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NORTH AYRSHIRE 

Health and Social Care 
Partnership 


Integration Joint Board 

_24 October 2019 

Subject: Aicohoi and Drug Partnership Annuai Report 2018- 

_2019_ 

Purpose: To brief the IJB on the annual report submitted to the Scottish 

Government as part of local reporting arrangements with the Alcohol 
_and Drug Partnership (ADP)._ 

Recommendation: To take cognizance of the reporting and outcomes in relation to the 

ministerial priorities, updates, and future planning which will assist 
in shaping the upcoming new ADP strategy. 


Glossary of Terms 

ADP 

Alcohol and Drug Partnership 

HSCP 

Health and Social Care Partnership 

NHS AA 

NHS Ayrshire and Arran 


1. 

EXECUTIVE SUMMARY 

1.1 

The annual ADP Report (Appendix 1) has been submitted to the Scottish Government 
in line with the 30'^ September 2019 deadline. A range of partners were asked to 
provide their service delivery input in line with the delivery Plan commitments outlined 
in the 2015-2018 ADP Strategy. 

1.2 

The ADP financial commitments are outlined within the Annual Report and detail the 
specific areas of spend required by Scottish Government. Throughout the document 
the development and initiatives outlined are financed by these funds. The underspend 
outlined (£131,000) is in the main, due to vacancies. 


The report requires underspend proposals to be outlined and this work has begun. 
They will be cross referenced with the upcoming ADP strategy and in line with specific 
Ministerial Priorities. 

1.3 

Priorityl - DAISy Implementation. 

The Scottish Government intend to implement a service user recording system (DAISy 
Drug and Alcohol Information System) along with an outcomes-based recovery web 
reporting Tool (ROW, Recovery Outcome Web) in all services where possible. This 
will ensure consistency in data reporting and cleansing through NHS Information 
Services Division. All services require training and implementation plans to roll out. 

1.4 

Priority 2 - Tackling Alcohol and Drug Related Deaths 

A local Drug Death Prevention Group has been established and has developed an 
action plan to prevent drug related deaths. Key improvement areas include further 
enhancing the work in relation to the supply of Naloxone, working in a whole systems 
approach with families and communities, continued support of community recovery 
activities, promotion of peer support and the value of ‘lived experience’ and the 
provision of a newly tendered service for early intervention and prevention (Turning 
Point Scotland). 


















1.5 Priority 3 - Ensuring a proactive approach to responding to prisoners and associated 
throughcare who experience alcohol/drugs problems. 

The partnership has robust links to prisons, Justice services and Community Justice 
Ayrshire. New developments include peer led recovery groups within prisons, gap 
analysis of individuals returning to Ayrshire placed in outer prison facilities and links 
upon liberation. The North Ayrshire Drug and Alcohol Recovery Services (NADARS) 
have developed a partnership clinic focussing on those who are most at risk and have 
complex needs. This clinic will engage with those upon liberation to ensure all support 
needs are in place. 

1.6 Priority - 4 Continued implementations of activity based on recommendations within 
the Care Inspection report and evidence of Quality Principles for Alcohol and Drug 
Services. The NADARS service recently employed 4 new full time permanent staff 
members who have lived experience of substance use who are now in recovery. All 
HEAT and Local Delivery Plan standards have been met included quick access to 
treatment and delivery of Alcohol Brief Interventions. . 

1.7 Formal arrangements for Working with Partners 

The report outlines the strategic reporting structures of the ADP and responsibility in 
relation to scrutiny by the chief officer’s group. 

The wider subgroups and linked groups provide an exchange of communication and 
actions which flow to and from the ADP. 

2. BACKGROUND 

2.1 The Scottish Government requires all ADP’s to submit annual reports to evidence 
progress made within the partnership and ensure public funds disbursed are used 
accordingly within ministerial priorities in relation to alcohol and drugs. People with 
experience of problem alcohol/drug use and those affected are involved in the 
planning, development and delivery of services. 


