The Scotsman's Martyn McLaughlin and Lynn MacDonald, Service Manager at Glasgow's Drug Consumption Facility "The Thistle' do a walkthrough of the facility.
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00:00So this is the entrance to the Thistle. People will come in here, they'll check in at the reception, say hello to the staff, nice warm welcome.
00:08A member of staff from the using space will come through, usually a nurse, take them into one of the chat rooms.
00:14What we'll do in here is we'll just have a quick chat about what birds they're planning to use, how they're planning to use them, what equipment they're planning to use that day and if they need any other services while they're on site.
00:26So there's a number of things people can access while they're here.
00:29So they'll then come into the using space. All the naming has been done in partnership with Living Experience Colleagues, so people who use services and will use services.
00:39And we've spoken about making it welcoming and taking away some of that medical terminology from the service and just making it a bit friendlier and a bit warmer for people.
00:48So people come in here into the using space, they'll stop at this area here at the nurses' station, they'll speak to one of the nurses about the equipment they're going to use that day.
00:57So they'll have their choice of size of needle, size of syringe and they'll be given all their equipment for a single use, a safe way to prepare and use their drugs that day.
01:06We'll then go over to one of the booths. We'll see we've got eight booths, some have got left handed pressures, some have got right handed pressures and we've got these ones in the middle that are wheelchair accessible.
01:16All our booths can be accessed by wheelchairs but these two are the best for it.
01:20People will then prepare and use their drugs. The nurses can't intervene in that part, they can't help prepare or administer the drugs.
01:27But what we can do is observe, supervise and give some advice.
01:31So once they've used their drugs they'll dispose of their equipment in the sharps bin, so again there's no litter lying in the street, there's nothing left lying about that can be problematic.
01:40You'll see the mirrors here are very slightly tilted at the top, that allows the nurse to do an observation without being too intrusive.
01:47So you want to give people a bit of space, a bit of dignity and this service is all about space, dignity and giving people a bit of respect and treating them well.
01:55And for people who have maybe spent months if not years injecting in doorways, injecting in alleys at night, this is going to be a transformation experience.
02:04Absolutely, so they're used to doing injections really quickly, really hurriedly, in damp, dark, unhygienic conditions.
02:11It's bright in here, it's warm, we'll invite them to wash their hands.
02:15So that'll heat their hands up, it'll help their circulation and help the injection process.
02:19It's a clean environment, so we'll encourage people to slow down and take their time, less likely to get an injury from their injection and therefore less likely to have problems with wounds in the future.
02:29Which can be really problematic for folk, leading to infections, things like sepsis can occur if it's left untreated.
02:35So again, it's about promoting people's health and wellbeing, encouraging them to think about their health.
02:41And actually encouraging them to realise they're valued and they're entitled to the same level of service you or I would get at any health board premises we attended.
02:50Once they're finished here, we've got access to the health rooms.
02:54The health rooms are where we can undertake a number of interventions.
02:58We anticipate we'll do quite a bit of wound care in here so people can get their wounds attended to, which will stop them deteriorating.
03:05We offer blood-borne virus vaccination, but actually we can also offer opportunistic vaccinations like flu and Covid vaccinations in the future.
03:13Our partners can use these rooms as well, so sexual health, blood-borne virus, podiatry.
03:19We're looking at bringing mobile dentistry down in the future as well.
03:22All services are proactive that you and I take for granted being able to access.
03:26People coming to this service wouldn't necessarily be able to access.
03:30Just all these things that make you a bit more comfortable and feel a bit better about yourself.
03:35It's really about making people feel better about themselves, not having to feel shame and hide away who they are and what they're doing.
03:42And obviously that's going to be a process.
03:44We know it's going to be something that's going to take a long time.
03:47It's probably going to be word of mouth within certain areas.
03:50It'll be a huge part of that.
03:52And despite all the reassurances around statement of prosecution and what have you, there's still a lot of apprehension and fear surrounding this.
04:01So people can come in and they can be anonymous?
04:04That's right. So this is a confidential service, so people can come in.
04:08If they want to just come in and access an injective facility in an area in here, they can come in and give us whatever name and date of birth they like, as long as they're over 18.
