Chamber and committees

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.

<>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.

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

<>I refer the member to the answer to question S4W-12799 on 04 March 2013. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.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 Scottish Government does not collect data on the alcohol intake of people following a Keep Well check.

It is up to individual boards to decide what data to collect locally, which helps them in planning their local service needs.

As part of the Keep Well health check, individuals are assessed for their alcohol consumption and where appropriate individuals are referred to alcohol services for further support.

The following table shows the estimated numbers of households in Scotland affected by housing benefit changes which have been implemented by the United Kingdom Government to date and those which are scheduled to be implemented from April 2013.

Assessments of the possible impacts of these changes are published on the Scottish Government website at:

Impact of Housing Benefit Changes in Scotland

Housing Benefit Change	Implementation date	Estimated number of households affected1
Changes to local housing allowance rates for tenants in private rented sector. - Removing £15 excess. - Restriction to 4 bedroom rate. - Capping LHA rates by bedroom size. - Basing LHA rates on 30th percentile rent.	Phased in from 1 April 2011	55,000
Local housing allowance rate for single people without dependants aged 25 – 34 restricted to the rate for a room with shared facilities.	Phased in from 1 April 2011	4,400
Under occupation penalty for working age households in local authority or housing association housing. - penalty of 14% of rent for those assessed as under occupying by 1 room. - penalty of 25% of rent for those assessed as under occupying by 2 or more rooms.	From 1 April 2013	105,000
Overall cap on benefits, which will initially be implemented through a reduction in housing benefit.	To be phased in from 1 April 2013	4,600

Uprating local housing allowance rates by the lower of consumer price index or actual increase in the 30th percentile rate. April 2011 Restricting the uprating of local housing allowance rates to a maximum of 1% per year for two years from 2014-15. April 2014

79,0002

Uprating non-dependant deductions to reflect increases in rent since 2001-02.	April 2011	No estimate available.
Changes to non-dependant deduction rates under Universal Credit.	Phased in from autumn 2013.	No estimate available.

Notes:

1. Since some households may have been affected by more than one of the changes it is not possible to provide an estimate of the total number of households affected.

2. Figure shows the total number of households receiving local housing allowance at the latest available date. The effect on households will depend on whether private landlords continue to rent to households on housing benefit at LHA rates restricted in this way.

Over the period from 2010 to the present date, the Scottish Government has sought concessions to the UK Government’s housing benefit reforms on numerous occasions since DWP first announced its welfare reforms. These are that:

Responsibility for housing benefit be devolved to the Scottish Parliament

The proposal to reduce housing benefit for benefit recipients unemployed for twelve months or more be withdrawn

The regulations on under-occupation deductions be withdrawn

Under-occupation deductions should not apply where there is no alternative accommodation available

Under-occupation deductions apply only to benefit recipients with two or more spare bedrooms

Vulnerable tenants be safeguarded against direct payments

Working families, disabled people, foster carers and parents who shared responsibility for children be safeguarded from under occupation penalties

The flexibility afforded to the Northern Ireland Assembly on direct payments be extended to the Scottish Parliament

People living in supported exempt accommodation be exempt from the benefits cap

The UK Government increases its discretionary housing payments allocation to local authorities.

Over the same period, DWP withdrew the proposal to reduce housing benefit for benefit recipients unemployed for twelve months or more; and decided to maintain current arrangements for covering the housing costs of benefit recipients in supported exempt accommodation for the next one to two years.

In respect of direct payments, DWP has committed to provide budgeting support and make payment exceptions to a proportion of tenants. It has funded six direct payment demonstration projects to inform practice on direct payments. We are closely monitoring progress in this area.

Although DWP has increased the discretionary housing payment (DHPs) budget, this constitutes less than 4% of the overall cuts to housing benefit. In respect of under-occupation, DWP intends that local authorities prioritise DHPs to people living in substantially adapted accommodation and foster/kinship carers.

The Scottish Government and Scottish housing stakeholders continue to engage with DWP to seek to influence the UK Government’s welfare reforms.

Individual NHS boards may have conducted their own, smaller-scale, staff survey since the last NHSScotland Staff Survey in 2010 but we do not hold this information. The 2010 NHSScotland Staff Survey provides information on the level of reported incidences of bullying and harassment broken down by individual NHS board. This information can be found at the following link:

http://www.staffgovernance.scot.nhs.uk/monitoring-employee-experience/staff-survey/.

It is for individual NHS boards to decide what, if any, action to take in response to the findings from the staff survey. We would expect any such actions to be recorded in boards’ staff governance action plans.

I refer the member to the answer to question S4W-12543 on 27 February 2013. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.