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Integrated Care for drug users: Principles and practice
ANNEX 2D
GLASGOW CITY COUNCIL, GREATER GLASGOW NHS BOARD AND PRIMARY CARE TRUST INTEGRATED ADDICTION SERVICES
Background
For the past twelve months Glasgow City Council Social Work Services and Greater Glasgow NHS Board and Primary Care Trust have been working to develop a model of integrated Addiction Services. This model has been developed through the secondment of two staff, one each from Social Work and Health who worked in conjunction with staff and managers across the current services.
This section describes the agreed framework for services and the specific proposals for community based services, which are currently subject to discussion with a range of stakeholders including staff trade unions. Two pilot services are due to commence from October 2002.
Further work is being undertaken in relation to developing a model for highly specialist treatment and care services within the Health Service and a review of services purchased from the independent sector is underway. Both these pieces of work are due to conclude later this year.
A Four Tier Model of Service Provision
The model proposed here was originally developed by the NHS Health Advisory Service in 1995 as a strategic model for Mental Health Services. It was later developed in 1996 in relation to drug and alcohol services in relation to young people.
The model describes four tiers within which it is possible to locate existing drug and alcohol provision within Glasgow. In using the model it has been our intention to provide potential for a re-shaping of existing services, within a tiered approach, in order to deliver the prospect of multi-professional Addiction Services.
As can be seen from the diagram below, the four tier approach moves from tier 1 'generic services', which in relation to addiction issues fulfill signposting functions, through to tier 2 which are described as 'generic with specialist functions', such as Social Work area services. It is in tier 3 and 4 where we identify the provision of specialist treatment and care services.
Community Addiction Teams
These teams will be located in nine areas of Glasgow and provide a direct access service across the whole city. They will combine current Social Work Addiction Services with existing and new nursing posts to form new integrated addiction teams under a joint team leadership and management arrangement.
The medical component of CATs will be provided through General Practitioners within the GP Shared Care Scheme for the methadone program. CATs will also have direct links to the highly specialist treatment and care services within Health and will ensure the effective care management of service users across the range of services provided and purchased from the independent sector.
The diagram below outlines the main functions of Community Addiction Teams and the interface between tier 3 and 4 services.
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