3. PROPOSALS 

3.1 The IJB is asked to acknowledge the report submitted and its responses to the 
Scottish Government and the current ADP Strategy. This report will further inform the 
new ADP strategy (2019 - 2024) to be delivered along with the assessment of need. 

3.2 Anticipated Outcomes 

The annual report outlines the response to the Scottish Government priorities and 
delivers on the expectations in line with the strategy and the delivery framework set 
out for ADP’s. 

Looking forward, our new strategy will include delivery plans, an improvement plan, 
a risk register and an ambition of enhanced governance and reporting arrangements 
with the Chief Officers Group, GPP Board and IJB. 

The new strategy also features greater collaboration on a pan Ayrshire basis through 
the Community Justice Ayrshire, an Ayrshire Health and Justice group and, where 
appropriate, co-ordination with the three Ayrshire ADP’s. Additionally, there is a 
focus on continuous improvement through engagement with and learning from key 
groups and agencies including the Scottish Drugs Forum, Scottish Recovery 
Consortium, Scottish Families Affected by Alcohol and Drugs, the Drugs Death Task 
Force, Alcohol Focus Scotland and Public Health Scotland. 




3.3 

Measuring Impact 


The ADP strategy contains a key set of delivery commitments, informed by the ADP 
strategy framework priorities and outcomes. This report adheres to the improvement 
goals set within that. 


The ADP reports quarterly to Scottish Government and has key performance 
measures within the HSCP Performance and Audit Committee report also. 

4. 

IMPLICATIONS 


Financial: 

The ADP is supported by Scottish Government monies. The 
upcoming strategy will continue to identify need locally and 
funding in response to that in line with the delivery framework. 

Human Resources: 

The Alcohol and Drugs Partnership works across agencies with a 
wide range of staff. 

Legal: 

Nil 

Equality: 

The ADP Strategy and Delivery Plan has been through the 
Equality Impact Assessment Process. 

Chiidren and Young 
Peopie 

Senior management within the HSCP in Children and Families 
have been consulted and contributed to this report. 

The Rights, Respect and Recovery Strategy, the outcomes of 
which the ADP will be tested against, has a clear focus on Getting 

It Right For Children, Young People and Families. 

Environmentai & 
Sustainabiiity: 

The ADP, by focussing its work on prevention and early 
intervention and locality-based recovery programmes contributes 
to this. 

Key Priorities: 

The ADP strategy helps support the delivery of the North Ayrshire 
HSCP Strategic Plan. 

Risk Impiications: 

The ADP is focussed on preventing harm in people affected by 
alcohol and drugs, their families and carers. 

Community 

Benefits: 

The ADP is committed to working within a Recovery Orientated 
Systems of Care and Whole Systems approach model to 
incorporate wider benefits to the community and Community 
Planning Priorities. 


Direction Required to 



Councii, Heaith Board or 

1. No Direction Required 

V 

Both 

2. North Ayrshire Council 


(where Directions are required 

3. NHS Ayrshire & Arran 


please complete Directions 
Template) 

4. North Ayrshire Council and NHS Ayrshire & Arran 



5. 

CONSULTATION 

5.1 

All ADP members and partners were consulted in relation to the production of the 
Annual Report. 

6. 

CONCLUSION 

6.1 

The 2018 - 2019 ADP annual report provides information in relation to finance, key 
priority areas and partnership working. The continued rise in drug related deaths and 

























our responses are ever shifting and changing. The ADP Drug Death Prevention Group 
have several improvement actions in place which requires multi-agency support. The 
continued commitment by the ADP in relation to peer support and creation of new 
recovery referral pathways is further enhanced by the tender for the new Turning 
Point, Scotland Service - Prevention, Early intervention And Recovery service 
(PEAR). _ 


For more information piease contact Paul Main paulmain@north-avrshire.aov.uk or 
Thelma Bowers at thelmabowers@north-avrshire.gov.uk 






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APPENDIX 1 

ADP ANNUAL REPORT 2018-19 (NORTH AYRSHIRE ADP) 

Document Details: 

ADP Reporting Requirements 2018-19 

1. Financial framework 

2. Ministerial priorities 

3. Formal arrangements for working with local partners 

Appendix 1 Feedback on this reporting template. 


