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3 Consultation Analysis by Question

3.1 Question 1

Are the standards and underpinning statements applicable to all types of services for substance misuse? If no, what could be done to make them more relevant?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 1

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

The responses generally welcomed the standards with the majority of those responding indicating that the standards were suitable for all services. The comments throughout the responses raised similar issues and largely centred on the wide range of services which are provided. Therefore, the applicability of the standards to all those services, e.g. to agencies that may not produce personal plans or that use an informal philosophy to ensure that they attract service users, such as drop in centres, needle exchanges, family support groups, or Alcoholics Anonymous ( AA) support groups.

"Yes in principle. However, there are some problems e.g. not all services will carry out assessments but may work to those of other services. Some users don't want a co-ordinated service. Some just want clean needles, some information or some counselling". Voluntary Agency Response

"The standards from 3 - 11 are not applicable to services for 'brief interventions', e.g. needle exchange, specialist nurses in GP practices". Health Service Response

Several responses indicated that more definition of the wording of the standards would be necessary to ensure that there was clarity in what services were covered by the term 'substance misuse services'. The concerns raised were mainly around ability to provide care planning and assessment.

"There should be a definition of 'substance misuse services', and a differentiation of those which can appropriately develop care planning, and those which cannot. The standards are too comprehensive to include all services as they stand". Local Authority Response

In addition, concerns were raised about the need to more fully address service responsibilities in relation to children and young people within the draft standards, particularly with regards duties in reporting and information sharing.

"The tone of these statements are wrong. A client cannot expect to be flame proof in a service if they have children. The statements in general lack honesty about the role of addiction services with children. It should be made clear that there are implications for clients with children, that, although their co-operation will always be sought, information is likely to be shared with other agencies about children, with or without their consent e.g. information on their children will be recorded on social work databases from initial contact". Health Service Response

Identifiable Actions from Responses

• The published standards should make clear that services will only be expected to meet those standards that are applicable to the type of provision that is being offered.
• Additional guidance should be developed in liaison with the providers of each specific type of service and published alongside the standards.
• The standards should be altered to ensure that they adequately reflect the needs of children and young people.

3.2 Question 2

Do all of the standards and underpinning statements apply to both drug services and alcohol services? If no, please identify which, and indicate why you think this is?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 2

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

The considerable majority of responses indicated that the standards are relevant for services that deal with people experiencing problems with either alcohol, drugs or both.

The difference in legal status between drugs and alcohol was highlighted as this can make a difference to the way in which services are obliged to operate.

"Problems/issues can vary depending on the substance being used, for example, criminality relating to drug use. The existence of these issues and how services should manage them are not reflected in the draft standards". Health Service Response

"The standards and underpinning statements seem to be applicable to the full range of services for substance misuse, but, as mentioned above, there are potentially contentious issues. For example, in the absence of any indication to the contrary, in addition to voluntary substance misuse services, it is assumed that the quality standards for substance misuse services are applicable to statutory agencies such as Criminal Justice Social Work Drug Court Supervision and Treatment Teams, which are responsible for the supervision of Drug Treatment & Testing Orders and Enhanced Probation Orders. In some instances this statutory service is obliged to enforce compliance with these orders and to take action initiating breach procedures with the courts. This obligation has the potential to conflict with some of the proposed standards, which generally reflect a voluntary basis to the service user and service provider relationship". Local Authority Response

It was also highlighted that to support the equal applicability of the standards to both alcohol and drug services, consistent data collection methods should be used for both groups which does not exist at present.

"There is absolutely no reason to define between the two and defining the standards to cover both alcohol and drugs emphasises the need to be inclusive of alcohol users in a way that has possibly not happened in the past. However, if both drug and alcohol problems are included there needs to be consistent data collecting measures, for example the recent SMR25¹only includes alcohol information where there is a primary drug problem". Local Authority Response

Identifiable Actions from Responses

• Guidance should be given to reinforce that the service needs to supply information to the service user about its limitations and obligations in regard to meeting legal requirements.

• Standardisation of recording would be beneficial and the viability of integrating data about problematic alcohol use into existing systems used for drugs should be investigated.

