NHS ADDICTION SERVICES. Prevention and Service Support Team

Transcription

1 NHS ADDICTION SERVICES Prevention and Service Support Team ANNUAL TRAINING REPORT January December 2014 Compiled by: Anne Kennedy, Addictions Prevention Officer March 2015

2 CONTENTS 1. Summary 1 2. Prevention & Service Support Team Overview 1 3. Evaluation of calendar courses 6 4. Course specific information 10 Alcohol Awareness 10 Alcohol Brief Interventions 11 Alcohol Related Brain Damage Basic 12 Alcohol Related Brain Damage - Advanced 13 Blood Borne Virus Awareness 14 Cannabis 15 Drug Awareness Basic 16 Drug Awareness - Advanced 17 Female Drug Use 18 Harm Reduction 19 Introduction to Recovery 20 Mental Health & Substance Use 21 Needle Exchange 22 New Psychoactive Substances (NPS) 23 Relapse Prevention 24 Stimulants 25 Working with Young People Additional training Ongoing developments Partnership Working Service Development Acknowledgements 39 Appendices 40

3 1. Summary This report provides an update on the training developed, co-ordinated and delivered by Ayrshire & Arran (A&A) NHS Addiction Services Prevention and Service Support Team. The report provides information covering work carried out during the period 1 st January 31 st December During this time the training team has provided training and educational opportunities to a wide variety of professionals on a number of addiction related topics, either through attending advertised calendared training courses or via in house training to specific teams and services. The following report includes: Details of training provided through calendar courses: - The topics covered in each course - Participant numbers and their evaluation of the courses The protocols for requesting training and details of training provided on an ad-hoc basis. Information on additional work streams Any future developments 2. Prevention and Service Support Team (PSST) - Overview. The Prevention & Service Support team is responsible for the development, coordination, delivery and facilitation of addiction related training events throughout Ayrshire and Arran. The training team consists of a Team Leader, three Addiction Education Specialists, and four full time and one part time Prevention Officers Training. In April 2014 a unique post was created to provide an exclusive link between NHS Addictions and Ayrshire College an Addictions Liaison Officer (ALO) was appointed and is also 1

4 managed by the PSST. The service support element of the team consists of one Service Development Facilitator Specialist and one Service Development Assistant. The team is supported and guided by the Clinical Operations Manager structure within NHS A&A Addiction Services. The team are actively involved in a number of working groups and partnerships across Ayrshire, including the Area Drug Partnerships (ADPs) and the Blood Borne Virus (BBV) Managed Care Network. These involve participation in regular meetings, development sessions, planning events and the provision of training and prevention activities to support the local and national agreed strategies. Although the PSST have always maintained links with Ayrshire College, in 2014 this has been strengthened further by the addition of the ALO post. Skills for Health Quality Mark Award In 2013, the PSST received the prestigious Skills for Health Quality Mark for our Alcohol and Substance Awareness and Prevention training after completing an intensive assessment process. This means that the PSST is one of only ten leading training and education providers in the UK that have been successful in receiving the quality mark. The main purpose of the Skills for Health Quality Mark is to: Make sure that providers of training and specific learning / training courses have met the high standards expected by healthcare employers; Assure that the staff delivering training have the right knowledge and skills and maintain these through continued professional development; and Give health employers greater confidence when investing in workforce development and make it easier to identify and select appropriate course and providers of training.

5 Training Calendar The training team provides a structured Training Calendar, which in 2014 consisted of a portfolio of nine one day courses and eight half day courses. These courses are constantly evolving and adapting to enhance knowledge and skills in the emerging issues within the addiction field. Three brand new half day courses were added for these were drug specific sessions on Stimulants, Cannabis and New Psychoactive Substances (aka Legal highs). The 2013 course on Harm Reduction & Needle Exchange was also split into a full day of Harm Reduction and a separate half day on Needle Exchange for The courses are open to all services, organisations and members of the community within Ayrshire and Arran. They are provided free of charge, although there are charges for non attendance or late cancellation. Upon completion of courses and evaluations, all participants receive a certificate of attendance. From 1 st January to 31 st December 2014, the calendared courses on offer were: 8 half day courses: Alcohol Related Brain Damage - Basic Blood Borne Virus Awareness Cannabis Drug Awareness Basic Needle Exchange New Psychoactive Substances (NPS) Relapse Prevention Stimulants 9 one day courses: Alcohol Awareness Alcohol Brief Interventions Alcohol Related Brain Damage - Advanced Drug Awareness - Advanced Female Drug Use Harm Reduction Introduction to Recovery Mental Health & Substance Misuse 3