04:17We will register them in a system called Neo, which is confidential, and they'll get a unique identifier that we ask them to use the next time they come.
04:26If they want to access other parts of services, so say they want to go into care and treatment, say we need to prescribe something, we do need more details from people.
04:34But you're right, there'll be anxiety there.
04:38The onus is on us to build trust and make people realise they can trust us.
04:42There are services there for them to meet their needs.
04:45And one of the positives is people are coming here of their own free will.
04:48Nobody's going to match somebody down here.
04:50So they're coming here because they want something from us.
04:52So the onus is on us to make sure they have a really positive experience.
04:55Because as you say, word of mouth is absolutely key to making this successful.
05:00And there's a cohort of around 400 to 500 people who inject in public spaces.
05:06So that's the focus of this, that's the people you're trying to attract.
05:10Out of that group of people, how many would you say are completely excluded from NHS services, whether it be addiction services or otherwise?
05:17It's really hard to tell. There'll be a number of people who drop in and out of services.
05:21I would anticipate there'll be quite a large number who partially engage with addiction services.
05:26But the reality is they probably won't engage with other services such as primary care.
05:31And maybe won't deal with any health issues until it becomes an emergency.
05:35If they're in an ambulance or going to a hospital, we aim to prevent that.
05:39We want them not to end up in an ambulance, not to have to go to a hospital, unless it's a pre-planned appointment.
05:45We want to deal with some of those medical issues while they're here and they're safe and they're warm.
05:50And prevent them escalating, prevent their health deteriorating.
05:53We may identify underlying health issues people didn't know they had.
05:57We'll have access to GP services so we can link them in with appropriate primary care if they need as well.
06:02And all the staff here, all the nurses, are trained to a really high standard of medical emergency training
06:07so we can respond to medical emergencies, be it an overdose or something else.
06:11Could be a cardiac episode, respiratory episode, could be undiagnosed diabetes.
06:16People have a huge number of underlying physical health conditions that aren't being addressed right now.
06:21We'll be able to support them with that.
06:23And so once people come in to the Thistle and they inject their drugs, they don't just walk out the door?
06:29No, absolutely not.
06:30Could you show me where people can come and spend a bit of time?
06:33So we really anticipate the using space will be a short part of the visit.
06:39It'll be the smallest part of the visit.
06:41It's very much about tasks, it's about we need this, we need that.
06:44And going through these tasks that need to be completed.
06:47Once somebody's injected they'll come through here to the recovery space.
06:50You can see the seats are quite high, they're very comfortable.
06:54These are designed so if somebody's sedated they won't fall off a chair.
06:57So we don't want people to fall, we don't want them to have an injury.
07:00So we want to manage that and make it safe and comfortable.
07:02We've got equipment here, we can monitor people's observations, their blood pressure, their pulse, oxygen levels, all these things.
07:09And we'll have a nurse on site here to keep an eye on that and just make sure somebody's not physically deteriorating.
07:14Where we really want them to stay is through the lounge.
07:17That's where we think all the really good engagement will happen, or where we hope the good engagement will happen.
07:22Because of the set up of the service, somebody has to go through here to leave.
07:26So when they're sedated, this is where we want people to spend some time.
07:29And you can see it's much less clinical.
07:32It's a much softer environment, it's more welcoming, it's warm.
07:36You've got soft seats and you've got couches.
07:39You've got the shelves and books.
07:41You know, just sitting out about somewhere warm with a hot drink.
07:45Because we've got coffee, we've got tea.
07:47We can't do Vault Wheels at the minute, but Launching House Mission Round the Corridor does that.
07:51So we can support people to access there.
07:54What we can do is snacks, maybe a cup of soup or some cereal, something like that.
07:58It's starting to encourage people to look after their basic nutritional needs as well.
08:02It's really important.
08:04And you'll see we've got more chat rooms here.
08:06So if people want a private conversation with maybe one of our amateur virtual workers or a social worker,
08:12or visiting services, they can have that.
08:15But also if they just want to sit and talk to their friends, they can do that.
