IJB Report - MAT Annual Report 2024 to 2025.docx
North Ayrshire Council · 25 September 2025
Back to Integration Joint Board — 25 September 2025 and its agenda
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Integration Joint Board 25 September 2025 Subject : North Ayrshire HSCP & ADP Medication Assisted Treatment - Annual Report Purpose : To present the annual report in relation to the continued implementation of the Medication Assisted Treatment Standards. This report is for :- • Awareness Recommendation : IJB are asked to note the content of the report. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required √ 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms MAT Medication Assisted Treatment HSCP Health and Social Care Partnership ADP Alcohol and Drug Partnership RAG ‘Red, Amber & Green’ – scoring system 1. EXECUTIVE SUMMARY 1.1 To present the 2024 to 2025 annual report regarding the continued implementation of the Medication Assisted Treatment (MAT) Standards. 2. BACKGROUND 2.1 The annual report (please refer to Appendix 1) provides detailed information relating to implementation of the MAT Standards, achievements, outcomes and priorities for the year ahead. 3. PROPOSALS 3.1 IJB are asked to note information in relation to :- • Effects of change during the past year; • Statistical data; • Developments and future priorities;
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• Experiential feedback; • Benchmarking scoring tracker and RAG ratings; • Plan for the year ahead. 3.2 Anticipated Outcomes Assurance regarding positive progress in the delivery across all 10 MAT Standards. 3.3 Measuring Impact All targets, standards and outcomes are monitored and evaluated with any learning implemented via quality improvement methodology. More detailed outcomes and positive impact measures are evidenced via regular reporting to the Scottish Government. 4. IMPLICATIONS 4.1 Financial There is a risk of being unable to sustain implementation of MAT Standard 7 (Primary Care) unless on-going funding can be identified (currently the ADP has provided non- recurring funding to implement a new model of care which will be evaluated by March 2026). 4.2 Human Resources The implementation of the MAT Standards involves a wide range of staff across a variety of partner organisations 4.3 Legal None 4.4 Equality/Socio-Economic Equality Impact Assessments are carried out where required. Services have used a human rights based approach to service development and improvement 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).
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4.5 Risk Risk assessments are completed. There is a Low risk grading with regard to full implementation of 9 of the 10 Standards. There is a Medium risk grading with regard to the full implementation of MAT Standard 7 (Primary Care) due to the absence of recurring funding. 4.6 Community Wealth Building Improvements will increase community confidence in partnership approaches and raise awareness of the impact of alcohol and drugs and the work of the ADP & HSCP to reduce drug related deaths. 4.7 Key Priorities Actions and improvements link directly with Ministerial Priorities to support the delivery of local strategic and operational plans across statutory and partner services and support wider actions to prevent drug related deaths in line with the National Mission. 5. CONSULTATION Service users, families and staff from across a variety of services have contributed to the achievement of MAT delivery. Caroline Cameron, Director Peter McArthur, Senior Manager, Alcohol & Drug Services. 01294 317840, peter.mcarthur@aapct.scot.nhs.uk Appendices • Appendix 1 Medication Assisted Treatment – Annual Report
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IMPLEMENTING MEDICATION ASSISTED TREATMENT (MAT) NORTH AYRSHIRE DRUG AND ALCOHOL RECOVERY SERVICE (NADARS) Reporting period: 1st April 2024 - 31st March 2025 Quality issue: In 2023, there were 1,172 drug related deaths registered in Scotland - 121 deaths higher than 2022. Whilst drug deaths in Scotland have been increasing over the last two decades, this is the second lowest number in the last six years. Ayrshire and Arran continues to have higher rates of drug deaths than the Scotland average. Evidence suggests quick access to treatment is crucial and being in treatment can be a protective factor for majority of individuals. The Scottish Drug Deaths Taskforce (SDDTF) has prioritised the introduction of the MAT standards to help reduce the number of drug related deaths. There is evidence that rapid access to MAT meets the needs of highly vulnerable groups and reduces mortality. Aim: To have no barriers to accessing treatment and care that supports an individual’s recovery. This project focussed specifically on improving access to appropriate Medication Assisted Treatment (MAT) within the North Ayrshire Drug & Alcohol Recovery Service (NADARS) in order to prevent deaths, reduce harms and promote recovery opportunities. Effects of change during 2024/25: • Improvement in the waiting time from point of referral to commencement of appropriate Opiate Substitution Therapy (OST) medication - average time from assessment to prescribed medication - 1 day. • Increased choice in OST medications • Improvement in satisfaction and experience of clients. • All individuals received a mental health assessment and support as required. • All individuals were offered Blood Borne Virus (BBV) testing, Harm Reduction interventions, physical health assessment and referred on for further support where required. • All individuals had the opportunity to access Recovery Development Worker's with lived experience to provide person centred recovery support. • All individuals had the opportunity of family involvement. • All individuals were offered housing, advocacy support and were referred for social care support where appropriate. Tests of change: Cycle 1: Implement and test the MAT clinic pathway on a Monday and a Thursday in one locality (Three Towns). Cycle 2: Secure funding to recruit staff to support the implementation of the full model. Cycle 3: Refine project charter to facilitate full model Cycle 4: Expand service to 5 days per week across 6 localities of North Ayrshire (NA). (Test of change is complete and now working towards sustaining full model during 2025/26) 0 2 4 6 8 10 Average number of days from assessment to prescription Median = 1 day 0 5 10 Average number of days from referral to prescription Median = 1 day