3.3 Question 3

Are they sufficiently comprehensive? If no, what else would you like to see included?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 3

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

Although the majority of responses received indicated that the standards were not sufficiently comprehensive this was by a small margin (4%).

The issues raised were consistent throughout the responses and predominately focused in on the need for clearer definitions and criteria for measurement.

"I have no issue with the standards as such but more detail is required. Some baseline criteria is required to define "quality support and care", "safe quality surroundings" etc. if the standards are to be common they require some definition, baseline and ideal criteria could apply". Private Individual Response

"The standards are too generic due to a lack of any definition of the term 'services'. The various requirements of specific resources need to be elucidated e.g. needle exchange, brief interventions". Representative Agency Response

"The standards appear basic in nature and do not clearly state specific service requirements. They give no indication of what would be considered good practice, and would perhaps have benefited from examples to give guidance and a basis for measurement". Local Authority Response

In terms of coverage, responses suggested that the standards did not make reference to enhancing potential and that they did not sufficiently emphasise responsibilities to children.

"These quality standards need more work especially on the getting our priorities right and hidden harm policy agenda. Mention is made of the needs responsibilities and expectations relating to children who are living with adult drug and alcohol clients but these need strengthening ". Area Alcohol and Drug Action Team Response

Identifiable Actions from Responses

• Guidance information should accompany the standards.
• A 'Glossary of Terms' should be included in the guidance documents.
• The standards should be altered to ensure that they adequately reflect the needs of children and young people.
• The standards should include reference to addressing peoples aspirations.

3.4 Question 4

How completely do you think working to the standards will achieve the aim of improving service quality and delivery? Have you any suggestions for how they could be improved?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 4

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

The vast majority of respondents indicated that the standards would improve service quality and delivery, although only a small percentage thought that the introduction of the standards would completely achieve this.

Comments in response to this question mirrored responses to earlier questions, particularly highlighting that areas of the standards required more clarity and definitions.

In terms of improving the value of the standards, clarity and guidance on the accompanying monitoring framework was one of the main areas identified.

"It is difficult to assess the impact that will come from the publication of a set of standards, without knowing what will be the monitoring framework accompanying them. It is understandable that the Steering Group were reluctant to impose another layer of inspection and it would be more constructive to use existing inspection frameworks. However, in the absence of knowing what this would look like does leave a question of how will the standards be monitored. This needs addressing in the future". Voluntary Service Response

In terms of enhancing the effectiveness of the standards, the identification and allocation of appropriate resources, including finances, training and support for staff was highlighted.

"The extent to which the standards will achieve improvements in service quality and delivery will depend on physical resources and the quality of the staff, including the level of their training". Voluntary Service Response

It was also noted that the impact of the standards is related directly to how much they are accepted by people.

"In order for the potential of the standards to be maximised, they will need to be embraced by whole organisations from management to front line staff". Area Alcohol and Drug Action Team Response

Identifiable Actions from Responses

• A national evaluation and monitoring framework should be developed which recognises different types of service.
• Methods of encouraging and supporting people at all levels to commit fully to implementing the ideals of the standards should be investigated. This should include service commissioners and providers.

3.5 Question 5

Is there sufficient emphasis in the draft standards on the responsibilities of the service user?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 5

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

Although there was a substantial body of responses indicating that the responsibilities of service users was dealt with sufficiently, the majority of responses indicated that this needed additional emphasis in the standards.

The responses largely provided feedback on how the responsibilities of service users might best be addressed and fell into three distinct categories as follows:

• The responsibility for meeting the standards lay with the services and the service users should not be held accountable for them not being met.

"We are convinced that a document on quality standards is the correct vehicle to emphasis service users' responsibilities. The emphasis should be on the responsibility of service providers". Area Alcohol and Drug Action Team Response

• There needs to be more emphasis placed on the partnership between the service and the service user. This would empower the service user by highlighting the benefits to them in actively participating in their own treatment and recovery. The disadvantages of not participating should also be explained.

