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The Public Health Scotland interim monitoring report on statutory-funded residential rehabilitation placements does not gather data on the number of successfully completed rehabilitation placements.

We have responded to calls for more transparency and accountability commissioning Public Health Scotland to develop a National Core Minimum Dataset that will provide data not only on the number of publicly funded placements but also with time will publish insights on outcomes from placements in Residential Rehab.

This will provide the Scottish Government with a clear line of sight on how residential rehab funding is being spent across the country and help to further the evidence base for this treatment model.

Public Health Scotland’s baseline report on the residential rehabilitation programme, published in February, outlines the complexities in evaluating shorter programmes within the context of wider residential rehabilitation.

As noted on Page 12 of the report, discussion as to whether two-week or four-week placements are best included or excluded from the total number of publicly funded residential rehab placements remains ongoing. The argument for including them is that they are publicly funded placements. The argument for excluding them is that there has been some evidence in previous reports such as the 2020 Residential Rehabilitation Working Group report which suggests that positive outcomes are more likely with longer placements.

However, all placements for residential rehab are assessed on an individual needs basis, and so we cannot assume that longer programmes necessarily constitute a comprehensive rehabilitation experience in general. It is ultimately for professionals and clinicians to make the decision locally as to whether a shorter programme is as effective for the individuals involved.

The Scottish Government published a capacity mapping report in 2021 which found that residential rehabilitation provision was disproportionally located around the Central Belt.

We acted on this by announcing the second round of the Residential Rehabilitation Rapid Capacity Programme in 2022, with a specific priority to support new or expanded residential rehabilitation facilities which were regional or would accept placements on a national level.

Over £14 million was made available to support the successful projects, which included the expansion of CrossReach’s service in Inverness (with outreach support to the Highlands and Islands), the extension and refurbishment of the Maxie Richards Foundation’s service in Tighnabruaich, and the creation of a new national residential rehab service in Aberdeenshire by Phoenix Futures.

These projects are progressing well and we expect all to be operational by the end of the year.

The Public Health Scotland’s Interim monitoring report on statutory-funded residential rehabilitation placements published on 18 July 2024, shows that during the period between October 2023 and March 2024 estimated costs for 33 placements to Ward 5 was £495,396 – averaging at £15,012 per placement.

The Scottish Government have allocated a £5 million uplift in funding to Alcohol and Drug Partnerships (ADPs) based on the National Resource Allocation Formula, for funding of residential rehabilitation placements and distribution of this fund at ADP and Health Board level is a local decision.

The Scottish Government survey of residential rehab providers, published in November 2021, found that the duration of treatment programmes varied substantially across providers, with an average core treatment duration of 23 weeks. Some providers suggested that this was flexible based on individual need. Typically, private providers reported shorter (5–12 weeks) programmes, while third-sector providers reported longer (14–156 weeks) programmes. Further breakdown of treatment duration by facility is available in the published report.

This report was referenced in Public Health Scotland’s interim evaluation of the Residential Rehabilitation Programme, published 13 February 2024.

The Residential Rehabilitation Development Working Group defines residential rehab as facilities offering programmes which aim to support individuals to attain an alcohol or drug-free lifestyle and to be re-integrated into society, provide intensive psychosocial support and a structured programme of daily activities, and which residents are required to attend over a fixed period of time.

The Scottish Government recognises that diversity of treatment options is important to empower individuals to have more choice and to meet the needs of individuals seeking different types of recovery, and this includes taking a person-centred approach to treatment length.

Public Health Scotland worked in close consultation with key stakeholders to develop the core minimum dataset, which will form the basis for the monitoring of residential rehabilitation. Early versions of the dataset were shared with the Monitoring, Evaluation and Research Advisory Group (MERAG) and the Residential Rehabilitation Development Working Group (RRDWG), which have representatives from groups such as individuals with experience, families and recovery organisations.

Current residential rehabilitation clients were given the opportunity to complete a survey to provide details of their own experience. Qualitative research was also undertaken with people with lived experience of having accessed residential rehabilitation to explore their experiences of the pathways into, through and out of this form of treatment.

The Scottish Government Residential Rehabilitation Literature Review published 30 May 2022 showed that demonstrating the association between residential rehabilitation and specific outcomes is complicated by the widely varied nature of provision in terms of programme length, treatment philosophy, the provision of throughcare (including preparatory work and aftercare) and quality.

The length of residential rehabilitation treatments varies substantially. This data on individual placements is not currently collated centrally. The Scottish Government have commissioned PHS to establish the necessary data infrastructure to monitor residential rehab in Scotland, and we expect that early extracts to be published in December 2024.

As the dataset continues to develop and becomes more mature, a greater level of insight and data will be available for publication, including treatment length and associated outcomes.

The Scottish Government will address the impact of changes to service provision on access and availability to alcohol and drug recovery services by continuing to ensure that the specific needs of women are considered in the design and delivery of services, and that a gendered approach is taken in all new or developing initiatives across the National Mission to reduce deaths and improve lives.

The Scottish Government provided specific funding of around £1.5m per year to Glasgow City Council to support the 218 Service. As a result of that funding relationship, Glasgow informed the Scottish Government of its plans to re-tender the service last year and discussions took place to confirm that the funding would still be available following that exercise.

Glasgow City Council has provided assurances that it worked closely with Turning Point Scotland to support individuals in transitioning to other support arrangements and that other services, including residential placements, are available to support people with similar needs. In particular, it has confirmed that all 218 service residents had moved on from the service as of 31 January 2024 – some residents naturally came to the end of their stay, while others moved back to their own tenancy or to accommodation with support.

We have responded to calls for more transparency and accountability by commissioning Public Health Scotland to carry out an independent evaluation of the Residential Rehabilitation programme as part of the wider evaluation of the National Mission.

By collecting and publishing robust data, we will be able to increase the evidence base that will help us to best direct financial resource. This improved understanding means that more people will be able to access the treatment type that is right for them at the right time.