Scottish Drugs Forum
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THE STOCK-TAKE - a review by any other name - of Alcohol and Drug Action Teams (ADATs) is here at last. It should be welcomed and is certainly long overdue.
It’s only fair that we put our cards on the table - SDF called for such a review in its submission to the treatment rehabilitation review in 2003. The areas for assessment are detailed on page three of this issue. Crucial among these will be the exploration of the barriers which inhibit efficient and effective working within the current ADAT structure and recommendations on the actions required to overcome the barriers.
Our view then – as now – was that there were major structural weaknesses in the existing ADAT model, such as lack of transparency/accountability, mainly through inappropriate funding arrangements and poor external communication; too many/lack of focused targets, and lack of regular local service reviews/needs assessments. We argued then that these would have to be addressed if ADATs were to operate properly and effectively.
ADATs must be given clear and unambiguous strategic primacy on drugs issues at local level, with a more highly defined framework to help them fulful their strategic role. They need to be clear about the need for services and gaps in existing provision, recognise the range and cost of provision, and be sure they can access the necessary relevant funding.
Current accountability arrangements of ADATs to the Scottish Executive are through their respective Chairs – a difficult situation for the Chairs, who have no authority over partners who may be reluctant to share decision-making with the ADAT. This flaw means that accountability is not clear and there is often a lack of transparency in the decision-making process.
Merging the myriad funding streams into one over a period of time - preferably routed through health and with the ADAT signing off all the funds disbursed - would be the best way to achieve transparent accountability. The role of the Scottish Executive here could be to provide guidance and figures for indicative spend on different aspects of the response, for example, prescribing services, outreach and employability.
The number of targets must be streamlined to focus on a smaller number of key priorities such as increasing the proportion of people in services, improving access to services, increasing numbers undertaking ‘move on’ opportunities and reducing drug related deaths. Delivering on a smaller number of key targets would allow ADAT support staff to focus their efforts on a smaller number of agreed agendas.
Control of finance is not the only key to enhancing ADATs ability to operate strategically. They must also have a clear picture of service provision in their area and how successful this is in meeting prevailing demand. ADATs must carry out regular service reviews and needs assessments to ensure that they are meeting current need effectively.
Over recent years, ADATs have focused heavily on the demands placed upon them from the Scottish Executive. With enhanced budgetary powers and reduced targets, ADATs could shift their focus externally to the communities they serve.
Galvanising the untapped energies of our communities will result in better, more informed, responsive and effective services in communities most affected by problem drug use.
However, another issue must be remembered. This is that the balance of service provision and how it is delivered should be based on a thorough assessment of the nature and extent of need through regular dialogue with users, carers and community groups, and remembering that needs will change over time. More formalised surveys could also include the views of managers and workers within services.
We must not forget the voluntary sector networks either – too many feel they do not have equal partnership status on ADATs in strategic planning issues, yet their role is a vital component of partnership working across Scotland.