Chief Medical Officer and Public Health Directorate Public Health Division Dear Colleague MANAGEMENT OF PEOPLE IN THE COMMUNITY WHO ARE DRUNK AND INCAPABLE: A NATIONAL MEMORANDUM OF UNDERSTANDING BETWEEN THE SCOTTISH AMBULANCE SERVICE AND ASSOCIATION OF CHIEF POLICE OFFICERS IN SCOTLAND This letter highlights a national Memorandum of Understanding (MOU) which has been developed between the Scottish Ambulance Service (SAS) and the Association of Chief Police Officers in Scotland (ACPOS), regarding the management of people in the community who are drunk and incapable. The MOU highlights the need for joint working and supporting actions in local areas to enable the delivery of integrated and appropriate services to this vulnerable group of people. The MOU is attached at Annex A. Background 1. There has been considerable debate about the most effective and efficient management of drunk and incapable people who come into contact with the emergency services, such as SAS, police forces and A&E services. 2. Limited data has been available on the scale of the problem. Scottish Government social researchers commissioned research to estimate the size and nature of the issue and examine how the needs of this population are currently being addressed. The findings from this research were published on 10 November 2009 1 and followed by a Chief Executive Letter (CEL 44/2009), signed jointly by the Chief Executive of NHS Scotland and by ACPOS, published on 17 November 2009. 3. CEL 44/2009 asked Alcohol and Drug Partnerships to ensure the needs of people who are drunk and incapable be included in local needs assessments when reviewing their service provision, and to ensure there are clear and effective partnership-based strategies in place to manage the needs of this vulnerable population and mitigate the impact they have on their communities. abcdefghijklmnopqrstu CEL 41 (2010) 09 December 2010 Addresses For action Chief Executives, NHS Territorial Boards Chief Executive, Scottish Ambulance Service Scottish Police Forces ACPOS Alcohol And Drug Partnerships Chief Executives, Local Authorities Community Safety Partnership Chairs Directors of Public Health, NHS Boards For information CoSLA Local Authority Chief Social Work Officers Enquiries to: Dr. Mini Mishra Primary Care St Andrew s House Regent Road Edinburgh EH1 3DG Tel: 0131-244 5066 Fax: 0131-244 Point of contact Mini.Mishra@scotland.gsi.g ov.uk http:// 1 Research report: http:///publications/2009/10/29154403/0 A review of the literature:http:///publications/2009/10/29154320/0 A summary of findings and recommendations: http:///publications/2009/10/29154234/0 St Andrew s House, Regent Road, Edinburgh EH1 3DG
4. A dissemination event was held in November 2009, attended by a broad range of stakeholders who highlighted a number of ways that the needs of this population can be effectively met through a range of provisions. It also clearly demonstrated the need for effective partnership working to meet the needs of this population, as highlighted by the research report. A copy of the letter outlining the outcomes from this event is attached at Annex B. Memorandum of Understanding (MOU) 5. The attached national MOU address the interactions between the Scottish Ambulance Service (SAS) and the Police Services in Scotland, who are usually the first point of contact for people who are drunk and incapable. It attempts to put in place a national framework and referral flowchart that sets out core principles and arrangements that should be further refined to meet local needs and resources. The aim is to manage effectively the needs and provide appropriate care of people who are drunk and incapable. The police forces will continue to respond to calls for assistance from the SAS, and will also respond to the directions of the Crown Office and Procurator Fiscal Service (COPFS). The COPFS reserves the right to prosecute cases for the crime of Drunk and Incapable, where the prosecution is in the public interest. 6. The signatories to the MOU will ensure that the MOU is reviewed annually, and any necessary changes will be recommended for endorsement by both organisations and local partners. Action 7. The MOU is part of other joint initiatives to manage people who are vulnerable through misuse of alcohol in the community. To ensure the effective implementation of this national MOU we would ask that local plans are multi-agency agreements, involving territorial NHS Boards, SAS, Police forces, Alcohol and Drug Partnerships, Local Authorities, Crown Office Procurator Fiscal Service, First Aid Organisations and Third Sector. The action plans should be seen as part of each ADP s strategy for tackling alcohol misuse, implemented and monitored by relevant agencies, and reviewed on a regular basis. Further Information 8. Further information or advice on the MOU is available from Chief Inspector Malcolm McMillan at Malcolm.mcmillan@grampian.pnn.police.uk or Gerry Egan, Paramedic Clinical Director at gegan@nhs.net. Yours sincerely Derek Feeley Acting Director General for Health and Chief Executive of NHS Scotland Deputy Chief Constable George Graham ACPOS St Andrew s House, Regent Road, Edinburgh EH1 3DG
ANNEX A St Andrew s House, Regent Road, Edinburgh EH1 3DG
ANNEX B St Andrew s House, Regent Road, Edinburgh EH1 3DG