10. NAC Cabinet report 2024 to 2025 - Alcohol Drug MAT Performance Management Information
North Ayrshire Council · 28 October 2025
Back to Cabinet — 28 October 2025 and its agenda
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NORTH AYRSHIRE COUNCIL 28 October 2025 Cabinet Title: Performance Information and Update – Drug and Alcohol Services – 2024/25 Purpose: To provide an update on the national and local drug and alcohol related targets and standards and performance in North Ayrshire. To provide information of the ongoing successful implementation of the Medication Assisted Treatment Standards. To provide assurance to Members of the performance, actions and service developments being progressed to address the significant challenges for our communities. Recommendation: To note the update on performance and improvement actions contained within the report. 1. Executive Summary 1.1 Detailed progress reports for Drug and Alcohol Services in North Ayrshire are included within: Appendix 1 – North Ayrshire Performance Management Report Alcohol and Drug Services 2024/25 Appendix 2 - Medication Assisted Treatment Progress Report 2024/25 1.2 During 2024/25 all the following national and local drug and alcohol related targets and standards were met in North Ayrshire: • ‘Access to Treatment’ waiting times • Medication Assisted Treatment (MAT) ‘access to MAT’ waiting times • Alcohol Brief Intervention (ABI) delivery • Substance Use treatment • Naloxone delivery 1.3 Improvement actions were delivered in support of implementing the Medication Assisted Treatment Standards (MAT). The most recent national benchmarking report has highlighted sustained delivery in North Ayrshire of MAT Standards one to five and improvement in standards 6ix to 10. All 10 standards are now RAG rated a ‘Solid Green’ (which evidences full implementation and meaningful changes across the ADP area).
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Further improvement actions have been identified through extensive experiential and data gathering and will be implemented in the year ahead. 1.4 In September 2025, the National Records for Scotland published its annual report titled ‘Drug Related Deaths in Scotland 2024’. 1,017 people across Scotland died from a Drug Misuse Death (DMD) in 2024. This was a decrease of 13% compared with 2023. Ayrshire & Arran Health Board saw a decrease of DMDs, from 83 deaths in 2023 to 64 deaths in 2024. North Ayrshire saw a decrease from 36 deaths in 2023 to 23 deaths in 2024. Sadly in the first six 6 months of 2025, the locally reported number of suspected (but unverified) DMDs, exceeds the total number of verified DMDs for 2024. Public Health colleague have issued communications in partnership with the Alcohol & Drug Partnerships (ADPs) that this may be linked to the presence of Nitazines, a synthetic form of heroin, in the illicit drug supply in Ayrshire and increasing multi-substance use. The most recent national alcohol related death report saw a 7% decrease in deaths across Scotland in 2024 compared with 2023. There were 80 deaths across Ayrshire and Arran Health Board (which remained unchanged from the previous year). North Ayrshire saw an increase of 2 deaths – 32 deaths compared to 30 deaths in 2023. 1.5 An increased number of individuals have been supported to access detoxification and residential rehabilitation support across North Ayrshire and Scotland wide. 1.6 Extensive service user and family feedback processes have been implemented which has led to continuous service improvements. A Human Rights based approach has been implemented to support service developments. 2. Background 2.1 ‘Access to treatment’ waiting times standards In order to promote the importance of individuals being able to access local support timeously, a national standard is in place for individuals seeing help for both for alcohol and drug related issues: • 90% of all clients referred to services will wait no longer than three weeks from referral to appropriate alcohol treatment that supports their recovery • 100% of clients will wait no longer than six weeks from referral to appropriate alcohol treatment that supports their recovery The same standard and measurements are also in place for individuals seeking support for their drug use 2.2 Alcohol Brief Interventions (ABI) standards for 2024-25 In order to promote the importance of engaging with individuals to reflect on their alcohol use and consider possible change, a national standard is in place to ensure opportunistic discussions can take place across a variety of settings. The ‘Priority’ settings are primary care, A&E and ante-natal. The ‘wider’ settings include partnership and local authority and 3rd sector services.
