Medication Assisted Treatment (MAT) standards: access, choice, support

Evidence that standards have been successfully implemented

Meeting the standards depends on a culture of improvement and raising expectations, as much as establishing the right procedures and protocols. Process, experiential and numerical measures are all necessary to get an idea of progress and success. No single piece of evidence is sufficient on its own.

The measures:

• are a guide for service improvement;
• should be overseen by the local quality improvement teams;
• are NOT intended for local or national performance management.

The aims are to:

• assess progress towards implementation;
• promote quality improvement - locally and nationally;
• inform the development of national indicators and quality assurance.

Three types of measures are presented

1. Process. The criteria defined against each standard include the governance, guidance, pathways and standard operating procedures necessary to meet the standard safely and efficiently. Documentation is required as evidence that these are in place.

2. Experiential. The qualitative measures are designed to explore the experiences of people who use services, their family members or nominated person(s) and people who provide services. The aim is to measure how well the standards are being met on the ground, and whether the processes in place are translated into an experience that:

• treats people with dignity and respect;
• demonstrates that services strive to promote access to treatment and support;
• promotes choice and offers people support to make an informed decision;
• is person centred, trauma informed and inclusive of family member or nominated person (where the person wishes this);
• provides appropriate options for whatever substance use problem the person is seeking help for;
• facilitates a range of harm reduction approaches;
• helps people plan for the end of treatment.

The qualitative measures required and a proposed methodology of how to collect the evidence is provided in Appendix 1.

The measures and approach were developed and agreed through a series of group and individual discussions with people with lived and living experience, family members or nominated person(s) and providers of services. The questions and methods which have been developed will be piloted 'in the field' to ensure that the design meets the aim, and will be further refined as necessary before a final version is produced.

3. Numerical. Against each of standards 1-5, one or more high level measurements are provided, with detail on what to measure, the data required to do this and what analysis to do. Methods will vary between areas because the information systems and pathways vary. This means that numerical data may not be directly comparable. But these high level measurements can be used for tracking trends and benchmarking between services, Alcohol and Drug Partnerships (ADP) and NHS Boards to facilitate learning. Some teams may wish to do deeper analysis that suits their pathway and capacity.

The numerical measures required against standards 1-5 are in Appendix 2.