Brief Insight 16: Scottish Ambulance Service: Non-fatal overdose pathway
Background
The Non-Fatal Overdose Pathway enables the Scottish Ambulance Service to identify people at high risk of drug-related harm on attendance. Frontline ambulance clinicians deliver this new model. They input key data which triggers the pathway at the local health board. Teams also use this opportunity to talk to people about and offer take-home naloxone.
Impact
From July 2021 to January 2023 the pathway generated 10,904 referrals. Approximately 40% of these referrals were for people unknown to local services. With the person’s consent, the ambulance team share information with the health board. Local drug treatment and support services use this information to contact the person. Examples of follow-on support include:
- Allocation of keyworker,
- Referral for Medication Assisted Treatment,
- Supply of take-home naloxone,
- Referral to local addiction psychological therapy teams,
- Referral to Community Mental Health teams,
- Connection to local Narcotics Anonymous groups.
Feedback from people has been positive. Some have experienced several non-fatal overdoses and welcome the follow-up this model offers.
“If it was not for the kind ambulance staff that put in the referral, I would probably be dead and that is a fact. I am now addressing my drug use, have housing support and feel in a place to change things. I wasn’t sure what ‘help’ even meant to be honest, but this service has helped me prioritise and support me. Thank you.”
Learning
A balanced and robust national data sharing agreement was key to the pathway design. Central to this was the will and engagement of the 14 health boards. The service design team worked with the boards to embed a strong harm reduction culture. Engagement with and training for frontline clinicians nurtured a person-centred approach. On completion of the training, staff highlighted the impact of hearing from people with lived and living experience.
Top Tips
- Encourage open conversations with frontline teams.
- Review existing services through a fresh perspective.
- Understand your service demographic.
- Design services with people with lived and living experience.
- Develop engaging and realistic educational content to maximise learning.
Next Steps
Scottish Ambulance Service is currently assessing the pathway’s local impact to support continued service improvement.