6 Working with Young People The courses on the training calendar are all planned events with dates spread throughout the year. Venues are coordinated to cover North, East and South Ayrshire. Places on these courses are booked in advance by individuals or organisations from services and agencies across Ayrshire. Advertising of the courses is via the Addiction Training Calendar which has a current mailing list of over 500; these include the NHS intranet, Local Authority intranet, Managed Health Network, GP surgeries as well as many other Ayrshire wide voluntary and statutory establishments to ensure ease of access. To date over 9,250 individuals from various professions and backgrounds have attended the calendared training. External speakers are invited to provide their expert specialist knowledge on a number of the courses. These include: NHS staff, local authority staff, specialist midwifes, and representatives from child protection and criminal justice services. All training delivered is responsive to the broad range of knowledge, skills and learning styles of participants. All calendar courses are mapped to the Knowledge and Skills Framework (KSF), and the Drug and Alcohol National Occupational Standards in the United Kingdom (DANOS) to aid professional development. In the period 1 st January st December 2014, 55 separate courses were delivered via the calendar and these were attended by 761 individuals from different services across Ayrshire and Arran including NHS, Local Authority, voluntary sector organisations and members of the public. Table 1 shows the number of calendar courses delivered and the numbers attending over the timescale in question. Table 1 Time period No. of courses delivered No. of participants 1 st January 31 st December

7 Figure 1 illustrates the numbers of participants attending the courses broken down by course title. Figure 1 Figure 2 illustrates the numbers of participants attending the courses broken down by nature of organisation. Figure 2 5

8 The 3rd Sector/ Voluntary category includes organisations such as, Quarriers, SACRO, The British Red Cross, East Ayrshire Advocacy, Unity Enterprise North Ayrshire Carers and Crossreach Children s services. Other includes individuals attending as students, University and College staff, the Scottish Fire Service and GPs. Additional Training The PSST also deliver a large amount of training sessions outwith the calendar courses. This training can be: - In-house training for any requesting agency - Inputs into schools Education Liaison These sessions are all tailor made for the requesting individual s needs and will be detailed individually later in the report. 3. Evaluation of calendar courses The evaluation process involves asking all participants to complete pre course, post course and follow up questionnaires. All are individualised to reflect the course content. The evaluation process was changed for 2014 due to the low number of post course evaluations being returned in previous years the post course evaluations are now completed on the day to ensure comparisons can be made regarding participant s learning. The follow up evaluation is now sent 6 weeks after completion and provides some useful information but is not now relied upon to evidence learning. The pre and post course evaluations emphasise changes in confidence, knowledge and skills pre and post training. The follow up evaluations concentrate on changes in practice since completion, any comments on usefulness and suggestions for future modifications to course content. Figure 3 details a flow chart of the evaluation process.

9 Figure 3 Pre Course Evaluation (On the day) COURSE Post Course Evaluation (On completion of course) Follow Up Evaluation ( ed 6 weeks after course) Pre and Post Course evaluations Pre and post course evaluation forms are distributed to identify course participant s beliefs about their knowledge and skills prior to completion of the training course and the subsequent impact of the course on these same factors. All course evaluations follow the same standard format. The pre and post course evaluation forms initially ask the same key questions, individualised to the topics in each course. Consequently a direct comparison can be made to show the shift in knowledge and understanding from pre to post course for each participant. (For an example of pre and post evaluations please see Appendices 1 & 2 respectively). Participants are asked to rate questions designed to assess the current knowledge and understanding of specific aspects of each course. For each question participants must choose one of the following five response options: Strongly agree, agree, neither agree nor disagree, disagree, strongly disagree. Table 2 below shows an example of a pre/ post course question. 7

10 Table 2 1 I have an excellent working knowledge of drugs and drug related issues. Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree The post course evaluation also includes questions on the more general aspects of training - organisation of time, quality of presentations, trainer knowledge and presentation style, and usefulness and enjoyment of session. The scoring options for these questions are shown below in Table 3. Table 3 Very Good Good Average Poor Very Poor Post course evaluations were collated for all 55 courses delivered, and the average scores for each section were calculated as follows in Table 4. Table 4 Average Score Organisation of time 1.33 Quality of presentations 1.30 Trainer knowledge and presentation style 1.20 Usefulness to you & enjoyment of sessions 1.31 This shows that all sections were rated, on average, between very good and good on the evaluation scale. The post course evaluations conclude with free text boxes to allow participants to make any further comment they would like to on what they liked most, least and on improvements they think could be made to enhance the courses. Follow up evaluations At approximately six weeks after course completion, participants are ed a follow up impact analysis evaluation. These evaluations ask the same four questions after each course: have your knowledge, skills and confidence changed in this area since

