Brief Insight 20: West Dunbartonshire Alcohol & Drug Partnership: West Dunbartonshire addiction service: Same day access to Medication Assisted Treatment (MAT)
Background
West Dunbartonshire is a rural area with three main urban regions, namely Clydebank, Dumbarton and the Vale of Leven. It has one of the highest levels of deprivation in Scotland. Around 700 people affected by substance use are supported here. In June 2022, West Dunbartonshire Addiction Service piloted a project on same day medication assisted treatment in Clydebank. The core project team focused on four key improvement areas:
- better patient engagement
- improved service access and choice
- reduced ‘did not attend’ rates (DNAs), and
- enhanced service experience.
Some of the new ways of working developed during the COVID-19 pandemic were maintained such as their open door policy and telephone and self-referrals. They also introduced the following changes:
- same day prescribing protocol
- access to virtual patient referrals
- flexible transport provision where required, and
- promotional materials developed in conjunction with people with lived and living experience.
Impact
Changes made to the service resulted in an 85% reduction in service access delays and a 65% increase in the number of people accessing treatment. Retention in treatment has also improved along with positive feedback on treatment choice and availability.
Learning
The team appreciated the value of pathway mapping in the design phase of the project. The development of a low-threshold assessment checklist supported team members to assess opiate dependence levels. This gave them more confidence in the early stages. The presence of senior clinicians also supported team members to adjust to new ways of working. Challenges for the service have been around balancing the needs and expectations of people accessing the service with safe clinical practice. Raising awareness of what to expect on the treatment journey and why is often critical to the success of interventions.
Top Tips
- Close collaboration with GP services to enable treatment access and choice.
- Clinical leadership to support teams to adapt to new ways of working.
- Ongoing engagement with people accessing services to enhance therapeutic relationships.
- Deploying current team members in creative ways while offering support and guidance.
Next Steps
The service is currently seeking Home Office licenses to upscale buprenorphine provision and continue to collaborate with local GPs to develop pathways between services.