Quality improvement in the system

MATPACT in NHS Highland: Finding Scotland's forgotten generation 


In 2023 the Police Custody Healthcare Team in NHS Highland identified that 52% of patients in police custody at risk of drug related death were not referred to health for support. The Medication Assisted Treatment Pilot at Custody Toolkit (MATPACT) was created as an innovative approach to proactively identify those at risk and offer health intervention.

Many team members were new to quality improvement (QI). The project’s strategic lead worked alongside teams to increase QI awareness and knowledge, often through approaches such as ‘see one, do one, teach one.’

Impacts to date

Staff wellbeing:

The innovation of this project is recognised and appreciated by the team and staff report that morale has never been better. There is also a cultural shift helping reduce stigma. Staff are hearing from people that this project’s care is the “first time anyone has bothered asking me about my substance use.” MATPACT is reaching people who may not be engaging with other services.

Building critical connections:

The project’s compassionate leadership approach is making an impact on connecting services. Staff have a weekly meeting with police that has helped change perspectives. Data results have helped reframe drug related harm to police; facilitating discussions about the underlying reasons why people use drugs, and showing drug related harms are not just about health.

Increasing access to right services:

MATPACT is acting as a platform to increase referral rates from police. Police Healthcare Liaison Inspectors play a key role in connecting the services. The MATPACT team is also signposting to further support available in the community supporting those to access services that will help them with their needs, whether this is with recovery, mental and/or physical health needs or psychosocial support.

Increased access to harm reduction interventions:

The project continues to evolve and improve through tests of change with planned expansion. Data collected so far has shown a 1,775% increase in take home Naloxone, 1,600% increase in blood borne virus (BBV) testing, and a 12% increase in referrals. The team recognise that this initial rate of uptake is unlikely to continue, however will continue to monitor over time. The team are identifying potential for expansion into prison services, primary care, A&E settings, and secondary care settings.

Key Learning for Spread

  • Collaboration – the form was developed collaboratively between team members, and in response to situations that present to the team. Working in parallel with police colleagues for data sharing.
  • Start small – the project began with focus on MAT standard four (harm reduction) and has now expanded to cover most of the MAT standards. Staff training also developed with time.
  • Value of skills mix – bringing different skills and experiences together. Launching MATPACT consisted of a team of dynamic project leads including a Drug and Alcohol Recovery Service strategic lead/ QI lead, Policy Custody service manager, and a senior charge nurse.
  • Continuous feedback and improvement – think creatively on how to collate information. Patient feedback via forms and interviews may not always be possible. MATPACT recognises people’s involvement and consent to Naloxone and BBV testing as a form of feedback.


Many thanks to the MATPACT team in NHS Highland for sharing their experiences and learning.

MATPACT's poster gives greater detail on the pilot which you can read here

If you have any questions or would like further information on MATPACT, please contact Marion Gillies, Service Manager for Police Custody Healthcare and Forensic Medical Services, marion.gillies@nhs.scot.