11 completing the course?; how useful were the materials provided to you?; can you think of any areas of improvement required?; and finally any further comments? (See appendix 3 for an example). In 2014, 129 participants returned their completed follow-up evaluations this is a 17% overall response (this typically low return rate is the reason that post-course evaluations are now completed on the day). Statistical analysis is not possible due to the free text boxes; however as a whole the feedback was overwhelmingly positive with regard to increased confidence and knowledge. See below for some examples: Doing this course has helped me gain more knowledge and understanding of female drug use, which will make me more aware and confident in challenging these issues. I felt this course coming from a background working with children and parents would have helped me at the beginning of my career (Female Drug Use, ). I am much more aware of the effects that drugs have on service users and the types of drugs available. I feel that I am more confident in dealing with service users who are under the influence and am more aware of the different effects that different drugs produce (Basic Drug Awareness, ). I feel I can promote needle exchange better in my area as I now have a good understanding of the services available and also how it is run. I am more confident in talking about safe injecting after this training (Needle Exchange ). The comments made about the documents and materials provided were almost all complimentary. The majority reported that receiving them electronically was more helpful for storage and review at a later date. A couple of participants felt that more resources could have been given to supplement further learning. Very few comments were made in the suggestions for improvement question. Those who did were mainly commenting on the length of courses (sometimes too long, sometimes could be more compressed) and the training rooms themselves which were at times too hot or noisy. 9

12 The statements made in the any further comments section were also largely complimentary see below for examples: I really have found the course interesting and helpful in my own recovery. And I know it will help me going forward (Alcohol Awareness, ). I did really enjoy the training. The trainers were excellent. There was a good mix of people from different areas giving good networking opportunities (Working with Young People, ). Thanks again for providing these courses free of charge vital for the voluntary sector they are very popular with our staff and the training calendar allows us to organise our training schedules in advance (Mental Health & Substance Use, ) 4. Course specific information The following sections provide details of all calendar courses delivered by Addiction Services PSST from 1 st January st December Pre and post course knowledge can be compared when both evaluations have been completed and submitted by the participant due to the change in procedure in 2014 this resulted in almost 100% completion. The minor shortfall in post course results would be due to participants having to leave early unexpectedly and therefore not completing both evaluations. a. Alcohol Awareness This one day course is designed to provide a basic awareness of alcohol and the issues surrounding it. Seventy-two participants attended Alcohol Awareness in Figure 4 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

13 Figure 4 Supporting comments from participants: I enjoyed it as there were a lot of practical exercises e.g. the calorie quiz & the Alcohol Awareness unit quiz putting the knowledge you learnt into practice Beer goggles. Informal delivery approach, open, honest, friendly trainers. b. Alcohol Brief Interventions (ABI) This full day course is aimed at people who already have a basic understanding of alcohol use and wish to add to their practical skills and have the tools to confidently deliver an alcohol brief intervention. Thirty-nine participants attended ABI training in Figure 5 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 11

14 Figure 5 Supporting comments from participants: All the courses should be like this!!! Very good!!! Thanks. I felt it was all very informative & educational. c. Alcohol Related Brain Damage (ARBD) - Basic This half-day course provides an introduction to Alcohol Related Brain Damage (ARBD) and related issues. This course would benefit anyone who has an interest in learning about Alcohol-Related Brain Damage. It may be particularly useful to those who work within the field of addictions. Seventy-three individuals attended this course in Figure 6 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

15 Figure 6 Supporting comments from participants: I enjoyed the whole session; I thought the group work was very good. Gave me a greater insight to the difficulties of diagnosis of ARBD. d. Alcohol Related Brain Damage (ARBD) - Advanced This one-day course provides an enhanced understanding of theory and practical application of this knowledge. It is designed for those who have previously completed the Basic ARBD course or have experience working within the field of ARBD and wish to further their knowledge and practical skills. Thirty-eight individuals attended Advanced ARBD in Figure 7 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 13

16 Figure 7 Supporting comments from participants: I liked the scenarios as it was beneficial to relate what we have learned to real life experiences. I enjoyed hearing from peer support worker who was able to tell her moving story. Brings theory to life. e. Blood Borne Virus (BBV) Awareness This half-day course gives an overview of Blood Borne Viruses and how they are transmitted. It caters for those who may come into contact with patients and others who may be affected by a blood borne virus. Thirty-three individuals attended BBV Awareness in Figure 8 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

