ADP & Homeless Programme: Reducing Harm, Improving Care
Healthcare Improvement Scotland has been commissioned by Scottish Government to deliver an improvement programme which engages specialist alcohol, drug and statutory homeless services along with the people who use them to improve access, reduce harm and achieve better outcomes.
During the pandemic the ways people accessed specialist services significantly changed. This led to greater joined up working between homelessness and alcohol/drug services, improving access for some people.
Further work is needed to improve access to support for all people.
Understand existing care pathways and test care coordination to improve quality of care and health outcomes for people experiencing homelessness who require alcohol and drug services.
Our activities will support:
System understanding – to understand the current system (including changes to local services in response to the COVID-19 pandemic), and the user and service needs that can be better met through service redesign and improvement.
System redesign – to work with four HSCP areas to support the design and delivery of an integrated care model to improve outcomes for people experiencing homelessness who require alcohol and drug services.
Co-design and co-production – to increase opportunities for people with lived experience, communities and partners from across the system to be engaged in planning, design and delivery of integrated Homelessness and Alcohol and Drugs services.
Learning system – to identify, share and spread good practice, innovation and learning about “what works” Scotland-wide to drive improvement and change in developing and delivering integrated and inclusive Homeless and Alcohol and Drugs services (including policy development).
Healthcare Improvement Scotland Operational Team
Using The Scottish Approach to Service Design (SAtSD), we will deliver the programme using the four stages of redesign.
Underpinning this will be an evaluation that will help us understand "what works" to support the spread of good practice.
Our approach blends the methods of strategic planning, service design, and user involvement to understand the experiences of people who use those services alongside those who deliver them, to design potential solutions and improvements.
We will then apply quality improvement methodology to test, refine and evaluate the solutions and improvements identified.
The project will be supported by a multidisciplinary team with knowledge and skills in these methods. The programme will be guided by subject matter experts in areas such as homelessness, pharmacy, and criminal justice.
It is crucial that we gain a firm understanding of current delivery models for people who are homeless and require alcohol and drug services.
We will do this to identify enablers and barriers to access and the key considerations for future service improvement.
Through workshops and coaching sessions we will support participating areas to understand their current systems, including capturing changes to local services in response to the COVID-19 pandemic.
We will work with people with lived and living experience to understand their needs to inform the basis of an integrated model of care.
Using data and evidence, we will identify existing integrated models of care that can be adapted as part of the design phase based on insights from service users and those delivering services.
Following the Understand phase, we will bring stakeholders together to use the learning gained and existing models of care coordination to identify guiding principles for an integrated model of care.
Based on the guiding principles, we will design a prototype for testing in participating local areas.
Prototype, Test, and Implement
We will support partners in local areas to complete a series of Plan, Do, Study, Act (PDSA) cycles to test prototypes for service change
Coaching and Workshops
Improvement Advisors will work with service providers and those with lived and living experience to facilitate PDSA cycles and capture learning and insights to provide recommendations for an integrated model of care.
We will work to upskill those using and delivering services to engage in future service improvements in their local area, by supporting their learning of the use of quality improvement methodology.
Increased capacity within local systems to drive service change
The work undertaken by this programme will drive improvements in integration between homelessness, alcohol and drugs services.
The involvement of people accessing services will ensure that improvements focus on what matters.