that the directions issued by the Integration Authority to the NHS and Local Authority support the delivery of outcomes identified in the local strategic plan. Commissioning and Planning Guidance for Integration Authorities sets out the required membership of the Strategic Planning Groups in this context.
20. ADPs will need to provide relevant performance and financial reporting to enable support the development of the Integration Authority's Annual Performance Report.
21. Healthcare services for people in prison are also included within Integration Authority scheme of delegation. Local strategic plans will need to include plans to improve outcomes for people in prisons sited within the local area; this includes considerations about the means by which people entering and leaving prison are able to access the right support.