17 Figure 8 Supporting comments from participants: Enjoyed course today and really glad I came have knowledge and confidence in BBV. Course was well explained. f. Cannabis This new half day course is designed to give participants a broader understanding of the prevalence, types, effects and issues surrounding cannabis use. It is recommended for anyone working within the addictions field, or anyone else with a general interest in the area. Forty-seven individuals attended this course in Figure 9 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 15

18 Figure 9 Supporting comments from participants: Very useful I enjoyed every minute of course. Group work was informative, learning about how it is prepared/ used. g. Drug Awareness - Basic This half-day course is designed to provide a basic understanding of the use and misuse of legal and illegal substances - including attitudes, effects and signs and symptoms of use. This level caters for those who have very little or no prior knowledge of illicit drugs and their use. Sixty-one individuals attended this course in Figure 10 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

19 Figure 10 Supporting comments from participants: Enjoyed all of this course refreshed and gained more knowledge. Enjoyed the course and will definitely try to attend more in depth training on this subject. h. Drug Awareness - Advanced This one day course is designed to provide a more in-depth understanding of the use and misuse of legal and illegal substances. This level caters for those who already have a basic knowledge of illicit drugs and their use, and would like to build on it. Thirty-six individuals attended Advanced Drug Awareness in Figure 11 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 17

20 Figure 11 Supporting comments from participants: Informal yet informative, everyone regardless of knowledge and experience opinions valued. My knowledge of steroid and VSA use has been improved. Interesting to know it s still so prevalent. i. Female Drug Use This one-day course provides an understanding of the reasons for female drug use and the specific challenges faced by female drug users. It is aimed at those who already have a basic knowledge of illicit drugs and their use but would like to raise their awareness of the specific issues faced by females. This course was attended by 37 individuals in Figure 12 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

21 Figure 12 Supporting comments from participants: Thank you. Very informative and interesting course. Presentations and speakers were excellent. Overall very knowledgeable for a male peer to learn. j. Harm Reduction This one-day course provides an understanding of harm reduction and how to advise service users about their risky drug using behaviours. This course will benefit anyone working with drug users, particularly intravenous users. This course was attended by 34 individuals in Figure 13 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 19

22 Figure 13 Supporting comments from participants: Vastly improved insight into drug use and knowledge of stigmas associated with same. Really enjoyed it. I now have a greater understanding and perception of harm reduction and needle exchange and BBVs. k. Introduction to Recovery This one-day course provides an introduction to the concepts of recovery, models relating to recovery, and the practical interventions available to support those in or working towards recovery. It caters for anyone who requires further insight into recovery within the field of addictions. Thirty-one individuals attended this training in Figure 14 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

23 Figure 14 Supporting comments from participants: Good delivery was very relevant to my services. Always good to share training with other agencies. I enjoyed the range of information given and the resources. l. Mental Health and Substance Use This one-day course is designed to increase awareness of the link between substance misuse and mental health issues. It is recommended for those who already have a basic understanding of substance misuse issues and are looking to develop their understanding of addiction further in relation to mental health. This will not be beneficial to those with prior mental health training. This course was attended by 63 individuals in Figure 15 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 21

24 Figure 15 Supporting comments from participants: Very informative and relevant to a range of service workers. It was a great course which demonstrated link between mental health and substance use well. m. Needle Exchange This half day course gives a basic overview and understanding of what is involved in a needle exchange. This will be of interest to anyone working within addictions or related services, where it would be beneficial to be able to signpost service users if required. Six participants completed this course in Figure 16 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

25 Figure 16 Supporting comments from participants: I found the entire course very beneficial. I enjoyed the history and legislation. n. New Psychoactive Substances (NPS) This new half day course provides an overview of new psychoactive substances previously referred to as legal highs. It will provide a solid background, as well as the most up-to-date information available on these ever-changing drugs. This course is suitable for anyone working with drug users or who has an interest in the area. Eighty-four participants completed this course in Figure 17 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 23

26 Figure 17 Supporting comments from participants: A very important awareness raising course delivered with passion and obvious expertise. I look forward to using the knowledge. I liked wide range of knowledge and subject matter, harm reduction rather than judgemental really important. o. Relapse Prevention This half-day course is designed to give an understanding of relapse and provide tools to use when relapse prevention work is required. This level caters for anyone wishing further information and skills in this area, but will be particularly beneficial for those with clients who are working towards recovery. This course was attended by 39 individuals in 2014 Figure 18 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

27 Figure 18 Supporting comments from participants: Really enjoyed session. Liked interaction within the training. Presentation was based on lives experience and very informative. p. Stimulants This new half day course is designed to raise participants knowledge on stimulant drugs and how they are used. This will include looking at individual substances, how they are used, the effects of their use, and how to minimise harm caused by them. This course is suitable for anyone who feels they do not already have enough knowledge about stimulant drugs or would like to refresh on current trends and issues. This course was attended by 27 individuals in Figure 19 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met. 25

