Brief Insight 11: Highland Alcohol & Drug Partnership: Argyll & Bute Addiction Team (ABAT): Improving choice and access to care in Cowal

Background

The Argyll and Bute Addiction Team (ABAT) is an integrated team comprising of specialist staff from NHS Highland and Argyll and Bute Council. Geography is an important factor in delivering care here. It is the fourth sparsest population of the 32 local authorities within Scotland with 47% of its population living in rural areas. One in 10 people are income deprived in this region which also includes 23 inhabited islands.

ABAT’s funding allocation enabled the team to focus on service delivery in Cowal. A region identified as needing more services as it is the most deprived area of Argyll and Bute. Cowal has the highest number of drug related deaths in the area and high numbers of people seeking support from domestic violence and mental health services.

Impact

The ABAT response and outreach service launched in March 2023 and operates an open door approach offering a range of treatment choices for people affected by substance use including a long acting form of buprenorphine. This reduces the need for a referral from professional services and offers people more treatment choice.

The team considers this new way of working as a significant change in culture for the communities it serves. Feedback so far indicates that people have found buprenorphine to be a life changing treatment option. Some people had been attending their local pharmacy every day for years. The availability of buprenorphine treatment now offers them more opportunities, flexibility, privacy and dignity.

Learning

Assertive outreach has worked well in communities to reach people who may hesitate to contact support services. Forming a multi-agency group approach enabled relevant agencies to come together and develop standard operating procedures. As a result their work was more consistent, cohesive, and everyone had a voice. The team faces ongoing challenges with recruitment, especially of response nurses, mostly due to fixed term funding for posts. Availability of equipment is also a recurring issue for those who are in post.

Top Tips

• Support people in a way they are comfortable with, when they are ready to engage.
• Consider models of care such as supporting people in their own home and which open new channels of trust and support.
• Create an approach that is also sustainable for the practitioner as some treatments are more intensive than others.

Next Steps

ABAT will focus on promoting and building on their response service in Cowal to expand across Argyll and Bute.