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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