28 Figure 19 Supporting comments from participants: Gained a lot of knowledge on stimulants & prior to course had only limited knowledge. Very informative & interactive. q. Working with Young People This one-day course is designed to equip participants with the confidence to use a range of prevention and intervention tools relating to substance use among young people. It will be beneficial for those working directly with young people, who may be particularly vulnerable to the effects of substance misuse. This course attended by 41 individuals in 2014 Figure 20 below, shows the change in participants responses between pre and post course evaluation. The marked shift towards agree/ strongly agree indicates that the course objectives were met.

29 Figure 20 Supporting comments from participants: Very relevant to my role as a young person s worker. Enjoyable. I liked the fact that others came and talked about the work they do with young people. 5. Additional training In addition to co-ordinating and delivering training courses via the Addiction Training calendar, the Prevention and Service Support Team receive a number of requests for in-house training. The team is proactive in recognising local training needs of services and agencies across Ayrshire, and develop relevant training to meet those needs. These training sessions are provided free of charge and take place at the venue of the organisations choice. The team have a flexible approach to these adhoc training requests, with many sessions being delivered at weekends and evenings if this is the most suitable option for the participants. These specially commissioned courses are designed around organisation or agency need and are delivered face-to-face by our trainers. The organisations requesting the training have varied requirements and as a result the sessions can be run as two 27

30 day, one day, or half day events. Awareness sessions of a few hours are also delivered regularly if this is more suitable to the service needs. During the planning of in house training, the organisation is sent a training needs questionnaire to complete. This form offers the variety of topics and training options available. On receipt of the completed questionnaire further discussion will take place with the organisations manager (or other person designated to arrange training), and a training package is developed to suit their needs. Evaluation of ad-hoc training is important but is dependent on the length of the session. The preferred evaluation manner is a pre-course questionnaire at the beginning of the session and then a post-course equivalent at the end of the session. This allows any shift in learning to be identified, and remove the problem of low returns if the post course evaluation is sent out many weeks later. If the session is under two hours long, no evaluation is necessary. These individual sessions have seen an excellent partnership develop with the individual organisations and areas, with future additional training and support being offered to continue learning and development. Ad-hoc training delivered In the period January to December 2014, a total of 108 additional training sessions were delivered by the PSST across Ayrshire & Arran. The services and organisations who requested these sessions included various NHS departments, ADPs, all three of our local authorities, and a host of voluntary agencies such as Sacro and Quarriers. There were a total of 1926 people in attendance at these sessions. Of these 108 sessions, twenty were health stands at various events, for example NHS summer roadshows and healthy working lives events in workplaces. The information stand provides a variety of leaflets and resources and usually includes an interactive component use of beer goggles, liver model etc and a challenge to pour a unit of alcohol. Although difficult to note exactly how many individuals were reached via these events, it is estimated that approximately 800 individuals were in attendance.

31 These figures do not include the sessions delivered in schools the Education Liaison figures are recorded separately and detailed later in the report. The training sessions covered an array of addiction related topics. The topics included Drug Awareness, Alcohol Awareness, Alcohol Brief Interventions, Alcohol Related Brain Damage, and Fetal Alcohol Spectrum Disorders. There was again a huge demand for training on New Psychoactive Substances (NPS), a current and fast moving issue. Sessions were all delivered using a blended learning approach including the use of power point, group work, short DVDs and Quizdom (an interactive device with handsets for each participant). In 2014, the scoring system used for evaluating these ad-hoc training sessions changed to mirror the calendared course evaluations. This was a phased process however and therefore the results unfortunately cannot be compiled into a report to give accurate information - some evaluations were in the old format and some in the new. Although no totals can be made for statistical analysis, each individual session which was evaluated did show an increase in all of the key areas. The 2015 training report will be able to fully utilise the new evaluation system. Education Liaison The Prevention and Service Support Team have an extensive remit within education which, throughout 2014 included the delivery of 52 training sessions to 1436* participants. Our education liaison remit includes the delivery of: Continuing Professional Development (CPD) training sessions to nursery, primary and secondary school staff; Specialist lessons to senior secondary school pupils Training on alcohol and/or drugs awareness to S6 peer educators Vulnerable young persons inputs University/College staff CPD training sessions University/College student inputs Information stands at parent evenings 29

