About you
3. What is your name?
Name
Vanessa Salmond
Organisation details
1. Name of organisation
Name of organisation
(Required)
Fife Health and Social Care Partnership
2. Information about your organisation
Please add information about your organisation in the box below
These are the collective views of Fife Council, NHS Fife and Fife ADP Partnership
Question page 1
1. Did you take part in any consultation exercise preceding the Bill and, if so, did you comment on the financial assumptions made?
Please provide your response in the box provided.
No
2. If applicable, do you believe your comments on the financial assumptions have been accurately reflected in the FM?
Please provide your response in the box provided.
Not Applicable
3. Did you have sufficient time to contribute to the consultation exercise?
Please provide your response in the box provided.
Not Applicable
4. If the Bill has any financial implications for you or your organisation, do you believe that they have been accurately reflected in the FM? If not, please provide details.
Please provide your response in the box provided.
The Financial Memorandum does not accurately reflect the costs associated with the implementation of the proposals within the Bill due to:
Lack of Accurate Drug Use Prevalence Data
The Public Health Scotland (PHS) prevalence data for opiate use and for those who could benefit for treatment, recently published are estimates based on assumptions made across 11 health boards. There is a large variation in the number of people in need of treatment and an accurate and reliable figure per ADP/Health Board Area is not obtainable. The last available data pertaining to opiate drug use is 2019/2020, 4 years out of date.
Without accurate prevalence data, it is difficult to predict associated costs. The data sources used to inform the Financial Memorandum are not reflective of patient choice nor of other needs.
In addition, national and local estimates for prevalence of other drug use (stimulants, benzodiazepines and harm risk pain medication) are not available and thus it is difficult to predict the number of people who would qualify for treatment within 3 weeks for this type of substance use.
Omission of Support Costs
Costs of complementary support to sustain long-term recovery including psychological therapy, psychosocial support and community and residential rehabilitation that may be of benefit to those requesting treatment is not reflected in the Financial Memorandum.
It is also difficult to accurately estimate cost per patient per annum and to be assured of the average length of treatment people would require.
Lack of Accurate Alcohol Use Prevalence Data
Similarly, there is a lack of prevalence data for alcohol use although there is an awareness of the number of deaths and associated harms attributable to alcohol, however this does not yield an accurate number of people qualifying for a right to treatment, type and length of treatment and thus an accurate costing can not be estimated.
In addition, there is not a reliable mechanism for forecasting prevalence across all care groups within the Fife ADP/NHS Fife Board area and estimates today are likely to be inadequate and out of date in future years.
Lack of Accurate Drug Use Prevalence Data
The Public Health Scotland (PHS) prevalence data for opiate use and for those who could benefit for treatment, recently published are estimates based on assumptions made across 11 health boards. There is a large variation in the number of people in need of treatment and an accurate and reliable figure per ADP/Health Board Area is not obtainable. The last available data pertaining to opiate drug use is 2019/2020, 4 years out of date.
Without accurate prevalence data, it is difficult to predict associated costs. The data sources used to inform the Financial Memorandum are not reflective of patient choice nor of other needs.
In addition, national and local estimates for prevalence of other drug use (stimulants, benzodiazepines and harm risk pain medication) are not available and thus it is difficult to predict the number of people who would qualify for treatment within 3 weeks for this type of substance use.
Omission of Support Costs
Costs of complementary support to sustain long-term recovery including psychological therapy, psychosocial support and community and residential rehabilitation that may be of benefit to those requesting treatment is not reflected in the Financial Memorandum.
It is also difficult to accurately estimate cost per patient per annum and to be assured of the average length of treatment people would require.
Lack of Accurate Alcohol Use Prevalence Data
Similarly, there is a lack of prevalence data for alcohol use although there is an awareness of the number of deaths and associated harms attributable to alcohol, however this does not yield an accurate number of people qualifying for a right to treatment, type and length of treatment and thus an accurate costing can not be estimated.
In addition, there is not a reliable mechanism for forecasting prevalence across all care groups within the Fife ADP/NHS Fife Board area and estimates today are likely to be inadequate and out of date in future years.
Question page 2
5. Do you consider that the estimated costs and savings set out in the FM are reasonable and accurate?
Please provide your response in the box provided.
No, as outlined in Point 4
6. If applicable, are you content that your organisation can meet any financial costs that it might incur as a result of the Bill? If not, how do you think these costs should be met?
Please provide your response in the box provided.
As indicated in the recent Audit Scotland report, drug and alcohol services are currently underfunded by 8% in real terms for current delivery to existing service users. Whilst the Fife ADP/Addiction Services would welcome increasing numbers of people in treatment, providing full and long-term care and support for what is an unpredictable level of unmet need could not be achieved within existing budgets.
7. Does the FM accurately reflect the margins of uncertainty associated with the Bill’s estimated costs and with the timescales over which they would be expected to arise?
Please provide your response in the box provided.
No, as outlined in Point 4