Brief Insight 13: Mid & East Lothian Alcohol & Drug Partnership: East Lothian Substance Use Service: Assertive outreach and same day access

Background

In October 2022, the East Lothian Substance Use Service began to offer same day access to Opiate Substitute Treatment (OST). This service is delivered by one member of the nursing team and provides three appointment slots every weekday. Referrals are generally seen on the same day unless the person requests a later date to suit their own preferences and availability.

Although referrals come into the service from a range of partners, an additional route opened in December 2021 through their new Assertive Outreach team. This team are well placed to facilitate entry into the same day treatment programme and do so at every opportunity.

Impact

Feedback from both elements of the service has been positive and the linkage between them has added an extra dynamic. People identified through the assertive outreach team are supported to travel to the Musselburgh clinic, and then provided with transport options to return and attend future appointments. This helps to reduce financial barriers for those who are ready and keen to access treatment.

Learning

Both parts of the service are developing and are seeking to find ways to improve the quality of referrals into the teams and their own service promotion materials. They have both found the addition of shared clinical support helpful in freeing up their capacity to work with people seeking treatment. They are continually seeking ways to respond to the changing needs of people, particularly as substance use trends change which can impact on the type of treatment they can safely offer.

Top Tips

• Make sure there are processes in place to ensure service resilience.
• Provide clear information to other services around referral requirements and pathways.
• Track your service data to identify trends in numbers and types of interventions, this helps shape future service delivery.

Next Steps

The team are seeking to continue to improve contacts across partner agencies and communities to promote their services. They are also hoping to acquire a vein visualisation system to support their harm reduction activities, and hope to see the development of a dedicated wound pathway over time.