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Purpose – The purpose of this paper is to illustrate how local drug services use their senior staff to respond to emerging ethnic groups presenting to treatment using flexible thinking and innovative processes. Design/methodology/approach – The methodology was a case study design that used a semi-structured questionnaire that looked at two drug services and their staff’s influence on service delivery in different boroughs of east London. Findings – The research found very innovative findings from the two boroughs. The boroughs had different racial mixes and therefore differing populations presenting to their local drug services. However, they used flexible approaches to structure their services to engage with emerging ethnic minority populations in drug treatment. From the findings, these different approaches and structures of providing drug treatment were very important. Approaches, for example, of clinical staff offering a “rapid assessment” are particularly important in engaging and retaining ethnic minority populations. Also, using flexible thinking within the staff team enables drug services to adapt treatments to be flexible in responding to emerging ethnic populations. Practical implications – This paper shows that thinking in designing approaches to drug treatment shows that ethnic minority populations can be successfully engaged in drug treatment. This has implications for drug treatment nationally and across Europe where there are “emerging” ethnic populations presenting for drug treatment. Originality/value – This paper shows that drug services can adapt and change to their different ethnic minority populations if they can able to be flexible in their clinical approach to service provision.

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This paper illustrates the key role the nurse can play in reshaping and streamlining a service for more effective treatment. This is demonstrated using the example at the Islington Drugs Service in London, where external pressures initiated a re-design of the part of the service and its aim and objectives.This re-design was successful and it is noted that, while the team delivering the service was multi-disciplinary, nurses played a central role in the effective design and implementation that ultimately received positive feedback from the clients involved in the project.Good clinical knowledge and an ability to think creatively and practically are important skills for nurses in today's healthcare system. This paper hopefully illustrates that nurses are well placed to play an active role in re-designing services and should definitely be playing a central role in strategic service delivery.