08:18If they want to sit and have a bit of quiet time and just be left alone, we can facilitate that.
08:23What we want to be able to do is say to people, if they want to re-engage family relationships, we want to support them with that.
08:30You know, we've got iPads there, so somebody's maybe not seen their mum.
08:33Their mum's probably really worried about them, doesn't know where they are.
08:37If you want to FaceTime your mum, just let her know you're warm, safe, people are looking after you.
08:41That can provide a huge amount of reassurance to families, to know that somebody's looking after their son or daughter.
08:47It seems like this room is designed to build trust.
08:50Absolutely.
08:51Trust between you and somebody.
08:54Mutual trust.
08:55Without a doubt.
08:56That seems to be one of the magic ingredients of this place.
08:59It's about treating people like equals.
09:01You know, people coming here should be treated the way we are if we go to a GP or a health centre.
09:06You know, it's accepted.
09:08People coming here are no different to you or I.
09:10And it's just saying, what do you need from us today?
09:12How can we help you?
09:13I have to say the design of this place has been really heavily influenced by our women's reference group in particular.
09:19And that's women who have had lived experience with services.
09:22They spoke to us about what they would want from a service.
09:25They told us to move away from some of the old models.
09:28The original drawings for this room are very different.
09:31Our design team linked with the women's reference group and we turned it in its head and we've done something really different for our services.
09:38And I feel really proud that we've done that.
09:40You know, because we've created a space that's welcoming.
09:43We've got shower facilities.
09:45We've got a clothing store.
09:47We've got laundry facilities.
09:48We've got an external smoking area so that if people want to have a cigarette, they don't have to leave the premises.
09:54They can go out there and come back in and have a hot drink.
09:57It's just about making it somewhere people want to be and value.
10:01And even the sign above the door, staying safe, saying to people, we care about you.
10:06Even when you're not here, we want to know you're okay.
10:09You know, people care about you because you're entitled to that and you deserve that.
10:14It's about dignity and respect.
10:16And you've been waiting close to a decade for this facility to open.
10:19We have.
10:20Big day arrives on Monday.
10:22Absolutely.
10:23What would represent success for you as a service manager?
10:27Somebody coming in and telling me we've got it right.
10:30Somebody coming in and saying I'm coming back.
10:32You know, that for me, I'm a nurse.
10:35That's my job.
10:37We'll do all the academic evaluations.
10:39We'll do all that.
10:40But for me, it's the human element.
10:42It's that person saying, I really like this.
10:45I feel safe here.
10:46I'll come back and I'll tell people and other people will come as well.
10:49That's success for me.
10:50People coming and engaging with us and getting to know us.
10:53So this is a small cafe area.
10:55So people can come here, they can get hot drinks, hot chocolate, tea, coffee, even get decaf.
11:01You know, there's biscuits.
11:02We'll have snacks or cereal, a couple of soups.
11:06Again, it's just about something social to sit.
11:09We won't go to a coffee shop and sit.
11:11You can be sure a lot of the people coming to our service would be asked to leave the coffee shop.
11:15They won't be asked to leave here.
11:16They're sitting having social interaction the way we all should.
11:20You know, it's just about treating people like we want to be treated.
11:23I'm assuming you've had people with lived experience coming in as the service has got closer to opening day.
11:28Yes, we have.
11:30It was a really emotional day.
11:32The day we had the reference groups in because they were part of the design.
11:36And to see it coming from drones and being live, I think we've really done a good job of getting what they wanted.
11:43You know, I think the feedback we got was this looks great.
11:46This is a place that they would have used, they would have liked to have been able to use.
11:50And they would have felt comfortable using it.
11:52The lived experience would also involve all our recruitment.
11:55So we had lived experience panels for the managers.
11:58So they had to have a panel of lived experience straight into a staff panel after that.
12:01So that was really intense.
12:03And all the other posts had lived experience members on the panels.
12:06And that completely changed the dynamic of the way we interviewed.
12:10It worked really well.
12:11And I think in terms of looking around the staff group that we've got just now, they're really positive and engaging.
12:16It worked for us and it's something we're going to roll out into future recruitment for all the other parts of our service.