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• Target number of ABI’s to be delivered across Ayrshire and Arran within ‘priority’ settings – 3,419 • Target number of ABI’s to be delivered across Ayrshire and Arran within ‘wider’ settings – 855 The national reporting of this standard has been ‘paused’ during 2025 2.3 Substance Use treatment target As part of the ‘National Mission’ the Scottish Government created a ‘Substance Use Treatment Target’ to increase the number of individuals being supported in treatment. North Ayrshire was set a target to increase numbers in treatment from 882 individuals in April 2020 to 959 individuals by March 2024. The national reporting of this target has been ‘paused’, however, local interventions and reporting continued. 2.4 Naloxone supply One of the key initiatives to prevent drug related deaths is to supply and promote the use of ‘Naloxone’ (which is an opiate antidote which can temporarily reverse the effects of an opiate overdose, providing more time for an ambulance to be called and treatment to be administered). An improvement plan is in place to promote the use of Naloxone and an increased local target was set for 2024-25 for services to supply, as a minimum, 480 kits. 2.5 Drug and alcohol related deaths Central to the ‘National Mission’ is the requirement to prevent drug and alcohol related deaths. Each and every drug and alcohol related death is a tragedy for individuals, families and communities and continues to be of great concern to all. Services have implemented a range of actions to prevent such deaths whilst also wishing to learn as much as possible about the circumstances around each death and work closely with partners to identify issues and areas for improvement. The North Ayrshire ADP enables partners to come together to implement actions aimed at preventing drug and alcohol related deaths. By adopting a wider public health and human rights based approach and working with local people, services and stakeholders, everyone can work together to prevent these deaths. Each year the National Records of Scotland produces its annual reports on drug and alcohol related deaths. 2.6 Residential Rehabilitation Another key element of the ‘National Mission’ is to increase access to residential rehabilitation support.
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For residents of Ayrshire and Arran, Ward 5, Woodland View, is available for hospital based detoxification support, shorter term rehabilitation support and also offers a day attendance programme. In addition, vulnerable families with young children can be supported to access Harper House in Saltcoats (who offer support to families from across Scotland - with a local enhanced pathway of support available for more vulnerable families from North Ayrshire). The ADP has continued to receive funding to ensure pathways are in place to support individuals to access longer term external residential rehabilitation support across Scotland 2.7 Medication Assisted Treatment Standards As part of the ‘National Mission’ services have been tasked with delivering on 10 Medication Assisted Treatment (MAT) Standards with the aim of improving access, choice and support for individuals. The term MAT is used to refer to the use of medication such as opioids, together with any psychological and social support, in the treatment and care of people who experience problems with their drug use. Over the last year, across North Ayrshire, there has been sustained improvement and progress across all 10 standards. 3. Proposals 3.1 ‘Access to treatment’ waiting times standards Alcohol • 90% of clients will wait no longer than 3 weeks from referral to appropriate alcohol treatment that supports their recovery Quarter 1 data Quarter 2 Quarter 3 Quarter 4 100% 97% 96% 98% • 100% of Clients will wait no longer than 6 weeks from referral to appropriate alcohol treatment that supports their recovery Quarter 1 data Quarter 2 Quarter 3 Quarter 4 100% 100% 100% 100% Drugs • 90% of clients will wait no longer than 3 weeks from referral to appropriate drug treatment that supports their recovery Quarter 1 data Quarter 2 Quarter 3 Quarter 4 99% 100% 100% 100% • 100% of clients will wait no longer than 6 weeks from referral to appropriate drug treatment that supports their recovery
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Quarter 1 data Quarter 2 Quarter 3 Quarter 4 100% 100% 100% 100% • All waiting times standards were met during 2024 to 2025: 3.2 ‘Alcohol Brief Interventions’ standards for 2024/25 Annual Target set by Scottish Government in priority settings (2024/25) – 3,420 • Total ABI delivery in priority settings (as at 31/03/2025) – 6,398 Annual target set by Scottish Government in wider settings – 855 • Total ABI delivery in wider settings (as at 31/03/2025) – 1,210 Note – national reporting on ABI is currently paused. Local reporting continues. 3.3 ‘Substance Use’ treatment target North Ayrshire had been set a target to increase numbers in treatment from 882 individuals in April 2020 to 959 individuals by March 2024. This was exceeded. In 2025, no new specific target has been set. As we await further national guidance, the expectation is for services to continue to support as many people into treatment as possible. North Ayrshire increased the numbers in treatment to 1,220 by March 2025. 3.4 ‘Naloxone’ supply Against a local target of supplying 480 Naloxone kits during 2024/25 – 741 kits were supplied across North Ayrshire (a further increase from the previous year). 73 lives across Ayrshire and Arran were reported to be saved through the use of Naloxone during this period (18 in North Ayrshire). Many ‘saves’ go unreported. 3.5 Drug related deaths In September 2025, the National Records of Scotland published its annual report titled ‘Drug Related Deaths in Scotland 2024’. 1,017 people across Scotland died from a Drug Misuse Death (DMD) in 2024, a decrease of 13% (155 deaths) compared with 2023. Ayrshire and Arran Health Board saw a decrease of DMDs last year, from 83 deaths in 2023 to 64 deaths in 2024. North Ayrshire saw a decrease from 36 deaths in 2023 to 23 deaths in 2024. Published confirmed deaths: East North South Total 2020 36 39 31 106 2021 38 39 23 100 2022 30 37 15 82 Target achieved Target achieved
