Almost everything you ever wanted to know about Integrated Addiction Services but were too afraid to ask Christine Laverty Head of Addiction Services North West Glasgow November 2013

‘Many drug users have a myriad of health and social problems which require interventions from a range of providers. Joint working across health and social care is therefore a key feature of an effective treatment. It is seldom the case that one clinician will be able to meet these needs in isolation’ (Scottish Exec 2007)

Setting the Scene – the Glasgow Context Glasgow City Council & NHS agree to integrate their Addiction Services Integrated Services piloted in two areas Evaluated (Peter Keenan) 2003 – 9 Community Addiction Teams (CATs) established in Glasgow City

Scale of the Challenge 33.1% of all individuals living within the 15% most deprived data zones in Scotland, reside in Glasgow Estimated 13,900 problematic drug users within Glasgow City (3.4% prevalence rate, 23.3% Scottish Total) 10,438 individuals engaged with Addiction Services in Glasgow 1 in 5 Drug Deaths in Scotland occurred within Glasgow City in 2012 (121 deaths)

Scale of the Challenge cont. 7,583 alcohol related discharges from a general acute hospital within Glasgow City in 2012/13 – 19.6% of the Scottish total Approx 6000 children linked to Adult Service Users

Aspirations Single Point of Access Open Access – Self Referral encouraged To engage and retain individuals with serious drug and/or alcohol problems in Addiction Treatment To develop a range of community based treatments and interventions

Achievements CATs are main vehicle for Addiction Service Delivery and access to Tier 4 Services Caseload doubled – now 10,438 Open Access although a challenge has been sustained and is crucial to the success of engaging this hard to reach population Waiting Times – 92% access treatment within 21 days 53% of current caseload - Parental Assessments have been completed for Parents where children live at the same address

Achievements cont. 2013/14 – To date 1856 individuals linked into Employment Support Services 2013/14 – To date 1608 individuals entering community or residential rehabilitation CAT Review – 10 years on, found that CATs had significantly improved the physical health of individuals in Glasgow with Addiction Issues Well established Recovery Communities Shifted the balance of care from residential and hospital based to community based A wide range of services are now in place CAT Review – Service Re-design underway

Some of the Challenges Volume Exit Strategies Vulnerability versus non dependent drinker Ensuring Consistency Professional Roles & Identity in Integrated Services Different Cultures Different Terms & Conditions

Critical Success Factors Robust Governance Arrangements Clear & Shared Vision between Partners Joint Performance Framework incorporating key objectives from both partner orgs Single Management Posts with Joint Contracts A focus on strong, visible leadership

Critical Success Factors cont. A strive to forge and maintain good partnership relationships and behaviours Adherence to agreed decision making processes Acknowledge and have a system in place for identifying and managing risks associated with partnership working

Good Behaviours of Partnership Working Audit Scotland – Review of Community Health Partnerships 2011 (in handouts) Really helpful tool

Q&A Session