In submitting this completed Annual Report we are confirming that this has been signed off by both the ADP Chair and Integrated 
Authority Chief Officer. 


The Scottish Government copy should be sent by 30 September 2019 for the attention of Amanda Adams to: 
alcoholanddruqdeliverv@qov.scot copied to Amanda.adams@qov.scot 


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1. FINANCIAL FRAMEWORK-2018-19 

Your report should identify all sources of income (excluding Programme for Government funding) that the ADP has received, 
alongside the funding that you have spent to deliver the priorities set out in your local plan. It would be helpful to distinguish 
appropriately between your own core income and contributions from other ADP Partners. It is helpful to see the expenditure on 
alcohol and drug prevention, treatment & recovery support services as well as dealing with the consequences of problem alcohol 
and drug use in your locality. You should also highlight any underspend and proposals on future use of any such monies**. 


A) Total Income from all sources 


Funding Source 

(If a breakdown is not possible please show as a total) 

preventing and reducing alcohol and drug 
use, harm and related deaths 

Scottish Government funding via NHS Board baseline allocation to Integration Authority 

£1,302,676 

Additional funding from Integration Authority (excludes Programme for Government Funding) 


Funding from Local Authority 


Funding from NHS (excluding NHS Board baseline allocation from Scottish Government) 

£462,922 

Total Funding from other sources not detailed above 


Carry forwards 


Total (A) 

£1,765,598 


B) Total Expenditure from sources 



preventing and reducing alcohol and 
drug use, harm and related deaths 

Prevention (include community focussed, early years, educational inputs/media, young 
people, licensing objectives, ABIs) 

£513,933 

Treatment & Recovery Support Services (include interventions focussed around treatment 
for alcohol and drug dependence) 

£924,516 

Dealing with consequences of problem alcohol and drug use in ADP locality 

£196,149 

Total (B) 

£1,634,598 


C) 2018-19 Total Underspend from all sources: (A-B) 

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Income (A) 

Expenditure (B) 

Under/Overspend 

£1,765,598 

£1,634,598 

£131,000 Under 


D) 2018-19 End Year Balance from Scottish Government earmarked allocations (through NHS Board 
Baseline) 



* Income £ 

Expenditure £ 

End Year Balance £ 

2018-19 investment for 
preventing and 
reducing alcohol and 
drug use, harm and 
related deaths 

£1,765,598 

£1,634,598 

£131,000 

Carry-forward of 

Scottish Government 
investment from 
previous year (s) 





Note: * The income figure for Scottish Government should match the figure given in table (a), unless there is a carry forward 
element of Scottish Government investment from the previous year. 

Note **Underspend Proposals 

The ADP is currently reflecting on the overall budget position and they are in the process of identifying the allocation of 
non-recurring funding with partners. Early proposals include a prison Navigator Programme in collaboration with the 
Scottish Violence Reduction Unit, Community Justice Ayrshire to enhance pathways, support and risk management upon 
liberation. 

Plans are being developed for a community engagement event to allow for a Participatory Budget initiative process in 
relation to prevention of drug deaths implementing a whole systems approach for the community. The main focus on this 
PB process will to be to involve and be informed by individuals, families and communities with lived experience. 

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2. MINISTERIAL PRIORITIES 

Please describe in bullet point format your local Improvement goals and measures for delivery in the following areas during 2018- 
19: 


PRIORITY 

*IMPROVEMENT GOAL 2018-19 
This should include your 
percentage target for each 
priority area where applicabie. 

PROGRESS UPDATE 

Maximum of 300 words for each 
priority. This shouid inciude 
percentage of deiivery against target 

ADDITIONAL 
INFORMATION 
Maximum of 150 
words 

1. Preparing Local Systems to 
Comply with the new Drug & 
Alcohol Information System 
(DAISy) 

• Ensure processes are in 
place to prepare for the 
implementation for the new 
DAISy system 

All services have reviewed their systems, 
processes and paperwork and are 
prepared to enter data into DAISy. This 
includes any relevant services based 
within the prison. 