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2023 31 36 16 83 2024 21 23 20 64 Locally services monitor and report all suspected DMDs, with the number being confirmed nationally through verification of the cause of death, hence there is a delay in confirmation of the verified number of DMDs each year. Sadly in the first six months of 2025, the locally reported number of suspected (but unverified) DMDs, exceeds the total number of verified DMDs for 2024. Public Health have issued communications in partnership with the ADPs that this may be linked to the presence of Nitazines, a synthetic form of heroin, in the illicit drug supply in Ayrshire. The ADP are working alongside Public Health colleagues and alcohol and drug services to help reduce risk and harm, with a focus to refreshing our actions to reduce the number of deaths in North Ayrshire. These include but are not limited to: • Continued delivery of the Medication Assisted Treatment (MAT) Standards • Ensure quick access to MAT support (during 2024, the time from point of referral to receiving prescribed medication was one day) • Continue to prioritise Blood Borne Virus (BBV) testing, Harm Reduction interventions and mental and physical health assessment and support • Ensure access to staff with lived experience to provide person centred recovery support. • Promote family involvement and offer housing, welfare and advocacy support • Continue to meet and exceed all local and national ‘access to treatment’ waiting times’ targets and standards. • Increase the number of individuals being supported to access Ward 5, Woodland View and external residential rehabilitation support • Continue to offer increased choice across the various Opiate Substitution Therapy medications 3.6 Alcohol related deaths The most recent national alcohol related death report saw a 7% decrease in deaths across Scotland in 2024 compared with 2023. There were 80 deaths across Ayrshire and Arran Health Board (which remained unchanged from the previous year). North Ayrshire saw an increase of two deaths – 32 deaths compared to 30 deaths in 2023. These avoidable deaths continue to cause significant harm to individuals, families, and communities across Scotland." North Ayrshire Alcohol Related Death figures for the past six years are as follows: 2019 – Total number of deaths: 50 2020 – Total number of deaths: 44 2021 – Total number of deaths: 37 2022 – Total number of deaths: 29 2023 – Total number of deaths: 30 2024 – Total number of deaths: 32 We have continued to refresh our actions to reduce the number of deaths in North Ayrshire with an increased focus to reduce alcohol related harms similar to prioritising
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improvement actions to reduce drug related deaths. 3.7 Residential Rehabilitation and Detoxification Another key element of the ‘National Mission’ is to increase access to residential rehabilitation support. Local hospital based support is provided in Ward 5, Woodland View, Irvine to anyone who has an alcohol and/or drug problem and mental health issues. Ward 5 has 10 beds for residential care – offering local access to residential, detoxification, rehabilitation and day attendance support. Seamless pathways of support are in place with local community alcohol and drug services supporting individuals before, during and after their placement (extra support in place for NA residents e.g. in addition to ongoing NADARS support, everyone is also provided with daily follow up support from the local Turning Point, Scotland, service for the first week following discharge). During 2024/25: 135 individuals received detoxification support – 72 from North Ayrshire 87 individuals received rehabilitation support – 51 from North Ayrshire Access to additional local residential rehabilitation - Harper House The NA H&SCP was instrumental in supporting Phoenix Futures, Scotland, to open ‘Harper House’ in November 2022 which offers specialist support for the ‘whole family to recover from the harms of problematic drug and alcohol use’. In 2024/2 NADARS supported three families into Harper House. Additionally NADARS supported four families who relocated to North Ayrshire from other areas in Scotland following completion of the Harper House residential programme. Access to External Residential Rehabilitation (ERR) Individuals wishing to access external residential rehabilitation support can do so via NADARS who will support the development of a care plan, identify a residential rehabilitation provider, seek funding and then support individuals into, through and after their ERR placement. In 2024/25, NADARS received 57 referrals for consideration of ERR. Following assessment, 16 individuals were suitable for ERR and funding was approved (41 individuals felt not ready or declined the ERR intervention at that time and were offered alternative community supports). No application has been declined due to financial considerations 10 individuals commenced ERR (with nine completing their agreed placement). 3.8 Residential Rehabilitation and Detoxification In 2021, the Scottish Government introduced 10 Medication Assisted Treatment (MAT) Standards for implementation. Evidence suggests that rapid access to MAT meets the needs of highly vulnerable groups and reduces mortality.
