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Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations are responding to the spectrum of mental health needs by working in partnership to improve quality. This article describes this system and the key organisations, and presents some findings of the National Overview Report of services undertaken by NHS Quality Improvement Scotland.

In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP).

The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny.

This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD.

The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources.

This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD.

Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities.

The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance.

The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use.

Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing.

Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care.

This paper is a first attempt to compare national social care statistics concerning day services and home care for adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

Since the late 1950s the focus of UK policy for people with learning disabilities has been on deinstitutionalisation and care in the community. In the last decade policy focus has shifted towards individualised support and community membership. Deinstitutionalisation in Scotland started later than in England, and still has some way to go. This article considers four aspects of the current hospital closure programme in Scotland: involving people with a learning disability and families, managing hospital closure, service reprovisioning, and strategic planning.

The purpose of this paper is to compare data from national censuses on specialist inpatient service use by people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National statistics (England, Scotland, Wales, Northern Ireland) reporting inpatient service censuses including people with learning disabilities were accessed, with data extracted on trends over time, rate of service use, young people and length of stay.

The number and rate of people with learning disabilities in specialist inpatient services varied across the UK: 230 people in Scotland (rate 4.88 per 100,000 population); 3,250 people in England (5.48); 183 people in Wales (5.90); 144 people in Northern Ireland (7.82). The number of people in inpatient services in Northern Ireland halved over four years, in other areas reductions were modest. Between 5 and 8 per cent of people in inpatient services were children/young people. Median length of stay in the person’s current inpatient service varied: 19 months in England; 33 months in Scotland; three to five years in Northern Ireland.

Different parts of the UK vary in the scale of their specialist inpatient services for people with learning disabilities. With the exception of Northern Ireland, which may still be in the last stages of completing a “regular” deinstitutionalisation programme, strong policy prescriptions for substantial reductions in specialist inpatient services are currently only resulting in modest reductions.

This paper is a first attempt to compare national inpatient service statistics across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

A survey was carried out of users, and potential users of the BBC Scotland Information Research Library services. Two postal questionnaires were sent out in the summer of 1995 to more than 100 individuals and organisations in Scotland. Based upon a 50% response rate, various conclusions could be drawn. Internal respondents were very satisfied with the services they currently received, but were, unsurprisingly, unwilling to pay significant sums to receive the services. There is some potential interest from outside the BBC in the Library's Events Guide. The exercise was undertaken both to assess the potential market for the Events Guide and to raise awareness generally of the Library's services. The results provide valuable pointers to how the BBC Scotland library services can develop, and, in time, the survey may turn out to have been a valuable marketing tool in its own right.

This study aims to provide data on substance use amongst young people in Scotland to inform policy and practice for an age group who generally do not access specialist alcohol and drug services. The main objectives of the study were to assess the problem severity scores of items from a modified version of the DAST-10 brief screening instrument among respondents; examine correlations between a range of variables in relation to DAST-10 problem severity scores; and explore respondent knowledge of how and where to seek help.

A fixed quantitative design methodology recruited a non-probability sample of 4,501 respondents from an online survey made available by “We are With you” Scotland.

The survey was ethically approved by the School of Education and Social Sciences, University of the West of Scotland. It consisted of 32 questions exploring substances used within the past 12 months, and 12 weeks, and included the DAST-10. We further explored help seeking, and knowledge of support available to respondents.

Substance use patterns were markedly different from people currently known to specialist alcohol and drug services. Over half of respondents were under 25, and 62% report being employed. The most commonly used substances were cannabis and cocaine. One third of respondents recorded substantial or severe problem severity scores and reside in Scottish Local Authorities with high concentrations of socio-economic inequality.

Secure accommodation, stable relationships and being employed are protective factors in relation to reported negative health consequences associated with problem substance use.

Just under one third (27%) of respondents report knowing where to seek help for substance use problems; however, they are unwilling to attend existing specialist alcohol and drug services.

A non-probability sample of the Scottish population has a potential for response bias due to how and what way the survey was made available to respondents. It is acknowledged that while useful as a method of generating drug use data, there are limitations in how recently the substance use occurred, and in relation to the types of substances reported (cannabis, cocaine and ecstasy).

The study provides data to inform wider public health measures in relation to accessing support and addressing societal discrimination associated with the use of substances. The study provides data on service design for young people who do not access specialist alcohol and drug services.

The study informs substance use policy in the Scottish context in relation to a population of young people who use licit and illicit substances. Data contributes to evidence supporting correlations between problematic substance use and socio-economic inequality. Data indicates that existing specialist services require redesign.

The study is the first to be conducted within a Scottish context.

The purpose of this paper is to qualitatively analyse the inspection and regulation of care for people with learning disabilities and mental health problems in Scotland, in two time periods.

The paper uses comparative historical research drawing on primary sources from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers, to compare inspection methods, quality standards and to identify persistent challenges to effective inspection.

