Chamber and committees

Child protection statistics gathered for 2011-12 will include, for the first time, information on children affected by parental substance misuse. These figures will be published on the Scottish Government website in the spring.

The following table shows the number of people that have received Alcohol Brief Interventions (ABIs) in 2010-11 and 2011-12, information for 2012-13 will be published in June 2013.

	2010-11	2011-12	Total Number of Interventions
Scotland	88,143	97,830	185,973
NHS Ayrshire and Arran	7,591	7,501	15,092
NHS Borders	2,862	2,727	5,589
NHS Dumfries and Galloway	4,349	2,337	6,686
NHS Fife	4,773	7,430	12,203
NHS Forth Valley	4,094	8,789	12,883
NHS Grampian	11,229	8,682	19,911
NHS Greater Glasgow and Clyde	15,465	18,571	34,036
NHS Highland	4,497	5,658	10,155
NHS Lanarkshire	7,813	9,034	16,847
NHS Lothian	14,930	17,093	32,023
NHS Orkney	155	308	463
NHS Shetland	287	361	648
NHS Tayside	9,563	8,733	18,296
NHS Western Isles	535	606	1,141

ABIs are an evidence-based and cost effective preventative intervention, potentially reducing the requirement for more costly alcohol related treatments later on.

Information on ABI’S is published on Information services Division website, which is available at:

http://www.isdscotland.org/Health-Topics/Drugs-and-Alcohol-Misuse/Publications/2012-06-26/2012-06-26-ABI-Report.pdf

The key components of the Scottish Government’s alcohol strategy are the Licensing (Scotland) Act 2005, Changing Scotland’s Relationship with Alcohol: A Framework for Action, the Alcohol etc. (Scotland) Act 2010 and the Alcohol (Minimum Pricing) (Scotland) Act 2012. These are being monitored and evaluated through a programme of work, Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS), which is being led by NHS Health Scotland in collaboration with NHS National Services Scotland Information Services Division.

The programme is delivered through a portfolio of commissioned and in-house evaluation studies. The in-house project team responsible for delivery consists of public health research specialists with expertise in evaluation, epidemiology, health economics, statistical analysis and critical appraisal and synthesis of evidence. Additional expertise is utilised as required, including external advisers where appropriate.

NHS Health Scotland is committed to providing ministers and publishing annual reports that set out key findings from the MESAS programme, including monitoring trends in consumption and alcohol-related harm. More information on MESAS can be found in the published reports:

The baseline report (first report) was published in March 2011, Monitoring and Evaluating Scotland’s Alcohol Strategy. Setting the Scene: Theory of change and baseline picture, and can be found on the following link: http://www.healthscotland.com/documents/5072.aspx;

The second annual report, Monitoring and Evaluating Scotland’s Alcohol Strategy 2nd Annual Report, was published in December 2012. This presents the findings of the current studies to date and can be found on the following link: http://www.healthscotland.com/documents/6182.aspx.

Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) is a programme of work to evaluate the key components of the Scottish Government alcohol strategy. It is led by NHS Health Scotland in collaboration with NHS National Services Scotland Information Services Division. The programme is delivered through a portfolio of commissioned and in-house evaluation studies which has the overall aim of assessing the extent to which the strategy contributed to reducing alcohol-related harms in Scotland.

As set out in Monitoring and Evaluating Scotland’s Alcohol Strategy 2nd Annual Report:http://www.healthscotland.com/documents/6182.aspx, which was published in December 2012, Scotland has seen recent improvements in levels of alcohol-related harm. However, as the report makes clear, alcohol-related harm must be viewed in a historical perspective and it is clear that harm remains at unacceptably high levels: alcohol-related deaths double and hospital discharges quadruple the levels of the early 1980s.

Scotland’s alcohol strategy continues to evolve and be implemented so it is not appropriate to set a single baseline year. The NHS Health Scotland MESAS first (baseline) and second annual reports make clear that a long term perspective on the overall impact of the strategy is needed, and that premature assessments of trends in consumption and harm based on a few years of data should be avoided.

