Item 12 - MAT Standards
North Lanarkshire Council · 14 February 2023
Back to IJB Performance, Finance and Audit Committee — 14 February 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No:12 SUBJECT: Alcohol and Drug Partnership (ADP) and Medication Assisted Treatment (MAT) Standards Update TO: Integration Joint Board Performance, Finance & Audit Committee Lead Officer for Report: Ross McGuffie, Chief Officer Author of Report: Morag Dendy, Head of Planning, Performance and Quality Assurance Head of Health DATE: 14th February 2023 1. PURPOSE OF REPORT 1.1 This paper is coming to the Committee: For approval For endorsement To note 1.2 The purpose of the report is to provide the Committee with update on work to implement the MAT Standards in North Lanarkshire and on progress in relation to ADP commissioning and investment in local services and supports. 2. ROUTE TO THE BOARD 2.1 This paper has been: Prepared By: Head of Health Reviewed By: Head of Planning, Performance and Quality Assurance Endorsed By: 3. RECOMMENDATIONS 3.1 The Committee is asked to: note the contents of the report require continued reporting within the agreed timeframes 4. BACKGROUND/SUMMARY OF KEY ISSUES 4.1 The number of drug deaths and level of harm caused by alcohol and drugs both national and locally requires a continued and consistent focus on the actions needed to reduce deaths and improve lives impacted by drugs and alcohol. 4.2 Reports to the Integration Joint Board and Performance, Finance and Audit Committee in 2022 in February, September and November, demonstrate the strength of the foundation work required to achieve real change in the lives of people in North Lanarkshire.
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2 4.3 This report provides an update on the progress being made specifically in relation to implementing the Medication Assisted Treatment standards and in relation to the service commissioning work which supports the strategic direction of the Alcohol and Drug Partnership. The Medication Assisted Treatment (MAT) standards plan 4.4 The Medication Assisted Treatment (MAT) standards direct what is needed for the consistent delivery of safe and accessible drug treatment and support in Scotland. The MAT standards apply to all services and organisations responsible for the delivery of care in a recovery-oriented system of care and are prioritised in an attempt to prevent and reduce deaths. 4.5 Th North Lanarkshire MAT plan has been developed by partners and has taken account of the voices of lived and living experience. 4.6 The current MAT standards in North Lanarkshire are: 1. Same day access: All people accessing services have the option to start MAT from the same day of presentation. 2. Choice: All people are supported to make an informed choice on what medication to use for MAT and the appropriate dose 3. Assertive outreach: All people at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT. 4. Harm Reduction: All people are offered evidence-based harm reduction at the point of MAT delivery. 5. Retention: All people will receive support to remain in treatment for as long as requested. 6. Psychological Support: The system that provides MAT is psychologically informed (tier 1); routinely delivers evidence-based low intensity psychosocial interventions (tier 2); and supports individuals to grow social networks. 7. Primary Care: All people have the option of MAT shared with Primary Care. 8. Independent Advocacy: All people have access to independent advocacy and support for housing, welfare and income needs. 9. Mental Health: All people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery. 10. Trauma Informed Care: All people receive trauma informed care. 4.7 The MAT Standards Implementation Plan produced in September 2022 to set out actions being taken in North Lanarkshire was developed by partners and takes account of the voices of lived and living experience. 4.8 Focusing specifically on MAT standards 1 – 5 the current status in North Lanarkshire is noted below: 1 Same day access - All people accessing services have the option to start MAT from the same day of presentation RED Pan – Lanarkshire Oversight and Governance group has been established North Lanarkshire MAT Working Group has been established North Project Lead recruitment progressed
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3 Leads for each MAT standard in place Action plan to support MAT 1 in place Learning from the Urgent Care Support Team Test of Change initiated in South Standard Operating Procedure setting out prescribing guidelines, care pathways and identify key localities to initiate/test same day access being developed Clinical prescribing guidelines have been written by lead pharmacist and signed off by stakeholders to support same day prescribing for MAT A Standard Operating Procedure has been written in regards to the Test of Change which will influence MAT service development Pan Lan Workforce development plan progressing NLADP Supporting experiential / lived experience feedback to this process via commissioned services and existing structures 2 Choice - All people are supported to make an informed choice on what medication to use for MAT and the appropriate dose AMBER Workstream lead identified Current approaches, processes, and resources available have been reviewed Short Life Working Group established to update named patient SOP and key action required to implement across MAT2 Test of Change sites and wider localities Work continuing to establish a standardised approach to choices offered across all services with relevant supporting guidelines to be developed Leaflet/promotional content to being developed for individuals accessing treatment highlighting MAT 2 setting out choices Lived experience to continue to monitor progress and feedback on an ongoing basis – NLADP supporting 3 Assertive outreach - All people at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT AMBER Work stream lead identified Learning from LORT/Assertive Outreach services including Justice reviewed to develop an MAT 3 action plan Assertive outreach capacity reviewed with recommendation to NLADP treatment group – informing ADP commissioning Progress on the Urgent Care Response Team mobile capacity sourced and resourced Developing standard operating procedure, information sharing protocols and pathways for rapid access to opioid substitution therapy and supportive care 4 Harm Reduction - All people are offered evidence-based harm reduction at the point of MAT delivery AMBER Work stream lead identified Review of current arrangements/processes MAT 4 WAND action plan developed MAT 4 workforce development plan to move to more consistent HR screening at each opportunity/appointment Workforce briefing sessions/training and ‘local champions’ to be identified for ach locality
