Integrated Addiction Services Glasgow City. Christine Laverty Head of Addiction Services North West Glasgow April 2014

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1 Integrated Addiction Services Glasgow City Christine Laverty Head of Addiction Services North West Glasgow April 2014

2 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 (Drug Misuse & Dependence UK Guidelines on Clinical Management - Scottish Gov 2007)

3 The Glasgow Context Glasgow City Council & NHS committed to integrate their Addiction Services 2 Senior Officers seconded to develop Integrated Addiction Services piloted in two localities CAT Evaluation ( Peter Keenan) /04 9 fully integrated Community Addiction Teams (CATs) established across Glasgow City

4 Scale of the Challenge 33% of all individuals living within the 15% most deprived data zones in Scotland, reside in Glasgow City 23% of Scotland s estimated problematic drug users live in Glasgow City (13, % prevalence) 1 in 5 Drug Deaths in Scotland were recorded within Glasgow City ( deaths) 20% of Alcohol Related discharges from a general acute hospital in Scotland are in Glasgow City

5 Aspirations Open Access Self Referral encouraged Single Point of Access for all Addiction Treatment & Care both community and in-patient Standardise Service Delivery across the city 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 To commission a range of services that would enhance what the CAT could deliver

6 Key Achievements I Open Access - crucial to the success of engaging this hard to reach population CATs in Glasgow City are currently working with 10,438 individuals with serious drug and/or alcohol issues Robust interface arrangements with Children & Families, Older People, Mental Health & Criminal Justice Services Partnership working with GPs and Allied Health Professionals Over 6000 children identified & linked to parents accessing CATs - 60% of parents living at the same address as children have engaged in an Impact of Parental Addiction Assessment Waiting Times 95% access treatment within 21 days

7 Key Achievements II Service Users routinely linked into Employment Support Services Shifted the balance of care from residential and hospital to community based - Service Users routinely accessing community rehabilitation, or where appropriate residential rehabilitation and in-patient GPs report that CATs have significantly improved the physical health of individuals Well established Recovery Communities A wide range of services are now in place CAT Review Service Re-design underway in line with ADP Strategy

8 Some of the Challenges Different Cultures Different Terms & Conditions Reluctance/Unwillingness to change custom and practice to a new integrated approach Integrated Service Delivery requires different business support solutions e.g. IT, Finance, HR, Commissioning

9 Critical Success Factors Commitment from both GCC and NHSGG&C that Integrated Addiction Services was the right thing to do Clear & Shared Vision between Partners Single Management Posts with Joint Contracts A focus on strong, visible leadership Robust Governance Principles for partnership working ('Behaviours' etc pgs 15-16) Joint Performance Framework Highly motivated multi disciplinary workforce

10 Recovery Communities Recovery Volunteers and Communities working in partnership with services Learning from Service User experiences Help to re-shape our services Building Community Capacity Reduce dependence on services Exit Strategy A crucial part of the solution