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IMPLEMENTING MEDICATION ASSISTED TREATMENT IMPLEMENTING MEDICATION ASSISTED TREATMENT 361 REFERRALS BY GENDER FEMALES MALES 127 234 (35%) (65%) REFERRALS BY GENDER & AGE GROUP 0 20 40 60 80 100 0 - 24 25 - 34 35 - 44 45 - 54 55+ COMMENCED SAME DAY/NEXT DAY (where clinically safe and appropriate) 93% of clients commenced MAT on same day or next day from assessment INTERVENTIONS OFFERED AT POINT OF MAT DELIVERY 100% of clients were offered Mental Health Support and Harm Reduction interventions BBV testing, IEP and Sexual Health 331 individuals chose this pathway of MAT related support. The reasons given for not commencing the pathway were: • clients went to prison • not ready to commence MAT but continued to receive support from the wider service NALOXONE AND OVERDOSE AWARENESS 100% 65%* of clients were of clients were supplied offered Naloxone with Naloxone or already had a kit *The remaining 35% declined* CLIENT SATISFACTION Of clients rated their initial waiting time either “excellent” or “very good” 92% 100% Of clients rated the communication from NADARS either “excellent” or “very good” Of clients who were able to commence medication at their initial appointment stated that there were no delays in getting their prescription 100% 100% Of clients felt that they were given sufficient information to make an informed choice on their treatment options 100% Of clients felt that the NADARS worker explained all the care and treatment options in a way that they understood 92% Of clients rated the overall service either “excellent” or “very good” OPIOID SUBSTITUTION THERAPY (OST) MEDICATIONS PRESCRIBED FOLLOWING ASSESSMENT 48% 44% 8% Methadone Espranor/ Buvidal Suboxone This evidences increased patient choice of OST
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IMPLEMENTING MEDICATION ASSISTED TREATMENT Developments during 2024/25: • Quarterly reports have been submitted to the Scottish Government evidencing progression across each of the 10 standards from the previous year. • An explicit delivery plan was put in place for delivering trauma informed practice • LOPs, SOPs, guidelines and clinical & care pathways of support were reviewed & updated • MAT availability was increased at Caley court and expanded to 5 days per week. MAT is now available across all 6 localities with immediate support available to all from Caley Court alongside remote (low threshold) access in more rural areas including the islands. • 186 individuals currently have ‘shared care’ support with Primary Care colleagues (increase of 95 from the previous year). • 126 referrals were made to advocacy for support from North Ayrshire substance use services (highest referring ADP across Scotland) • A workforce training plan is in place to ensure all staff offering MAT & OST can provide the core harm reduction services at the same time and place as MAT delivery • A robust wide reaching experiential process was implemented by the NA ADP, to capture, analyse and utilise feedback from clients, families and staff to inform service improvement • Appropriate recording information systems were updated to collect and analyse data • In the absence of additional national funding being able to be accessed, the NA ADP committed non- recurring funding to implement initial MAT 7 (Primary Care) developments at pace. • A new staff guidance document was approved for implementation to provide an ‘interface protocol’ as to how secondary care mental health services & alcohol & drug services can better support individuals with co-occurring mental health and alcohol and/or drug use. • A human rights based approach has been carried against 6 of the 10 MAT standards with improvement actions identified. Priorities for 2025/26 • Sustain a ‘solid 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) • Conduct a local analysis of our experiential data to identify themes for further improvement. • Based on national feedback/approval we will update the NA MAT 7 model & explore options to secure ongoing funding. • Work underway, with all ADP partners, to scope out requirements and system change to support MAT delivery for individuals using Stimulants and Benzodiazepines; • Engage with service users, families and staff to evaluate and learn from the recently implemented MAT 9 related multi-agency ‘operational interface protocol’ to better support individuals presenting with co- occurring mental health and alcohol and/or drug use INFORMATION AND FEEDBACK 361 referrals were received between 1st April 2024 and 31st March 2025 331 clients commenced MAT support (the others declined service, required preparatory support or disengaged from service) 93% of clients commenced MAT on the same day or next day from assessment (where clinically appropriate and safe) 126 individuals were referred for and received Advocacy support Reasons for timescales over 7 days include initial non- attendance with follow up in place, required additional preparatory support Detailed numerical data on referrals, timescales, interventions etc was submitted to MIST in April 2025, which is now being analysed to identify good practice and learning.
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IMPLEMENTING MEDICATION ASSISTED TREATMENT EXPERIENTIAL FEEDBACK • To gather feedback and data in a consistent and impartial way, the ADP adopted a multidisciplinary approach by identifying a mixture of service staff and individuals with Lived & Living Experience (LLE) to gather experiential feedback from service users, families/carers of people on MAT, and staff delivering the service. • Individuals identified to carry out the interviews attended a 3-session training course delivered by MIST (national MAT Implementation Support Team). • A mixed methods approach was applied to gather data e.g. 1-1 interviews, smaller engagement events. • The ADP Support Team collated, analysed, and themed the data for submission to MIST (with full involvement of the Experiential Engagement Team and people with LLE). The feedback received was mainly positive and demonstrates the ease of access, increased choice of medications and no barriers to the overall support received. “They made me aware of the different choices...The prescriber fully explained each option to me and the pros/cons of each medication” “We spoke about all the available options to me, and I felt well informed” MIST BENCHMARKING 2025 – SCORING TRACKER Plan during 2025/26 • Sustain a ‘solid 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) IMPLEMENTING MEDICATION ASSISTED TREATMENT