We have reviewed our compliance with 
the 12 weeks follow up review data in 
preparation for DAISy. We have also 
implemented the ROW tool as a local 
outcome measure. 

The North Ayrshire ADP is on target for 
commencement of DAISy. 

Awaiting 

implementation of 
DAISy in January 
2020. 

We have identified 
staff to undertake 
the DAISy Train for 
Trainers course’. 

Still awaiting training 
dates. 

2. Tackling drug and alcohol 
related deaths (DRD & 
ARD)/risks in your local ADP 
area. 

Which includes - Increasing 
the reach and coverage of the 

• Set up a North Ayrshire 
specific Drug Death 

Prevention Group; 

During 2018, The North Ayrshire Drug 
Death Prevention Group (DDPG) was 
convened as an ADP local subgroup of 
the larger pan-Ayrshire Drug Death 
Prevention Group. This inclusive group 

The group meets bi¬ 
monthly but will 
convene quickly in 
the event of any 
local adverse activity 


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national naloxone programme 
for people at risk of opiate 
overdose, including those on 
release from prison and 
continued development of a 
whole population approach 
which targets harder to reach 
groups and focuses on 
communities where 
deprivation is greatest. 


• Increase the availability of 
Naloxone across North 
Ayrshire 


• Utilise peer workers to target 
and engage with individuals 


has met regularly and has developed an 
Action Plan focussing on specific priority 
areas: 

• Caring for people in contact with 
services 

• Reaching those not in contact with 
services. 

• Reducing Risk 

• Working with Families and 
Communities 

Across North Ayrshire there has been an 
increased focus in widening the use and 
supply of Naloxone. In the last year over 
220 Naloxone kits were distributed which 
was an increase from previous years. It 
was reported that 13 lives have been 
saved in North Ayrshire though the 
administration of Naloxone. This figure 
will be higher but unfortunately many 
‘saves’ go unreported. There is an 
opportunity to widen the availability and 
access to Naloxone across the H&SCP 
and North Ayrshire Council and we would 
expect as a minimum target to increase 
delivery of 60 kits in the next year (a 
proposal is currently being developed). 


or increase risk 
within the community 
that may require or 
benefit from 
partnership response 

Further work and 
analysis with Police 
Scotland in relation 
to data available and 
drug deaths are 
taking place. 


The ADP are testing 
our processes 
against the SDF 
Staying Alive (2019) 
Good Practice 
Indicator 1 


Increased Naloxone 
distribution will be a 
key priority for the 
ADP during 2019/20. 
The ADP are testing 


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not known to service or not 

During 2018/19, the North Ayrshire Drug 

our processes 


currently engaged in service; 

and Alcohol Recovery Service (NADARS) 

against the SDF 



reviewed its staffing skill mix and, based 

Staying Alive (2019) 



on positive Peer Support initiatives 

Good Practice 



implemented by the ADP, complemented 
its Addiction Service workforce by 
recruiting to 4 full time permanent 

Indicator 8 



Recovery Development Workers 

A pilot has been 



(previously known as Peer Recovery 

proposed to take 



Workers). Through this staff group and 

place in HMP 



other peer workers, there has been a pro¬ 

Kilmarnock where 



active targeting of individuals not known 

individuals will 



to service and those who have ‘dropped’ 

receive nasal 



out of service. Pro-active support has 

naloxone (Nyxoid) 



been offered across 3 Community Cafes 

for their possession. 



in North Ayrshire and within HMP 

thus increasing the 



Kilmarnock whilst peer workers have also 

numbers of those 



set up recovery support groups focussing 

liberated with access 



not only on alcohol and drug recovery but 
also Blood Borne Virus identification and 

to naloxone 


• Ensure that the new service 

treatment support. 

The ADP has inbuilt 


being procured by the ADP 


within a new service 


has outcomes relating to 

During 2018/19 the ADP commissioned a 

specification that: 


early intervention, assertive 

new service which focuses on the 

the required skill mix 


outreach and supporting 

following priority areas: 

is a minimum of one 


harder to reach groups. 

