Imaginative approaches to improving access

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Imaginative approaches to improving access

• Netta Maciver

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Imagine

• Today is the day Im going to go
• I made it
• They can see me in three weeks time
• I really want to keep that appointment
• What do you think?

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Approach

• TPS has no set way of providing service
• TPS has a commitment to make service work for
  people
• TPS has a commitment to direct access
• TPS has a commitment to exclude no one
• TPS has a commitment to a professional service

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Access

• Referrals take time
• Some examples of direct access
• GDCC
• Peterhead
• Paisley
• Leith
• Big River

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GDCC

• 24/7/52- 50,495 visits
• An average of 150 people each day
• 4/5000 vulnerable and chaotic
• Waiting time is 5 minutes
• Busiest day last year Sunday 23 June (164)
• Hub working with many partners

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Peterhead

• Arrest referral and day programme
• 24 hour call out system to police- attend within
  one hour
• Same person sees them next day
• One year 106 a/r (27 re-referrals)- 32 used the
  service 40 take up
• Can help CAT to hold people
• Sees 8 in the am, 20 12-4, 71 4-8pm

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Paisley - Cactus

• Fax referral system from Paisley Police
• Everyone seen within 24 hours and sticks
• 44 take up
• Customise practice to fast track into prescribing
  clinic

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Leith

• Direct access drop in service -641 people
• Drop in for locality clinic, crisis, telephone,
  needle exchange, ear acupuncture
• Locality clinic saw 179
• Above came from 15 different GP practices

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Big River

• Works across the Borders
• Accessing means we come to you
• Where and when will be agreed with you
• Drop ins in Galashiels, Kelso or Eyemouth

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Service

• Range on offer within services
• Retention is key to successful outcomes
• Need to include the most challenging
• Treatment is more than methadone
• Begins in needle exchanges
• Needs to focus on real needs- where to stay, what
  to eat, how to sort

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Flexibility

• Service opening hours- from 24/7 to 6 day opening
  to evening opening hours
• Responses that cross generations
• Ability to see individual needs
• 1-1, group work, advocacy, alternative therapies,
  practical needs
• Working with other providers

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Barriers

• Who runs first level services (who is capable of
  undertaking assessments)
• Geographic rules- every person receiving a script
  must
• Compliant, stable users who block services
• This is how its done here