Examples of what this might involve:

1. 

• Oversight of the protocol’s implementation by appropriate governance structures such as Mental Health, Learning Disability, and Substance Use steering groups, Patient Safety and Quality Improvement groups.
• Development of data collection methods to measure staff awareness and understanding and use of local protocols.
• Feedback mechanisms to monitor adherence to local protocol and identify potential improvements or areas of concern. This would include (1) Data for adherence (2) Data for monitoring positive practice (3) Data for performance support (4) Data to inform workforce planning.

2. 

Governance systems and processes that enable collaboration, mutual respect, shared learning and decision-making based on an authentic understanding of what is happening within systems of care.

3. 

A holistic approach to setting measures which are based on outcomes for people and other relational factors (e.g. organisational culture). There should also be use of key data such as readmission rates, crisis team involvement, Mental Health Act assessments and rejected referrals.

4. 

Identification of appropriate clinical and care governance, patient safety and quality improvement forums for data to be discussed at.

5. 

Further development of commissioning relationships to build trust and shared understanding, enabling a system of care that is flexible and responsive to emergent needs. reporting requirements within contracts for commissioned providers.

6. 

Generation of insights from sources such as local outcome measures, Significant Adverse Event Reviews, complaints, third sector organisations, engagement activities and informal mechanisms.

7. 

• Using the Medication Assisted Treatment Standards experiential programme to inform redesign of services as part of a broader landscape of change, not just within those services supporting Medication Assisted Treatment. 
• Routine follow-up with services to check on implementation of Significant Adverse Event Review recommendations.