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The Scottish Government published Quality Standards for Paediatric Audiology Services (2009) and Quality Standards for Adult Hearing Rehabilitation Services (2009) which both state that patients (and their families in the case of children) should be given a copy of their ‘Individual Management Plan’ following visits to services.

It is for Health Boards to ensure that this takes place in line with the quality standards set out.

The range of experts that have been involved in the Best Start and the Options Appraisal Process represent the leading expertise on this issue and are fully competent to reach an objective decision. I have no doubt that the process of determining where the final three units should be located was independent and robust, and can see no reason to commission a further review.

The Early Interventions for Children and Young People working group are currently developing recommendations of what good quality early intervention support services should be available across Scotland for young people with emerging problematic drug and alcohol use.

In Spring 2023, the working group began engaging with young people, using a co-design approach, to gather their views of what good support should look like. These findings, along with existing international evidence of good practice will be used by the working group to develop standards of support for children and young people.

The co-design work will conclude in January 2024.

The working group will then outline the minimum principles of support that is required by local areas to meet the needs of children and young people, providing early intervention support in a way young people want.

Scottish Government has outlined the importance of a person-centred approach to treatment in it’s alcohol and drug treatment strategy, Rights, Respect, Recovery . By developing recovery oriented systems of care and creating services that are trauma informed, the root causes of problematic alcohol and/or drug use can be identified and supported.

We recognise the many drivers behind problematic use of drugs and alcohol, and the importance of working together to address the underlying causes, providing support to those affected to live full and healthy lives.

We are tackling this by ensuring a holistic approach and strengthening links between work on poverty, structural inequality, education, children and young people and work on alcohol and drug policy.

Over the period 2019 to 2021, all UK nations saw an increase in the number of alcohol-specific deaths. The increase for the whole of the UK over this period was 27.4% with the increase for Scotland being 22.1%. The Office for National Statistics (ONS) suggests, on their website, that the impact of restrictions related to COVID-19 may be a factor in the increase in alcohol-specific deaths seen across the UK.

The Scottish Government has a range of alcohol harm prevention and treatment policies and interventions intended to reduce harm. Recent research estimated our world-leading Minimum Unit Pricing (MUP) policy has saved hundreds of lives, and likely averted hundreds of alcohol-attributable hospital admissions each year and is having an effect in our most deprived areas. We are currently consulting on the Scottish Government’s preferred position on MUP which is a continuation of the policy and, in the event of continuation, at a price of 65 pence per unit of alcohol. On support and treatment, in 2022-23, we made £106.8 million available to Alcohol and Drugs Partnerships to support local and national treatment initiatives. We have been involved in a UK-wide group on reviewing and updating clinical guidance for alcohol treatment, which is now out for consultation . We are exploring the evidence around Managed Alcohol Programmes, and we are undertaking a review of the Alcohol Brief Intervention programme to ensure the programme is as impactful as possible in Scotland.

Scottish Government supports the use of digital solutions to overcome barriers to treatment for those impacted by problematic use of alcohol, such as the use of Near Me video appointments and With You’s online wechat service. However, we recognise these must be applied appropriately, with adequate training for staff and ensuring online safety and safeguarding for service users.

The recently published consultation on United Kingdom alcohol treatment guidelines which are expected to come into effect in 2024, highlight the need to consider digital practices and implement them carefully. The consultation will run until 8 December 2023: UK clinical guidelines for alcohol treatment - GOV.UK (www.gov.uk) .

We are aware that stigma can act as a barrier preventing people from seeking treatment. This is why we are taking actions to reduce the stigma around alcohol misuse.

For example, last year we ran a national campaign to increase people’s awareness that a drug or alcohol problem is a health condition, which requires help and support and not judgement. We also referenced stigma on the NHS Inform website , which reinforces the message that a drug or alcohol problem is a health condition requiring help.

In addition, we published a cross-government Stigma Action Plan , aimed at tackling the stigma of substance use. We are working with a range of partners and stakeholders to co-design the next phase on the details of the actions outlined in the plan.

We also welcome the ‘See Beyond, see the lives’ campaign , which recognises the importance of supporting the families of people with problem substance use, who are often stigmatised and excluded from support, despite experiencing harms in their own right. In delivering the actions in our stigma action plan we will work with families to ensure that we can tackle the specific types of stigma that they experience both in accessing services and support and in daily life.

Moreover, we are planning to ensure treatment standards for alcohol, informed by the UK-wide clinical guidelines, will introduce new approaches to treatment, including non-stigmatising service delivery.

One of the key aims of the National Mission is to improve and save lives by ensuring that every individual has access to, and choice in the type of recovery and treatment they need. In response to the Changing Lives report published by the Drug Deaths Taskforce, the Scottish Government published a Cross Government Plan which sets out examples of how we are improving alcohol and drug services to make them more flexible, convenient, accessible and easier to navigate.

For example, we are supporting local areas further develop their assertive outreach programmes both through the implementation of the MAT standards and in other ways such as the Primary Care Alcohol Nurse Outreach Service (PCANOS), which embeds specialist harm reduction services within Deep End GP practices and supports patients in engaging with and navigating treatment services.

We are also investing in residential rehabilitation to ensure people can access help when they need it and have established an Expert Group to recommend improvements for crisis management and stabilisation.

In addition, we sponsor a number of third sector organisations which offer convenient and accessible technology-based help, advice and treatment for people with problematic drinking, for example, Scottish Families Affected by Alcohol and Drugs and We Are With You, who also provide a live web chat services which have improved engagement for many people.

We are also supporting the UK Government in developing the clinical guidelines for alcohol treatment, which were published for public consultation on 16 October 2023. The guidelines encourage more flexible and convenient interventions by using digital technologies when appropriate.

The Scottish Government provides funding to support our local Alcohol and Drug Partnerships (ADPs) who are responsible for the design and delivery of treatment and recovery pathways at the local level. They ensure a full range of recovery services are available such as aftercare, detox, residential rehabilitation and psychosocial treatments.

In 2022-23, £106.8 million was made available to ADPs, and nationally there is ongoing work including the expansion of our residential rehabilitation capacity by 50% by the end of the current Parliament and the UK Alcohol Treatment Guidelines which are currently out for public consultation until 8 December 2023.

Scottish Government also provides funding towards specific projects that support those with alcohol dependency, such as the Managed Alcohol Programme pilot being delivered by Simon Community Scotland in Glasgow.