Chamber and committees

The information requested on how many staff each NHS board has to ensure that patients being treated for cancer are provided with follow-up health checks following surgery and whether it considers these numbers are sufficient is not held centrally.

It is for each NHS board to decide how best to plan and deliver their services to meet the needs of their population. This includes how best to utilise funding and staff, taking account of national and local priorities to meet local health needs. The Scottish Government does not advocate minimum staffing levels.

Scottish Government Ministers and officials regularly engage with alcohol treatment providers via Alcohol and Drug Partnerships (ADPs). When engaging with ADPs, Scottish Government Ministers and officials cover a range of topics given the broad remit and function of ADPs.

ADPs are strategic partnerships, established in 2009 and are responsible for: developing local strategies for tackling problem alcohol and drug use and promoting recovery, based on an assessment of local needs; and, putting in place an evidence based process for agreeing how funds should be deployed with a clear focus on the outcomes that the investment will deliver. ADPs are embedded within Community Planning Partnership structures and contribute to the delivery of local Single Outcome Agreements.

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.

While the Scottish Government provides funding for Alcohol and Drug Partnerships (ADPs) via their respective health boards, the government does not performance manage them as ADPs are accountable to local Community Planning Partnerships.

On 20 April 2009 we launched a new joint Framework, signed jointly by Scottish Government, the NHS and Convention Of Scottish Local Authorities (COSLA), for delivering action on alcohol and drugs at local level. 30 Alcohol and Drug Partnerships (ADPs) were created as a result of the framework and are anchored in Community Planning Partnerships. This document is available at:

http://www.scotland.gov.uk/Publications/2009/03/04144703/0.

Scottish Government, COSLA and NHS Scotland issued ADP Planning and Reporting Guidance for 2012-15 to local areas on 5 April 2012. It identifies seven core outcomes which ADPs are expected to deliver on and are augmented by a set of core indicators, which are available at:

http://www.scotland.gov.uk/Topics/Health/Services/Alcohol/treatment/Partnership-Outcomes.

This Guidance aims to support the embedding of outcomes based planning and reporting at local level, helping ADPs to self-assess their performance (including benchmarking against other ADPs) and to articulate their contribution to their local Single Outcome Agreement, as well as contributing to a national picture of our overall progress in supporting alcohol and drug prevention, support and treatment.

<>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 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.

<>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.

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.