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Public Health Scotland’s 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.

Public Health Scotland’s (PHS) most recent report confirmed that 461 statutory-funded placements were approved in the second half of the 2023-24 financial year alone, with 938 placements approved for the year overall. This indicates that we are already on track to meet our commitment of 1000 people accessing statutory-funded residential rehab in 2026 (an increase of 300%).

While the PHS statistics indicate welcome progress, we recognise the scale of the challenge that we continue to face and are determined to do more.

We are working with ADPs to aid the development of clear pathways into residential rehabilitation across the country, and the establishment of pathway development clusters by Healthcare Improvement Scotland has resulted in 29/30 ADPs publishing their pathways. This will help facilitate a further increase to statutory funded placements and support our aim of meeting the final target before the end of the National Mission in March 2026.

Residential rehabilitation services in Scotland are regulated by appropriate governing bodies independent of the Scottish Government; namely the Care Inspectorate, Healthcare Improvement Scotland or the NHS.

It is the responsibility of these bodies to monitor and ensure that residential rehabilitation services are providing safe, quality support to people in recovery across the country.

The Scottish Government entrusts these bodies to carry out this responsibility diligently, and in line with the qualified levels of clinical expertise that they provide.

The Scottish Government commissioned Scotland Excel to develop a National Commissioning Framework to support the procurement of residential rehabilitation placements. The Framework launched in April 2024 and includes a service specification as part of the contractual arrangement. This service specification was developed in conjunction with the regulators to ensure a minimum level of care provided by each provider on the framework.

We have responded to calls for more transparency and accountability by working with Public Health Scotland to track the number of residential rehab placements that ADPs have funded and the development of 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.

Residential rehabilitation services in Scotland are regulated by appropriate governing bodies independent of the Scottish Government; namely the Care Inspectorate, Healthcare Improvement Scotland or the NHS.

It is the responsibility of these bodies to monitor and ensure that residential rehabilitation services are providing safe, quality support to people in recovery across the country.

The Scottish Government entrusts these bodies to carry out this responsibility diligently, and in line with the qualified levels of clinical expertise that they provide.

The Scottish Government commissioned Scotland Excel to develop a National Commissioning Framework to support the procurement of residential rehabilitation placements. The Framework launched in April 2024 and includes a service specification as part of the contractual arrangement. This service specification was developed in conjunction with the regulators to ensure a minimum level of care provided by each provider on the framework.

We have responded to calls for more transparency and accountability by working with Public Health Scotland to track the number of residential rehab placements that have been funded using public money.

PHS and SG have worked collaboratively with stakeholders to establish a core minimum dataset to support the monitoring and evaluation of residential rehab. The first batch of returns for the dataset have now been received from most providers. It is expected that the first extracts from the dataset, including the number of publicly funded residential rehabilitation placements will be published in December 2024.

A greater level of insight and data will be available for publication, including average treatment length and associated outcomes, as the dataset continues to develop and become more mature.

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 Scottish Government remains committed to addressing the twin public health emergencies on alcohol and drugs and recognises the key role treatment and recovery services play.

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.

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 the duration of treatment.

We commissioned The Gate Worldwide to develop and launch a National Directory of Residential Rehab providers. This directory will be announced soon and will include details on standard programme lengths for each provider listed.