Action on Scotland's drugs deaths undermined by 'unacceptable' data problems

It reported “a general lack of understanding that the purpose of information sharing in this process is to save lives”.

The review also found that bereaved families were being let down by the system. 

The criticisms are contained in the final report of the Drug Death Reporting short life working group, which was published by Public Health Scotland today.

There were a record 1,339 drug-related deaths in Scotland in 2020, the seventh consecutive year to show an increase.

Drug-related deaths are collated and reported in two ways - annually by the National Records of Scotland and every two years by the National Drug-related Death Database (NDRDD), which goes into more detail about the circumstances of the fatalities.

The expert working group was set up to examine the NDRDD dataset.

The data for this are manually uploaded by NHS boards following an audit of a deceased person’s case notes, and the increasing number of deaths has increased the workload.

Changes to the way toxicology testing was done in Scotland in 2019 added to delays, which were then compounded by the Covid pandemic. 

The report said the upshot was that the NDRDD had “failed to provide users with up-to-date information” which could help address a worsening public health issue.

“The potential benefit of learning from these data to help prevent further deaths is not being fully realised,” it said.

The group said variations in NHS board practices were “unacceptable and undermined the quality and usefulness of the data” and recommended these be standardised. 

It added: “It was felt that bereaved families were not provided with adequate information or support as part of the existing DRD [drug-related deaths] process and that this needs to be addressed.

“Resources for families bereaved following a DRD are available to Police Scotland, but there were variations in access to these and in families’ experiences in these circumstances. 

“The roles of agencies in relation to providing support to families are unclear. 

“While there are examples of good practice around the country, these need to be built upon as part of a co-designed approach.”

The group recommended the NDRDD report move to a 12 month reporting timeframe rather than 24 months, be more accessible, and offer recommendations “to help prevent drug-related deaths and describe the impact of families and relevant service improvements”'.

It also recommended drawing a clearer distinction between deaths by suicide involving controlled drugs and acciental deaths from overdoses.

The Scottish Government has already approved more funding to implement the recommendations.

A Scottish Government spokesperson said: “As part of the National Mission to reduce the toll of drug deaths across Scotland, the Scottish Government has already started publishing quarterly suspected drug death Management Information from Police Scotland – in addition to the annual National Statistics report from National Records Scotland – to provide more timely release of data on drug death trends. This helps ensure everyone involved in the national mission is aware of the challenge ahead.

“In addition, to ensure more up to date data to monitor progress, at the end of last year the Minister for Drugs Policy announced £1.1m of new investment into public health surveillance projects to improve our real-time understanding of harms to enable better and faster responses. The Minister has also announced a target to increase the number of people with problematic opiate drug use in life-saving community treatments.  

“We are also working closely with Integration Authorities on accountability and transparency, and recently approved a new governance framework with COSLA. This will improve the effectiveness of Alcohol and Drug Partnerships in advance of the more ambitious reforms under the new National Care Service.”