First, we reviewed existing protocols and best practices. This helped us understand the challenges and successes, and what worked well and what didn't.

This stablished a strong foundation for the protocol’s design. In our review of the evidence we wanted answers to the following questions:

• What does existing research say about successful protocols, and what barriers exist?
• What evidence supports the effectiveness of certain practices?
• Why do they succeed?
• How best to structure protocols?

Our research highlighted varied perspectives on current services:

• Individuals using services expressed that support was piecemeal and not flexible.
• Families and carers reported challenges with continuity. Potential harm or setbacks for their loved ones concerned them.
• Service providers voiced support for integration. But they cited organisational barriers such as conflicting priorities and limited resources.

These findings showed the need for a protocol. Which should be flexible, person-centred, and has good communication between services.

Read the evidence scan

The team conducted a strategic gap analysis to identify critical areas of focus. This compares current practice with best practice. The analysis identified workforce needs, and the importance of communication across services and the provision of integrated care to meet the needs of those with co-occurring conditions.

The gap analysis emphasised the need for:

• Clear roles and responsibilities across services.
• Agreed-upon protocols for co-occurring needs, such as referral systems and response timelines.
• Improved communication channels that foster informed decision-making.

These identified gaps were included to the national protocol. This is to support the development and implementation of protocols in local areas. This enables services to align their practices with national standards.

Read the Strategic Gap Analysis

Access the national mental health and substance use protocol

Three Reference Groups helped make the protocol. They were central to informing its development. The groups included practitioners, organisations, and people with lived experience.

Their different views made sure the protocol was grounded in real-world challenges. This let it be practical and useful for many services. It is adaptable for various support services.

Our Reference Groups played a crucial advisory role in protocol development:

Clinical and Operational Leads Reference Group: Provided expert advice, drawing on their professional insights and organisational experience.

Lived Experience Reference Group: Shared their thoughts on access, what they wanted to be better, and their priorities.

National Organisations Reference Group: Representing national health and community organisations. This group provided critical friend feedback and supported alignment with broader strategic goals.