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Chapter 6: Conclusion
Collaboration between partner organisations is an inherently difficult process. The CAT evaluation presents an integrated addictions strategy being implemented. It was a complex and challenging process that resulted in a range of benefits for parent organisations, such as better patient access, informal information sharing and improvements in general service development. The integrated approach also realised benefits for service users where nursing and social care staff working together were able to produce a positive outcome for the same client.
Evaluation Limitations
The evaluation describes the experience of East and North East CATs in Glasgow only. Some elements of the Glasgow experience may resonate with addictions staff within addiction services across Scotland, and the lessons learned in Glasgow may prove to be useful to future CATs across Scotland when introducing integrated addiction services in their localities.
It cannot be assumed that the way in which events unfolded in East and North East Glasgow are likely to be exactly the same for future CATs elsewhere. Local issues which influence the development for CATs may vary, and addictions staff and stakeholder response to the introduction of CATs may not be the same as those in Glasgow. Local service user and carer needs may also differ ( e.g. in rural areas) and influence how CATs are implemented in different types of localities.
The Glasgow CATs experience, however, has provided an excellent opportunity for future CATs to learn about the benefits of integrated addiction services, as well as a strong reminder of the key challenges involved in the change process.
Managing integrated services
"…We need to help staff across agencies overcome barriers to change..."
- Joint Futures Strategy (2000)
Managing integration between health and social care addiction services may not require the use of traditional change management approaches adopted to overcome barriers to change applied within a single organisation. As the CAT evaluation has demonstrated, there are different kinds of issues that frequently emerge that arguably do not arise as often during a transition within single organisations e.g. changes to role identity, managerial accountability across organisational boundaries, co-location, etc. Helping staff to overcome barriers to integration may involve a reappraisal of those barriers, pre-empting any difficulties that commonly surface when partnerships implement a joint strategy.
One of the main aims of the CAT evaluation was to identify key factors which dominated the first year of operation in East and North East CATs. These can help to assist organisational learning for future CATs across Scotland. The evaluation also contributes to the wider discussion in integrated teams, Joint Futures initiatives and Community Health and Social Partnerships, by asking:
"Where do we go from here with integrated services across community care, based on what we know about implementing Community Addiction Teams?"
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