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4 Increase naloxone provision targeting to localities of concerns identifying key people who will respond in suspected overdose situations including community link and families Harm Reduction Team Standard Operating Procedure to be developed with Harm Reduction Team and Addiction Recovery Teams in conjunction with service manager. Improvement plan to be developed based on Standard Operating Procedure delivery. Home testing plan being developed to work alongside normal team-based testing Electronic system currently in development with IT services, which will consist of a harm reduction form on MORSE, reporting to Harm Reduction Team Harm reduction packs (IEP, Wound packs, BBV test kits, documentation, aide memoire) to be developed that will be individual workers responsibility to take to appointments 5 Retention - All people will receive support to remain in treatment for as long as requested RED MAT 5 Lead identified Review of current Standard Operating Procedures and information offered to individuals in relation to treatment and care Pathways and process review – planned/unplanned discharge rates reviewed to identify appropriate assertive outreach support/follow up opportunities Action plan and timeline for MAT 5 developed NLADP reviewing family inclusive practice across treatment and care services Further work is being undertaken to have structured and documented pathways in place to make best use of statutory and commissioned services Established shared care arrangements with GPs that includes proactive and supported transfer of people stable on MAT is a challenge North Lanarkshire ADP 4.9 NLADP has a strategic commitment and strong aspiration to create a whole system approach to holistic, person-centred and recovery focused services and supports, building on the many examples of innovative involvement of people with lived experience at individual, service and partnership levels to proactively consult, engage and seek feedback. 4.10 A significant review of services and analysis of performance has informed the commissioning and investment position captured in the table below. 4.11 There is a commitment to 3-year funding approach with quarterly reporting and annual reviews: NLC initiatives continuing NHS initiatives continuing Creative Faces Family Plus Project Older Person Advocacy support Addiction Psychology posts Occupational Therapy posts Harm Reduction posts ART – Integrated Team
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5 Drug Testing and Treatment Order – DTTO Housing Life Coaching Kickstart project Substance Misuse Liaison Team VAW Partnership Services for retender on a 3 + 1 year basis New Services on a 3 + 1 + 1 year basis Recovery Development Youth Information and learning Individual Placement Support Crisis/overdose response and assertive outreach service Adult Family Support Community and voluntary sector initiatives Test of Change Initiatives Medics Against Violence – Acute Navigators Phoenix Futures – T2 Treatment Service Barnardos – young person support Equal Say Independent Advocacy Phoenix - Prison Through Care support Scottish Drugs Forum – Addiction Worker Training Programme Youth Justice Contextual Safeguarding - Arrest Referral Solution Courts Lived & Living Experience Panels Substance Misuse Support Fund – VANL Extended Youth Work Provision & Diversionary Activities – CL&D Corra Funded initiatives Research, Development and Scoping Blue Triangle – Breakthrough Service Family learning centres support Barnardos/Phoenix – family support ToC SRC – Residential Rehab provision River Garden Circle – Families and Justice HIS Substance Use and Mental Health Scotland Excel – Residential Rehab Scottish Recovery Consortium - Rehab Training and events calendar to follow in 2023 building on learning from our first training needs analysis. 4.12 The intention is to seek performance reporting on a quarterly basis with regular engagement with the ADP support team through named contacts with all services. 4.13 Reflecting an increase focus on whole system responses, annual stakeholder engagement sessions in springtime of each year will give an opportunity for all stakeholders and people with lived and living experience to reflect on the impact on the loves of people in North Lanarkshire. 4.14 A full and detailed annual report will be brought to the PFA and will facilitate completion of the Self-Assessment required by the Scottish Government. A detailed performance report will therefore be brought to the Performance, Finance and Audit committee in Cycle 3 of each year August – September. 5. IMPLICATIONS 5.1 NATIONAL OUTCOMES The Annual Performance Report contains content relevant to all national outcomes.
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6 5.2 ASSOCIATED MEASURE(S) None 5.3 FINANCIAL None 5.4 PEOPLE None 5.5 INEQUALITIES EQIA Completed: Yes No N/A 6. BACKGROUND PAPERS None 7. APPENDICES ............................................................................. CHIEF ACCOUNTABLE OFFICER Members seeking further information about any aspect of this report, please contact John Holleran on telephone number 01698 753651.