EAST CENTRAL SCOTLAND ADDICTION SERVICES MANAGED CARE NETWORK ECSAS MCN

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EAST CENTRAL SCOTLAND ADDICTION SERVICES MANAGED
CARE NETWORK (ECSAS MCN)

• THE CONCEPT
• Introduced in Scotland by Sir David Carter, the
  then Chief Medical Officer.
• MCNs Addressed the problem of delivering locally
  accessible high quality specialist clinical
  services to health board areas in which the
  population size and demand were insufficient to
  support them.
• The aim was for groups of health board areas to
  collectively commission such services as more
  regional resources, thus gaining added value
  from economies of scale, improving the quality of
  clinical services to localities as well as staff
  training and retention.
• ECSAS-MCN BACKDROP
• The MCN consists of the Health Service-based
  treatment services dealing with drug and alcohol
  problems in Fife, Tayside and Forth Valley.
• Forth Valley services have performed
  multi-disciplinary external reviews of treatment
  services in both Tayside and Fife and subsequent
  developments have followed the guidance in these
  reports.
• Tayside Alcohol services have offered in-patient
  facilities to Fife, helping reduce the burden of
  OATs on Fife treatment budgets.
• Fife Addiction Services have supplied medical
  cover to both Forth Valley (staff grade) and
  Tayside (Consultant Psychiatrist) when faced with
  medical staffing crises.
• Forth Valley/Tayside have reciprocally supported
  one anothers medical services during the
  transition period between consultant
  appointments.
• The new MCN will cover a population of some
  900,000 comprising urban, rural and semi-rural
  populations a significant population in size
  and with demographic characteristics similar to
  Scotland as a nation.
• ADDED VALUE
• Less reactive and more proactive response to need
• Improved sustainability (not dependent on
  personal relationships)
• Linked into the planning process (DAATs Health
  Plans)
• Increased likelihood of area-wide developments
  which cannot be supported locally
• Cross-fertilisation of staff and a more
  consistent approach to care across the MCN

• KEY INDICATORS OF SUCCESS INCLUDE-
• (1) Shared staff resources/flexible staff
  deployment covering services, holidays on
  call or out of hours cover. Fulfillment of the
  4th tier of a tiered model of care e.g. The
  ECSAS MCN has received funds from Tayside Health
  Board to support a comprehensive sustainable
  psychology service, currently unavailable, with
  training opportunities to bring on junior staff.
• (2) Increased availability of relevant
  high-quality experiential skills-based training
  and supervision.
• (3) The development of a broader Clinical
  Governance network allowing development of
  harmonised clinical guidance and protocols, based
  on the best available evidence and strong systems
  of external review across the area.
• (4) Better planning, co-ordination and
  flexibility ensuring best use of trained staff to
  deliver services across the MCN, reducing the
  likelihood of high waiting times for specialist
  services and increasing demonstrable clinical
  quality.
• (5) Economies of scale allowing the development
  of specialist services likely to be recommended
  for development in the light of a forthcoming
  Scottish Executive paper on treatment of
  concurrent mental health problems in addiction.
• (6) The capitalisation of Tayside specialist
  alcohol in-patient facilities addressing service
  gaps.
• (7) Highly developed academic links to CARES,
  increasing the likelihood of attracting and
  retaining high quality staff as well as improving
  the academic profile of services and trusts.
• (8) Improved strategic planning with the
  appointment of senior staff with significant
  experience at a strategic level.
• (9) comparisons across different criminal justice
  interventions of the three MCN areas and
  collaborative work improving service delivery,
  governance systems and external review.
• EVALUATION
• ECSAS MCN has engaged a researcher from the
  University of Dundee to develop a framework of
  evaluation which will be objectively carried out
  at arms length. This evolving protocol will
  include an analysis of the process of MCN
  development (including factors that have enabled
  or hindered success) as well as the ability of
  the new arrangements to deliver improved
  outcomes. NHS RD Funding for a pilot project has
  been secured.