32 Of the 52 sessions delivered in 2014, four were health information stands which reached 254 people. These stands were placed at two primary school parents evenings, one university freshers week event and one for a Sharing Experiences day for the Inside Out project. Inside Out is a joint venture between Ayrshire College and partner agencies. It develops dramatic performances of short plays focussing on mental health and stigma, and tours them around secondary schools throughout Ayrshire. The PSST has been involved for a few years now, both with advising the drama students on the addiction related content, and in facilitating the post play discussion groups with the school pupils. Another six of the total sessions delivered in 2014, were these discussion groups which reached 100 senior pupils. The remaining sessions delivered were predominantly to S5/6 PSHE classes at secondary schools such as Ardrossan, Kilmarnock and Ayr Academies. Seven of the sessions delivered were Peer Education for S6 pupils to deliver to the younger year groups and assist them in their development and achievement of a Young Scot qualification. *participant may have attended more than one training session and therefore be counted more than once. New Psychoactive Substances (NPS) The structure of Addiction Services, NHS A&A allows the Prevention & Service Support Team (PSST) to be proactive in identifying NPS issues and developing and delivering training very quickly when required. NPS training sections were added to all relevant calendar courses and a half day course was added to the calendar in This course was a great success with three additional dates being added to meet demand. Seventy-five people attended the half day calendar training course in 2014.

33 NPS was added to the topic options on the training request forms and ad-hoc training was delivered to 446 people representing various statutory and charitable agencies. These included SACRO, North Ayrshire Womens Aid, Quarriers, Police Scotland, South Ayrshire Throughcare Team, Lighthouse Foundation and NHS homelessness staff. See Table 5 below for a breakdown of NPS sessions slpit by locality. Table 5 No of Courses Participants North Ayrshire South Ayrshire East Ayrshire A program of education on NPS was initiated for a selection of 5th and 6th year school students, which included NPS classes and peer education training provision - approximately 308 senior pupils in Ayrshire have accessed this. NPS workshops are also delivered within Ayrshire College to both students and college staff by the Addictions Liaison Officer. Two hour NPS training sessions were developed and offered to the three area Alcohol & Drug Partnerships. The arranged dates included an evening session in each area - this enabled parents, part-time and sessional staff and others who are unavailable during the day to attend the training session. These sessions were a great success and attended by 23 participants from North Ayrshire, 40 from South Ayrshire and 50 from East Ayrshire. The course evaluations highlighted a need for the participants knowledge to be updated regularly; therefore a new refresher session has been developed and will be offered to the 3 ADPs during 2015 and annually thereafter. The team continues to contribute significantly to the Ayrshire Drug Trend Monitoring Group. 31

34 Alcohol Brief Interventions (ABI) NHS Ayrshire and Arran was set the target to deliver 4,076 ABIs from 1st April 2014 to 31st March The actual amount of ABIs delivered between 1st April 2014 and 31st December was 3675 and therefore we start 2015 in a strong position for meeting the overall target. The Prevention and Service Support Team provided tailored training and ongoing support for all participants to enable them to competently and confidently deliver Alcohol Brief Interventions. ABI Delivery Performance: Quarter 1 to Quarter 3 1 st April 2013 to 31 st December 2013 NHS Ayrshire & Arran Number of Alcohol brief interventions delivered between: 1st April st December 2014 Ayrshire & Arran Primary Care A&E Antenatal Wider Settings Health Board Total ABI's delivered (Q1) ABI's delivered (Q2) ABI's delivered (Q3) Total Performance broken down by ADP locality area: North Ayrshire South Ayrshire East Ayrshire *Pan Ayrshire Primary Care A&E Antenatal Wider Settings Total for North Ayrshire *Pan Ayrshire statistics are mainly from A&E, however small numbers of staff report pan Ayrshire figures in relation to their job role. Staff where possible within A&E are encouraged to refine reporting to reflect locality of presentation.

35 E- Learning/Learnpro Modules The team use a blended learning approach by developing online modules using the Learning Management System (LMS) which supports learnpro. Courses that have been developed and are available for NHS staff to access are Hepatitis C Awareness, HIV, Hepatitis B Awareness and Alcohol Brief Interventions. From the period 1 st January to 31 st December 2014 a total of 1641 members of staff from across the organisation have accessed the four courses with 71% (1171) of staff successfully passing the assessments with the desired pass mark of 80%. See Table 6 for details. Table 6 Course Title Enrolled for course Passed Assessment Alcohol Brief Interventions Hepatitis B Hepatitis C HIV Total Naloxone and Overdose Awareness training Naloxone is a pharmaceutical drug which can temporarily reverse the effects of an opiate overdose, providing more time for an ambulance to arrive and treatment to be given. The National Take Home Naloxone programme involves Naloxone being provided to those thought to be at risk of opiate overdose - once they have undergone specialist training. The training focuses on the wider issues surrounding drug-related death and drug overdose. Topics covered include: Drug-related death in Scotland, Causes of overdose, Recognising overdose signs and symptoms, Identifying groups of people who are especially at risk of overdosing, 33

