The Medicated Assisted Treatment standards provide guidelines for care delivered to individuals engaged with addiction services within Scotland. Occupational therapy within addiction services is an under-researched and often overlooked area of practice for occupational therapists. The Ayrshire and Arran Improvement Foundation Skills programme introduced quality improvement methodology and tools that enabled and enhanced service user group engagement and participation. A significant learning from this experience was that small, targeted change can have a significant impact on the patient care provided, and has changed the approach taken to both new and existing patient care initiatives.