Area 1 - Identification, education and 

third of the workforce 


prevention 

secured for 



Area 2 - Brief Intervention and psycho¬ 

individuals with lived 



social support 

experience of 



Area 3 - Ongoing Recovery support for 

alcohol/drug use and 



individuals, carers and families 

in recovery i.e. Peer 
Support Workers. 


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The commissioning 
and procurement 
process have been 
completed, with a 
new service provider 
(Turning Point, 
Scotland) 
commencing in 

August 2019. 

3. Ensuring a proactive and 
planned approach to 
responding to the needs of 
prisoners affected by problem 
drug and alcohol use and their 
associated through care 
arrangements, including 
women 

• Support the implementation 
plan of the Community 

Justice Ayrshire (CJA) Local 
Improvement Plan through 
the Health & Justice 

Thematic Group. 

• Working in partnership with 
the CJA further develop the 
service user involvement 
model for people involved in 
community justice services. 

• Develop peer-led support 
approaches for individuals 
involved with justice services 

Attendance at the HMP Kilmarnock 
‘community links’ drop-in sessions to 
engage with men prior to liberation, and 
then linking then into community supports 
as required. 

Delivery of a peer-led recovery group 
within HMP Kilmarnock 

Links made with HMP Greenock and 

HMP Polmont to identify any gaps in 
provision for people returning to Ayrshire 
post-liberation. 

Contribute to the development of the 
practice guide to service user 

The work of 

Community Justice 
Ayrshire and their 9 
areas of focus in their 
CJLOIP (which include 
‘gender specific 
approaches’ and 
‘keeping out of the 
justice system’) has 
significant crossover 
with the ADP. This will 
be developed further 
with the collaboration 
with the ADP, SVRU 
and CJA project at 

HMP Bowhouse and 
also through a pan 


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who have alcohol or drug 
issues, including individuals 
in HMP Kilmarnock. 

involvement (SUI) in justice settings in 
association with the University of 
Strathclyde and CYCJ. 

Share the learning from the SUI project to 
date through contribution to pan-Ayrshire 
SUI events, and celebrate success 
achieved to date. 

NADARS have implemented a test of 
change partnership clinic to engage with 
individuals with the most complex needs. 
The clinic will include those being 
liberated from prison who are in receipt of 
a methadone prescription. The clinic will 
promote and maximise client opportunity 
for review with their prescriber and offer 
the opportunity to have a conversation 
with essential partner agencies who may 
support them in their recovery journey. By 
introducing this approach, it is hoped that 
this will promote stability and expedite 
recovery for each client involved. The 
service would aim to stabilise all clients 
involved with this more supportive 
approach and refer them back to 
mainstream management. 

Ayrshire health and 
justice group which 
will develop areas for 
diversion of 
prosecution and 
consistency in 
practices with SAS / 
NHS. 

4. Continued implementation 
of improvement activity at a 
local level, based on the 
individualised 

recommendations within the 

• Increasing involvement and 
referrals by statutory drug and 
alcohol services to peer 
support services. 

NADARS now employ 4 full time peer 
recovery workers. This development has 
enhanced pathways across services and 
strengthened links between statutory 

In recent years the 
Partnership has 
benefited from the 
experience of 


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Care Inspectorate Report, 
which examined local 
implementation of the Quality 
Principles. 


The ADP to develop family 
inclusive practice is embedded 
across funded services. 

Embedding a systematic 
approach to monitor 
performance improvement 
activity of all ADP funded 
services. 

The ADP would benefit from 
further evaluation of timely 
access to services. 


services and local recovery communities. 

North Ayrshire ADP work in partnership 
with individuals with lived experience of 
addiction and service providers to deliver 
recovery meetings. These are co¬ 
produced. 

In the commissioning of the new tier2/3 
support services, North Ayrshire ADP 
stipulated that a percentage of the work 
force required to be made up of 
individuals with lived experience of 
addiction. 


