Brief Insight nine: Glasgow City Alcohol & Drug Partnership: The WAND harm reduction initiative

Background

The WAND initiative is an incentive based harm reduction programme for people who are affected by substance use in Glasgow City. It encourages people to engage with four key harm reduction interventions:

  • Wound care,
  • Assessment of injecting risk,
  • Naloxone awareness and promotion, and
  • Dried blood spot testing.

Specialist staff from NHS Greater Glasgow and Clyde deliver the service with their third sector partners. They encourage people to attend every three months so they can support them over time. This helps to keep track of their progress and allows for timely identification of risk and onward referral to relevant services.

Impact

The Assessment of Injecting Risk (AIR) tool is key to the service. It identifies injecting-related harms and their causes while promoting conversations about harm reduction. In the first year of the service, 831 people attended the service with 41% returning for a second round of interventions. Numbers have increased since then and the service now has a control group to further assess the service’s impact. To incentivise engagement, people receive a PayPoint voucher on completion of all four interventions. Current evidence shows that people use these vouchers to support their daily lives in practical and meaningful ways.

Learning

The service identified a correlation between injecting below the waist and the development of deep vein thrombosis (DVTs) and venous ulcers. This resulted in the service purchasing a vein finder device. This device uses innovative technology to create a real-time visual map of the veins on the surface of the skin and can result in less trauma to the skin and a reduction in the development of ulcers. 

The WAND initiative has also seen indicators of short-term behaviour change including:

  • Signs of decreased levels of main drugs used,
  • Higher proportion of people tested for Blood Borne Viruses (BBVs),
  • Increased numbers of people carrying naloxone on follow-up.

Top Tips

  • Proactive collaboration with other specialist agencies and sectors who have the required skills and expertise.
  • Engage in meaningful ways with people who use the service.
  • Equip and train staff to feel confident and safe delivering services.
  • Develop and maintain links with partner agencies, gathering feedback to support follow-up interventions.

Next Steps

Analysis and evaluation of both service and patient outcomes and the impact of the vein finder device is currently underway.