"There needs to be much more emphasis on partnership with service users and the fact that this is a two way process. It would be useful to incorporate into the standards words such as participation, engagement with the service, and empowerment". Local Authority Response

• The service user's responsibilities should be clearly explained and detailed. This would include areas such as attending appointments, acting courteously towards staff, arriving at the service having consumed drugs/alcohol etc.

"The responsibility of the service user should be clearly identified. For example, to attend appointments timeously; to be courteous and treat staff and other parties with dignity and respect. It should be stated how many appointments can be missed by the service user before the case is closed and that locations of meetings must meet the health and safety requirements of staff and service users". Health Service Response

Identifiable Actions from Responses

• The responsibilities of service users should be more clearly defined within the standards.
• Consideration should be given to what emphasis should be adopted with regard to the responsibilities of services users.

3.6 Question 6

How easy do you think services will find them to implement in the immediate future? Can you identify what difficulties they are likely to face with implementation?

3.6.1 Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 6

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

Although the majority of responses which stated the level of ease or difficulty of implementing the standards in the immediate future indicated that they would be difficult to implement, this was by a small margin with only a small proportion (less than 7%) indicating that they would be very difficult to implement.

Key difficulties identified by respondents, which reflected comments made throughout the responses, were:

• The potential for the standards to be interpreted in a variety of ways, given that the underpinning statements are very broad which would be counterproductive to the ethos of having standards.

"The development of standards is generally welcomed as a means of developing services in a measurable way. However, the process is likely to remain difficult unless there are clear and agreed definitions accompanying the standards". Local Authority Response

• The absence of any framework or tool to assist in the measurement of services against the standards, which would make it more difficult for services to put them into practice. In addition, if implementing the standards imposed additional work on services or an additional layer of inspections this would hamper full participation.

"Most significantly, the weight of monitoring these standards will be challenging in the best circumstances, and the best circumstances would require monitoring to add no additional burdens on services". Representative Agency Response

"There are numerous agencies inspecting services which cause duplication of work. This is a big issue and requires to be talked prior to the standards being implemented". Private Individual Response

• The attitude of services and staff towards the standards and their implementation was also identified as a crucial factor in how successful the standards could be.

"I would like to think that services would find it easy or very easy to implement these standards. I am realistic enough to realise that in some places services will have difficulties with this. This does not reflect the degree of difficulty associated with these standards but much more to do with local service behaviours and attitudes". Private Individual Response

• The standards aim to promote and increase the partnership working across services and it was suggested that further support on how this will work in practice might be required.

"Communication between services can sometimes be lacking regarding client needs. It is all very well having standards written in theory but putting it into practice may prove the challenge". Voluntary Service Response

Identifiable Actions from Responses.

• Efforts need to be made to ensure that all stakeholders understand the benefits of the standards.

• The standards need to be clearer and more precisely defined and guidance documents should be provided including a glossary of the terms used.
• Tools for measuring the standards need to be developed and monitoring and inspection criteria made explicit.
• Ways should be identified to use and combine existing systems rather than impose new ones.

• How to make available training and support on the standards should be investigated.
• The Scottish Executive, local ADATs and commissioners of services should make additional efforts to encourage partnership working between agencies.
• Protocols should be developed to enable interagency information and resource sharing.

3.7 Question 7

How easy do you think services will find them to implement in the long term? Can you identify what difficulties they are likely to face with implementation?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 7

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

A significantly greater proportion of those who responded to this question indicated that the implementation of the standards in the long term would be easy or very easy, suggesting that the standards will become easier to implement over time.

"If the standards are implemented and given time to develop and grow within a structure wherein they become an automatic way of working and a matter of course, whilst embracing good practice, long term implementation should be easy". Representative Agency Response

Potential difficulties identified with the long-term implementation reflected the same issues as those identified in the previous question. For completeness, these were:

• Greater clarity and guidance on the standards and their applicability;
• Identification of a monitoring and inspection framework and the development of tools for measuring, monitoring and evaluating;
• Resources and activities to support promotion of standards and assist in their implementation within services; and
• Encouragement of partnership working between services.

Identifiable Actions from Responses

• Ways of ensuring adequate resources and support are available over a sustained period should be investigated.