<>The national Drug and Alcohol Treatment Waiting Times Database (DATWTD) gathers access information from specialist drug and alcohol treatment services to measure performance against the HEAT A11 Drug and Alcohol Treatment Waiting Times Target. The DATWTD is managed by NHS National Services Scotland Information Services Division (ISD) and related data is published on a quarterly basis. Latest figures, published in December 2012, indicate that (for July – September 2012) 7,208 entries were recorded on the database for people starting alcohol treatment during the quarter. These figures can be viewed at: http://www.drugmisuse.isdscotland.org/wtpilot/reports.htm.

This data provides an indication of numbers of people being treated for alcohol dependency as the purpose of the DATWTD is to gather information on access to treatment interventions as opposed to numbers of individuals in treatment.

Figures for the number of people dependent on alcohol in Scotland are not available. The Scottish Health Survey 2012 included, for the first time, the Alcohol Use Disorder Identification Test (AUDIT). AUDIT is a validated screening tool specifically designed to identify those with alcohol dependence. Findings from the 2012 survey will be published in September 2013.

Decisions on the assessment and appropriate treatment for individuals are taken by practitioners, who take account of the needs and circumstances of each client. Their aim is to ensure that the treatment package will provide the most effective support for that individual. A comprehensive assessment is a key part of this treatment package and should be undertaken with each client to determine their individual needs and goals.

A range of support services for people affected by problem alcohol use are available across Scotland. These services help individuals to recover from the harms caused by alcohol.

The provision of prevention activity, recovery focussed treatment and support services are for each local area to consider, taking account of local needs, circumstances and resources. Responsibility is devolved to Alcohol and Drug Partnerships (ADPs) to commission (informed by robust needs assessment) evidence-based, person-centred and recovery-focused prevention and treatment services to meet the needs of their resident populations.

Alcohol Focus Scotland provides a search facility to identify support services throughout Scotland on their website. This is available at: http://www.alcohol-focus-scotland.org.uk/getting_help/

<>The Societal Cost of Alcohol Misuse in Scotland for 2007, which was published in January 2010, can be found on the Scottish Government’s website via the following link http://www.scotland.gov.uk/Publications/2009/12/29122804/0. This is the most recent publication estimating the annual cost of alcohol misuse in Scotland and uses a cost of illness approach. The study includes estimates of the relevant direct, indirect and intangible costs associated with alcohol misuse, and covers the following categories: health care, social care, crime, productive capacity of the Scottish economy, wider social costs.

The total cost of crime in Scotland for 2007 is estimated to be in the range of £114.2 million to £346.8 million annually with a midpoint estimate of £230.5 million.

Section 7 in the study provides further detail on the costs of crime.

Keep Well is an anticipatory care programme that contributes to tackling health inequalities by targeting cardiovascular disease and its risk factors in the most deprived areas of Scotland.

NHS Health Scotland manages the mainstreaming of the Keep Well programme through a co-ordinated framework of activity which helps to ensure that territorial NHS boards remain committed to Keep Well and the sharing of best practice. It has also helped implement guidance for engaging with the Keep Well core target population based on learning from earlier implementation of Keep Well. NHS boards are required to produce an annual report on their Keep Well activity.

Over 180,000 Keep Well health checks have been delivered across Scotland so far (between March 2009 and end June 2012).

The Scottish Government is committed to reducing the gap in health inequalities between deprived and affluent areas, and has committed provides funding of £11.3 million per annum over 2012-2015 for the delivery and implementation of Keep Well.

From 2013 we will monitor the provision of structured education for people with type 1 and type 2 diabetes through the Scottish Diabetes Survey.

Our Diabetes Action Plan, published in 2012, fully recognises the important role that structured education can play in supporting people with diabetes to self-manage their condition.

In implementing the Action Plan we have supported the appointment of a National Diabetes Education Lead at NHS Education Scotland. This led to the development of a review process for structured education: “Assessment of Patient Education in Scotland” and “Tools for Assessment of Patient Education in Scotland”. These resources are helping to ensure that structured Education across Scotland is consistent and quality assured.

The Scottish Diabetes Group has also given funding to NHS boards, Managed Clinical Networks to support the roll out of structured education. In 2011-12 this amounted to £154,450.