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Results/outcomes (2024/25) • Improvement in the waiting time from referral to commencement of appropriate Opiate Substitution Therapy medication (75% of individuals were offered a first MAT assessment on the same day as engagement with the service) which was a further improvement from the previous year) • 100% of individuals were supported to make an informed choice on MAT medication and the appropriate dose • 75% of notified high risk events to the multi-agency assessment team for assertive outreach were contacted on the same day (improvement from previous year) • 86.49% of individuals were retained in service for more than 6 months (improvement from previous year) • 186 individuals have shared care with Primary Care (improvement from previous year) • 100% of individuals received a mental health assessment • 100% of individuals were offered BBV testing, Harm Reduction interventions and a physical health assessment. • Improvement in satisfaction and experience of clients (improvement from previous year) • A RAGB self-assessment was completed, and evidence (numerical, experiential and process information) was submitted to the MIST team for analysis and benchmarking. The table below highlights a very positive final RAGB score for the implementation of MAT standards 1 to 10 across North Ayrshire Plan during 2025/26: • Sustain a green RAG rating for standards 6 to 10 • Move to a RAG rating of blue during the next year for MAT Standards 1 to 5 (as the definition of a final blue RAG rating is to be able to evidence 2 years of sustained implementation of a green RAG rating and evidence of benefit to people plus ongoing monitoring of the standard across all MAT services)
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4. Implications/Socio-economic Duty Financial 4.1 The performance report provides an overview of the funding allocated and directed by the ADP to deliver on its strategic plan priorities. There remain financial risks including recurring funding which will require to be identified to ensure sustained implementation of all 10 MAT Standards and MAT Standard 7 in particular. The substitute prescribing budget in the HSCP remains under pressure due to the positive promotion of choice of medications (as directed by the Scottish Government). Discussions continue with the local ADP and key partners to explore and identify funding opportunities. Human Resources 4.2 None Legal 4.3 None Equality/Socio-economic 4.4 The majority of people at risk of drug and alcohol related deaths are among the most marginalised and disadvantaged in our population. Many of those people experience significant disadvantage of opportunity and poorer health outcomes. The programmes of work delivered via our ADP, HSCP, NHS Board, NAC and wider partners contributes to reducing inequalities and in the prevention of drug and alcohol related deaths through public health and human rights based approaches utilising the following: • PANEL principles (a framework for applying a human rights-based approach in practice, emphasizing Participation, Accountability, Non-Discrimination, Empowerment, and Legality) • FAIR model (a practical framework which focuses on understanding the facts, analysing rights at stake, identifying responsibilities, and reviewing actions) • AAA approach (a framework focusing on the Accessibility, Availability, and Appropriateness of services and resources, particularly in the context of public health and well-being). Climate Change and Carbon 4.5 None Key Priorities 4.6 The information contained within this report and the improvement actions that have been implemented have a positive contribution to play in support of one of the Councils key themes: • Wellbeing (we will address health inequalities, promote children and young people’s wellbeing and enable community wellbeing)
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Community Wealth Building 4.7 None Islands Communities Impact Assessment (ICIA) 4.8 All the information relates to North Ayrshire and Arrans 6 localities including the island communities to ensure consistent and equitable service provision. United Nations Rights of the Child (UNCRC) 4.9 All developments and proposals ensure that all the key themes in Children’s Rights are considered with an additional focus on ensuring all support to adult service users ensure the essential protection of children. Consumer Duty 4.10 Central to service provision and development is the consideration of the impact on service users, families and communities and the strategic priority to reduce harm and prevent drug and alcohol related deaths. 5. Consultation 5.1 This report notes the significant collaboration and engagement undertaken both nationally and locally across the health and social care system to prevent alcohol and drug related deaths and to ensure that all standards and targets are met. The report has been presented to the ADP and also the Integration Joint Board. Caroline Cameron Director – North Ayrshire Health and Social Care Partnership For further information please contact Peter McArthur, Senior Manager – Alcohol and Drug Services, on 01294 476000. Background Papers 2