3.8 Question 8

How would you propose monitoring their implementation?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 8

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

From the responses, it is clear that effective monitoring of the standards is seen to be linked directly to establishing a framework to measure them by, which should be consistent across all services in Scotland.

Whilst a range of suggestions were offered with regard to the systems that could be used to monitor services against the standards, it was emphasised throughout responses that such a framework should be consistent or integrated with existing systems of monitoring and inspection systems to minimise any additional work required.

"A successful improvement to services, based upon these standards, relies upon a monitoring framework. The challenge is to ensure the burden of monitoring is kept to a minimum and is entirely in keeping with existing commitments". Representative Agency Response

"In order to establish a national standard a system of benchmarking would need to be established. This could be done by cross referencing these standards to the existing Care/ SP standards with the existing Inspectorate having the role of endorsing the service". Voluntary Service Response

Similarly, responses suggested that data collection should use existing collection methods which would incorporate all the information required by various funders and inspection agencies. This process could further be enhanced by ensuring that the data collected is able to be shared, perhaps by having co-ordinated electronic systems which are able to communicate throughout all services.

"Audit may end up being another paper exercise. It should be electronic and linked as far as possible to other data collection". Health Service Response

Some practical suggestions on overseeing the process and ensuring ease of integration into existing practices included:

• Internal management groups could be created to ensure quality control with quarterly reviews by an internal sub-committee;
• Quality standards monitoring could be incorporated into existing staff supervision systems, with questionnaires and interviews used to enhance this;
• Service users' personal plans could be designed to incorporate the statements and service users themselves could be involved in all parts of the monitoring process.

"Monitoring should be an ongoing process. It is important that monitoring is a participative process inclusive of all partners, not least service users. Feedback should be sought from service users and changes made to reflect this within the monitoring system so that later evaluations meet a desired result. It is important that service users participate within this process as this can be empowering for them which often leads to increased self esteem". Representative Agency Response

"It is vital that the views of service users are included in monitoring arrangements". Area Alcohol and Drug Action Team Response

• Externally services could use a form of 'peer review' system where services evaluated each other, which could also help develop greater partnership working between services.
• Service commissioners and funders could include the standards in service level agreements with the services.

"The ADAT would incorporate any standards into the commissioning process. This would include the monitoring of service level agreements or other arrangements with service providers". Area Alcohol and Drug Action Team Response

Identifiable Actions from Responses

• Monitoring of the standards should be integrated with the variety of systems already in use.
• A monitoring framework should be developed which is able to be used nationally but should have enough flexibility to allow for differences both in locality and in type of service provision and build on good practice criteria for various service types.
• Local area commissioners should integrate the standards into their service level agreements and perform routine reviews of the services.
• Services should be encouraged to perform internal monitoring and use the results of this to develop an action plan for improving the services.
• Existing inspection processes carried out by agencies such as the Care Commission or the Social Work Inspection Agency should include an audit of the standards.
• The data collected by the monitoring process should inform local action plans, be included in any national reporting requirements and used to assist in developing Scottish drug and alcohol strategies and policies.
• All stakeholders should be fully involved in the process, with additional efforts made to ensure that the views of service users are taken into consideration.
• Methods should be established to ensure that the whole process of measuring services against the standards is viewed as a positive experience and suitable support provided.

3.9 Question 9

What could be done at national level to support you in the monitoring process?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 9

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

The development of a national framework for the audit of the standards was felt necessary to ensure that the benchmarks which services are measured against are consistent throughout Scotland. It was further suggested that its development be progressed by the formation of local strategic groups.

"Develop national audit framework, including example audit tool, for the standards. This would allow national benchmarking, and facilitate sharing examples of good practice". Representative Agency Response

"The development, or the enhancement of local strategic groups which have representation at decision making level and mandated at a national level would be extremely helpful". Local Authority Response

Having a common set of data and minimising duplication of data/information collection would facilitate the monitoring and inspection of services with regard to the standards.