The ADP have developed links with 
Scottish Families Affected by Alcohol and 
Drugs (SFAD). NADARS staff have 
attended an information session 
regarding family and bereavement 
support available and routinely offer this 
to service to family and carers. 


NADARS have been focusing on more 
welcoming family inclusive practice, in 
particular, regarding documentation and 
including families and carers to attend 
appointments. Suggestion boxes have 
also been placed within clinic settings to 
garner the views of family members and 
carers. 


individuals with lived 
experience, many of 
whom who are now 
role models in 
recovery working in 
the voluntary and 
statutory sectors. 
Our learning from 
them and their 
contribution to the 
lives of people at 
risk of harm is 
significant. The 
Partnership is 
committed to 
continuing to learn 
from people with 
lived experience as 
well as examining 
feedback and good 
practice at a local, 
national and 
international level. 


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The new ADP funded tier2/3 support 
service will offer family and carer support, 
this was an explicit factor in the 
commissioning process. 

North Ayrshire ADP have worked with 
NAG commissioning and procurement 
department to refresh the current service 
level agreements, incorporating ADP 
outcomes and ministerial priorities and 
implement a robust monitoring process. 
This process will be carried out jointly 
with the commissioning and procurement 
team, and representatives from the ADP. 
This process will be monitored through 
the ADP Finance group. 

North Ayrshire ADP funded services 
continue to meet and exceed the national 
waiting time targets. 

As part of the new strategy development 
a large proportion of engagement took 
place with stakeholders, individuals using 
services and members of the community. 


* SMART (Specific, Measurable, Ambitious, Relevant, Time Bound) measures where appropriate 


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3. FORMAL ARRANGEMENT FOR WORKING WITH LOCAL PARTNERS 


What is the formal arrangement within 
your ADP for working with local partners 
including Integrated Authorities to report 
on the delivery of local outcomes? 


As well as reporting to the North Ayrshire Community Planning Board the ADP now reports to 
the Chief Officer Group along with related updates on Child Protection, Adult Protection, 
MAPPA and Violence Against Women. 

This permits the work of the ADP to be scrutinised by the COG which is chaired by the local 
authority Chief Executive and has members including Director of H&SC and pan Ayrshire post 
holders including Chief Exec of NHS Ayrshire & Arran, police Divisional Commander. 


Similar reporting progresses to the Integrated Authority which will soon include updates on 
performance, improvement plans and escalating risks. 


Each of the ADP sub-groups has a designated section within the Delivery Plan, in order to 
demonstrate a clear focus on the delivery of actions contributing to the strategic priorities of 
Prevention, Protection, Recovery and Communities, incorporating national and local outcomes. 
Ministerial priorities. Opioid Replacement Therapy recommendations and local contribution to 
the Single Outcome Agreement. 

The ADP Delivery Plan is reviewed by each of the subgroups on a regular basis and a quarterly 
update is provided to the ADP Strategic Management Team. The ADP reports within the Health 
& Social Care Partnership/ Integration Joint Board structure. 


The ADP has representation within several strategic structures in order to highlight work taking 
place and contribution to cross cutting agendas. These include- 

• Strategic Planning Group (H&SCP Strategic Priorities) 

• Children Services Strategic Plan 

• Safer North Ayrshire Partnership (CPP Local Outcome Improvement Plan) 

• Community Engagement Network 

• Housing First 

• Prison Reference Group 


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• BBV Managed Care Network 


• Community Justice Ayrshire 


• M.A.D (User Involvement Council) 


• FASD Steering Group 


• Education Representative in the Health & Wellbeing Group 


• Chief Officers Group 


In submitting this compieted Investment Plan, we are confirming that this has been signed off by both the ADP Chair and 
Integrated Authority Chief Officer. 

Paui Main, Chair, North Ayrshire Aicohoi and Drug Partnership. 

Paui Main. Date. 


Stephen Brown, North Ayrshire Integrated Authority, Chief Officer. 





Stephen Brown. Date.26 September 2019 


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APPENDIX 1: 

1. Please provide any feedback you have on this reporting tempiate. 

Nothing of note to feedback 


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