Political, clinical and public awareness led initially to criticisms of existing care and eventually to the development of the “The Lunacy Act” of 1857. This Act resulted in the first attempts to set minimum standards of care for individuals at risk, with enforceable regulation. Some factors recur as challenges to effective practice in the inspection and regulation of care today.

There are problems of definition, reliable monitoring of quality standards and adequate, independent inspection of services that respond to unacceptable standards of care. There is a growing evidence base about best methods of inspection of services for people in care who are most at risk. These methods attempt to strike a balance between evidence- and value-based judgments. Perspectives from history may help focus resources.

This paper compares common and common challenges in two time periods to investigate what can be learned about the development of policy and practice in inspection and regulation of care.

In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is described. The Scottish Parliament passed primary legislation in February 2014, which places requirements on Health Boards and Local Authorities to work together more closely than ever before. The paper aims to discuss these issues.

This paper sets out the Scottish Government's legislative approach to integrating health and social care, based on previous experience of encouraging better partnership between health and social care working without legislative compulsion.

The Scottish Government has concluded that legislation is required to create the integrated environment necessary for health and social care provision to meet the changing needs of Scotland's ageing population.

The paper is confined to experience in Scotland.

Legislation is now complete, and implementation of the new arrangements is starting. Evaluation of their impact will be ongoing.

The new integrated arrangements in Scotland are intended to achieve a significant shift in the balance of care in favour of community-based support rather than institutional care in hospitals and care homes. Its social implications will be to support greater wellbeing, particularly for people with multimorbidities within communities.

Scotland is taking a unique approach to integrating health and social care, focusing on legislative duties on Health Boards and Local Authorities to work together, rather than focusing on structural change alone. The scale of planned integration is also significant, with planning for, at least, all of adult social care and primary health care, and a proportion of acute hospital care, included in the new integrated arrangements.

The research examined Scottish public libraries and the libraries' response to the coronavirus disease 2019 (COVID-19) pandemic of 2020–2021. The research focussed particularly around the way that the libraries helped to support community resilience and cohesion during periods of lockdown. The study considered issues around the closure of services in March 2020, digital services, the loss of physical library spaces and governance models. The research presents the voice of service managers rather than being a user study. The research was funded by the Arts and Humanities Research Council (AHRC), part of UKRI (United Kingdom Research and Innovation), as a part of the council's scheme to provide response to the pandemic of 2020.

This was an exploratory study examining how Scottish public library services responded to the COVID-19 lockdown in 2020. Three methods were deployed in the investigation. First, the gathering social media and other web-based content from library services over the months March–September 2020 (amounting to over four thousands snips of content) were analysed thematically. Second, 19 semi-structured interviews with service managers across Scotland were conducted. These were recorded, transcribed and analysed. These elements formed the cornerstone of the research but were supported by a short survey distributed to all public library services in Scotland focussed on e-lending during lockdown.

Findings are presented in respect of the lessons to be learnt from the closure of physical services and the migration to digital only provision, the contribution made to supporting communities, health and well-being, the importance of the balance of physical and digital library services around governance models for library services, as well as around the process of reopening services. This research explores how staff responded to this unparalleled situation, how the staff maintained close relationship with the communities the staff serve, what services themselves learnt through lockdown, and how the staff's management practices adapted. The findings present voices from Scottish libraries during 2020.

The research presents a snapshot of activities during a period of fast-moving change. The research, therefore, presents a snapshot of March–December 2020, which is, however, an extremely important snapshot. The first lockdown was perhaps most interesting to study from a research perspective because the authors witnessed, real-time, how the staff responded and reacted (with lessons learnt and applied in subsequent regional or national lockdowns later in 2020 and in the 2021). The second lockdown and subsequent periods were outside the scope of this research.

Recommendations are offered around the need for a national conversation about digital content provision in public libraries and the exploration of possibilities of a national approach, the role libraries have as digital enablers (in supporting effort to overcome the digital divide in society), the crucial nature of continued strong advocacy for public libraries, the importance of the library as a physical space, and on how to maintain the flexibility, agility and autonomy which emerged during lockdown.

The research presents strong testimony about the social value of public libraries as free, safe and public spaces within communities. It also highlights the continued digital divide which exists in many places and the important role that public libraries have in being digital enablers for many members of the public. The closeness of library service staff to users is strongly evidenced in the testimony from managers as is the need for parent organisation (local authorities or in culture or leisure trusts) to recognise more fully the breadth of services the public library provides and how these are “essential” for many users.

The value and distinctiveness of this research lies in the fact that the research captured the voices, thoughts and perceptions of Scotland’s public libraries during the period of lockdown in 2020. The evidence gathered suggests important conversations are required around equity of e-lending provision, the role of libraries as digital enablers, the balance between physical and digital provision and around the ways libraries are managed (directly by local authorities or in culture trusts). The research affords lessons for public library provision beyond Scotland with many issues being transferable to other contexts.