"Existing national inspection structures/institutions get together to agree data collection and information needs regarding substance misuse at national level and all ask the same questions (or use each others inspections)". Health Service Response

The creation of a standardised data collection tool would support the collection of data to allow effective monitoring. It was suggested that this would be further enhanced if it was in electronic format with the data able to be shared.

"Substantial investment in IT development across all sectors. Use of electronic data capture and reporting - agreed common system or systems which can interface with one another". Representative Agency Response

The value of additional guidance was also highlighted, to include defining terminology, accountabilities and responsibilities and clarifying the baseline and expectations, for example of the level of standards expected or what constitutes a care plan.

"Given that the standards will undoubtedly have an impact on resource requirements in terms of monitoring and evaluation, it would be helpful if the standards had at least a background guidance pack to support the development of monitoring processes. Such a pack could include good practice examples, a range of potential implementation suggestions, suggestions as to where support may be nationally or locally available etc.". Local Authority Response

Training and sufficient time to enable services to fully implement and monitor the standards and deliver the required levels was also raised, with the suggestion that an external agency could be created to give advice, support and to assist with the implementation of the standards.

"The establishment of 'monitoring assistance officers' would help with implementing and maintaining standards". Voluntary Service Response

Finally, consideration should be given to adequate funding provision both nationally and by local commissioners.

"Ensure that the Scottish Executive departments take account of standards in the development of policy and funding regimes". Area Alcohol and Drug Action Team Response

Identifiable Actions from Responses

• Develop a national monitoring framework linked to existing local and national inspections.
• Standardised monitoring tools should be developed.
• Integrate electronic systems to allow ease of collecting and analysing data.
• National and local strategies to ensure that sufficient funding is available.
• Make available support with training on any aspect of implementing the standards to services and commissioning bodies.

3.10 Question 10

Do you have any further comments?

Quantative Data

Graph of responses by type measured in percentages of those responding to the question.

Question 10

* For the purpose of analysis, the term "Health Service" groups together all medically based services. ( GPs, NHS, Health Boards, community health services, etc.)

Summary of Responses

The standards generally were supported but conditional on implementation not causing any additional burden to services. There were however views that the standards were at a low level and therefore would not assist in improving services.

"These standards have met with overwhelming support. All organisations consulted felt they were long overdue. Majority did not feel that the implementation of the standards would place an unacceptable burden. However, many organisations mentioned that if they had to produce additional reports in order to demonstrate compliance this would be unacceptable. The non-statutory organisations and those statutory organisations required to submit regular regional and national reports felt that the implementation of these standards could be used as an opportunity to streamline". Area Alcohol and Drug Action Team Response

"I am disappointed in this draft standards document. I feel that the statements are bland and reflect basic standards which are at such low level that they are not going to stretch many services. I appreciate that it may stretch some services and that, on a national level, it may be that the Scottish Executive is aware of a high level of services which are not attaining any of these quality standards. However, my general sense is that it would have been helpful to set standards which were far more of a challenge". Private Individual Response

Issues that were raised tended to reflect those that had occurred in response to other questions, including:

• How the standards reflected the policies relating to children and young people. In addition, how the standards relate to carers and families was also questioned.

"We were encouraged that there is reference to the needs of children (Statement 3 and 11). However in recognition of the importance of national guidance from 'Getting Our Priorities Right'²and 'Hidden Harm'³this should be given greater prominence. We would recommend that greater emphasis is placed on the responsibility of every agency to ensure the wellbeing of the children and young people of parents who misuse substances. This should be embedded within each of the standards". Local Authority Response

"Overall implementation of the quality standards would not detract from service delivery. There was a feeling that the standards as published were targeted at adult services and does not reflect young peoples services". Representative Agency Response

• That greater clarity would be necessary, particularly around definition of the terms used and the areas of monitoring and evaluation.

"It would be helpful to have a glossary of terms given the comments already made about the need for clearly defined terms". Representative Agency Response

"Generally we welcome the work to date on the development of national standards but would suggest that further work is needed on definitions and assessment frameworks to ensure that services are measured and evaluated appropriately". Local Authority Response

• Within the monitoring process it would be important to make sure that there is a consistent approach taken across all geographic areas and service types. As well as ensuring best practice the development of any monitoring framework should incorporate existing guidelines and regulatory tools.