36 Opportunities for preventing drug-related deaths, Basic first aid skills, The role of Naloxone in an emergency. Courses are available for services, staff, carers and family members From the period 1 st January to 31 st December 2014, four Naloxone Training for Trainer training sessions have been delivered to Addiction, Homelessness Nursing Staff and Voluntary Sector staff groups where over 40 staff are now trained to deliver Naloxone and Overdose Awareness sessions to those thought to be at risk of opiate overdose. SPiCE The team have developed the SPiCE (Substance Misuse Prevention in Community Education) around the Curriculum for Excellence Health and Wellbeing experiences and outcomes for substance misuse. The resource provides teachers and education providers with clear topic lesson plans including, PowerPoint presentation with additional notes, reading material and extension activities. SPiCE provides a consistent approach to the delivery of substance misuse education. Resource topics include interactive lesson plans around alcohol, substance use and misuse and attitudes and behaviours. For further information about the resource please contact: Adelle Still, Addictions Education & Prevention Specialist, Adelle.Still@aapct.scot.nhs.uk Rachel Rose-Smith, Addictions Education & Prevention Specialist, Rachel.Rose-Smith@aapct.scot.nhs.uk 6. Ongoing developments Work being undertaken is evolving continuously with the team being proactive in researching and evaluating emerging issues and any recent developments within the addiction field.

37 Blood Borne Virus (BBV) In the last 12 months work generated has met with the prevention outcomes of the BBV & Sexual Health Framework. We continue to play a proactive role in the BBV MCN subgroups, namely Steering Group, Workforce Education & Development, Resource Group, and the Care & Support Sub Group. Our partnership with the BBV MCN has resulted in the design and production of a BBV MCN Joint Training Calendar which is being launched early in On a national level, members of the team play an active role in NHS Health Scotland s BBV Prevention and Behavioural Subgroup (previously the Peer Education National Reference Group). This allows us to share local examples of person centred best practice and influence strategic and national plans. The PSST also play a key role in client support with the continued success of the North Ayrshire BBV Support Group. This model and approach rolled out in East & South Ayrshire in the last 12 months. Following the success of a 6 week self management programme in South Ayrshire during February and March of 2014, an addictions/self management monthly support group was established in April 2014 at the Girvan Community Hospital. The group is actively involved in working in partnership with NHS, Local Authority, Third Sector staff and the local community to establish a recovery service for the people of Girvan. We continue to work in partnership with our third sector recovery orientated partners across the whole of Ayrshire. This has resulted in providing Dry Blood Spot Testing training and support to staff of Addaction in South Ayrshire and signposting support group members to our pan Ayrshire third sector recovery support services. The team have also been central in the development of the South Ayrshire ADP Peer Support Workers, a number of which are now on placement with the South Addictions Team and a BBV Peer Support Worker on placement with the PSST. Our focus continues to look at how service users can play a vital role in supporting both the BBV MCN and future service development. 35

38 ARBD (Alcohol Related Brain Damage) The PSST continues to work with partner services and organisations to provide training to those who work with clients with ARBD and to raise awareness of the issues surrounding alcohol and the brain. We have worked in partnership with the Infuse Co-operative to design and produce a resource for those diagnosed with the condition. The PSST have also been working with the communications team to produce an information leaflet informing of the condition and where to access help about ARBD. The training calendar features two levels of training (Basic and Advanced) on ARBD which incorporates the newly developed pathway for those seeking help for ARBD in Ayrshire and Arran. We are lucky enough to have the involvement of a peer support worker at the Advanced level to provide a personal perspective of the condition and recovery. Professional Development Award for Brief Interventions in Substance Misuse The Professional development Award (PDA) in Brief interventions for Substance Misuse has been developed by the Prevention and Service Support Team (PSST) in association with The Scottish Qualifications Authority and The VQ centre based at Ayrshire Central Hospital. PDAs are principally designed for those already in a career or vocation who would like to extend or broaden their skills base. This award takes approximately 9 months to complete and consists of four mandatory units, three Health and Social Care units and one Higher National unit. Candidates are awarded 32 credit points at SCQF Level 7 on completion. The PSST in collaboration with colleagues form The Training Centre at Irvine is the only team which offers this newly developed award. To date six addiction services staff have completed the award - A further cohort of 3 staff are currently working on their award. Another cohort is being planned for 2015.