"There needs to be a national consistent approach to the implementation, monitoring and evaluation of these standards". Other Agency Response

"The concept of national standards for addiction services is very welcome however there needs to be clarity around the actual standards and an agreed monitoring system which would be reported on a national basis. There also needs to be consideration of how these standards tie in with other national standards for example QIS⁴standards which are reported on through NHS provision". Health Service Response

• Training, support and resources required to support the implementation of the standards and associated framework should be recognised, along with ways of minimising cost and encouraging closer partnerships between services.

"Guidance for what each service framework should include. Clear guidance, training and adequate resources will be key to implementing standards". Representative Agency Response

"Scottish Executive should look at how services can work together to achieve these standards". Representative Agency Response

• Service users should be included in all parts of the process from initial design of the services, though to monitoring, evaluation and inspection. Their views should be sought and used to inform developments and improvements.

"It is a good idea to consult with service users as this allows them to influence the provision of services. The benefits are that the people are the experts of their own reality. The hope is that the consultation process has some influence on future policy". Private Individual Response

In addition to responses from service users to the consultation, both as individuals and through inclusion within responses from agencies they are involved with, there were two consultation meetings arranged by Service User Groups, which were facilitated by Alcohol Focus Scotland and the Scottish Drugs Forum. These meetings concentrated on the following set of questions which were similar to those used in the consultation questionnaire but tailored to be suitable for the forum. The reports of these meeting were submitted as their response to the consultation and have been included with the responses to question 10 for the purposes of this analysis.

The meetings focused on the following questions:-

• Are the standards easy to understand?
• Will they improve services?
• Are they achievable?
• How should they be measured and monitored?
• Would service users like to be involved in their monitoring?

On the issue of whether they were understandable there was a marked difference of opinion between the alcohol and the drugs service user meetings. The alcohol meeting thought that they were easy to understand whilst those involved in the drugs one did not. Both groups agreed that there is a need for this information to be available in different formats, they should be explained in person by the services and that they should be clarified when people were at a stage to understand them.

" When I was rattling I lacked information as to what I could expect from a service. I don't feel that all my options were fully explained to me. I am now resentful when I look back as I feel that I didn't get all my options fully explained. Maybe this (the standards) would have helped". Service User

The majority thought that the standards would help improve services and that these standards were not being met at present.

"The majority of the service users consulted believe that the draft quality standards will vastly improve services. Many of the participants reported that in their experience of accessing substance misuse services, many of the proposed standards had not been met". Service User Group Response

All agreed that the standards should be achievable but that further clarity and guidelines would be necessary.

One of the areas of concern within this topic was about the responsibilities of service users. The both groups indicated that the tone of the standards was not correct. They indicated that at present they gave the impression that treatment was something that was done to service users and the emphasis needed changing to one of empowering the service user to take responsibility for their part in this.

"It focuses more on what the service user should expect not what is expected of them. Recovery is about empowerment, taking responsibility would come into that." Service User

Monitoring of the standards should be done through a variety of means including self, locally and by an independent body. Increased resources and training should also be available to ensure the standards are able to be adequately implemented.

"Services should monitor themselves and then they would be ready for independent audit teams". Service User

All agreed however that service user involvement should form an integral part of this and all wished to take part in this type of exercise.

Identifiable Actions from Responses

• Additional definition and guidance on the standards should be developed.
• Efforts should be taken to ensure that any monitoring, evaluating and inspection frameworks that are used do not place additional burdens on services.
• Steps should be taken to make sure that the monitoring framework for the standards is developed and implemented consistently throughout the country.
• More emphasis should be placed on how the standards address the needs of children and young people and how they tie into existing regulations and good practice guidelines.
• To make the best possible use of information and resources services should be encouraged to work together more closely by local Alcohol and Drug Action Teams and by the Scottish Executive.
• Service users should be encouraged and supported to participate in developing the standards and any evaluation, monitoring and inspection processes. Their views should be sought and taken into consideration at all stages, in ways that are appropriate and allow them to feel safe.

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