39 7. Partnership working Ayrshire College NHS Addictions Liaison Officer Ayrshire College and NHS Ayrshire and Arran jointly appointed the Addictions Liaison Officer (ALO) post in April 2014, the first of its type in Scotland, to work exclusively with the College. The post delivers key benefits to Ayrshire College, NHS Ayrshire and Arran and the individuals and linked communities by providing health prevention messages and education across the multi-site campus. This provides both staff and young people with an increased knowledge of alcohol and drug use through prevention, education and training, for personal awareness and future career opportunities. Between April and December 2014, 81 workshops were delivered by the ALO, to 1150 students, in topics such as alcohol awareness, addiction and drug awareness, and training sessions have also been delivered to College staff. The ALO post has also provided opportunity for early intervention by supporting students with substance misuse issues and referring onto appropriate services. Other aspects of the role have included the delivery of specialist information at College health promotion events, such as the delivery of brief interventions, keeping safe advice and education in relation to alcohol and drugs through a range of interactive resources. The ALO has also coordinated events such as Alcohol Awareness Week and worked in partnership with Police Scotland to deliver Respect Week, with both campaigns focussed on students personal safety, and utilising local organisations to deliver workshops to College students. If you would like more information, please contact: Cara Durnie, NHS Addiction Services/Ayrshire College Addictions Liaison Officer Cara.Durnie@ayrshire.ac.uk Tel:

40 Healthy Working Lives The team work closely with the NHS Ayrshire and Arran Healthy Work Lives group and through this partnership working, tailored made sessions are developed and delivered to organisations identified through Healthy Working Lives. Sessions requested ranged from health stands to bespoke training courses and covered a variety of courses - from Basic Alcohol and Drug Awareness to staff information on the new reduced drink driving limits. Stepping Stones for Supervision Course The team has been granted a half day session in this three day course. Topics covered include alcohol and drug awareness and raising the issue for new supervisors to become confident in asking staff the questions around substance use. The aim is to promote health and wellbeing among staff and to reduce the harm associated with substance misuse. Child Protection Inputs The team provide interactive alcohol and drug sessions within the North and South child protection training courses. Topics covered are parental substance use covering substance effects on mother and baby, signs and symptoms and referral process to addiction services. Self Management The team has representation on the Steering Group of Ayrshire & Arran s Self Management Network and examples of peer support and self management best practice regularly feature at the networks learning events.

41 8. Service development Service Development continue to support the service in providing the right care, at the right time, in the right way for service users of NHS Addiction Services throughout Ayrshire and Arran and to ensure they receive the best care and treatment possible by embedding the six strands of quality effective, efficient, safe, timely, patient-centred and equitable therefore providing a more streamlined approach relating to all aspects of Clinical Governance. Service support includes the regular undertaking and compilation of audits including those determined by the organisation or directorate, such as Record Keeping, Customer Care Commitments and Client Satisfaction. Audits measuring compliance are also required in relation to recommendations identified from adverse incidents. Service development provides support to each locality area within NHS Addiction Services to complete Action Plans and gather evidence required to demonstrate implementation and effectiveness of learning. Service Development are also utilised by the training team and clinicians to help in the development of recording and reporting systems as well as the collation and analysing of data. We also support the streamlining and embedding of processes and the development of any new guidelines, Standard Operating Procedures (SOPs), Local Operating Procedures (LOPs) and new information resources. These work streams link with a number of strategic drivers including the Clinical Governance agenda to ensure the service we are providing within Addiction Services is of the highest quality possible and targets are met by measuring efficiency and effectiveness (see appendix 4). 9. Acknowledgements The PSST would like to thank all the clinicians and speakers from outside agencies who continue to support the team, and assist in the co-facilitation of our training courses. Thanks must also go to all those who provided information for the various sections of this report. 39

42 Appendix 1 ALCOHOL AWARENESS 2014 PRE-COURSE EVALUATION Name Team/Service Date of course *Please list the address you wish all future course correspondence sent to: Please rate how much you agree or disagree with each of the following statements (by ticking the appropriate box): 1 I have an excellent understanding of the impact of alcohol on society 2 I have an excellent understanding of how alcohol travels through the body, the factors that affect metabolism & the links to certain cancers 3 I have a solid understanding of units and am aware of the recommended drinking limits. 4 I have a thorough and detailed understanding of the short & long term effects of alcohol. 5 I am aware of the links between alcohol use and fire, and am able to identify how to reduce the risks 6 I am confident in recognising the signs and symptoms of alcohol use. 7 I have an understanding of the impact of alcohol use during pregnancy. 8 I am aware of the current news topics related to alcohol, and of the alcohol services available in Ayrshire & Arran Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree