The Scottish Government

1. To put in place a national, long-term "responsible drinking" communications strategy.

The "How Much is Too Much?" campaign, which was launched in April 2002, ran national TV, radio and cinema advertising targeting 18 to 35 year old excessive drinkers during 2002. The campaign was brought within the Executive's Healthy Living communications umbrella and the subsequent "Don't let too much drink spoil a good night out" campaign was launched in May 2003. Research with young adults to assess the impact of the campaign found the advertising had high levels of relevance, distinctiveness and memorability. A National Communications Co-ordinator was appointed in February 2003 to manage the national campaign and provide support for local ADAT communications activity.

Training for ADATs on dealing with the media was held in November 2003 and campaign materials have been issued to link national and local media activity. Communications toolkits for local partners issued in August 2004.

2. Communications with both the general public and specific target groups should reinforce the terminology of "alcohol problems".

Local alcohol plans show that most ADATs have adopted the revised terminology and are working with member and partner organisations and the media to encourage wider adoption. The Scottish Advisory Committee on Alcohol Misuse ( SACAM) was renamed SMACAP in order to demonstrate commitment to appropriate terminology.

3. More organisations and professional bodies should adopt alcohol policies that define sensible and appropriate use of alcohol by their members, relevant to their work or other pursuits.

Alcohol policies are being promoted under the auspices of Scotland's Health at Work ( SHAW) where it is a requirement of the silver level scheme. The creation of the Scottish Centre for Healthy Working Lives will reinforce this drive (see action point 13 below).

4. The research strategy to be developed as part of the plan will give high priority to developing the evidence base for prevention, education and communications actions.

A review of research requirements was completed (action point 57) and the updated Plan for Action includes a commitment to develop an alcohol research strategy. Research undertaken to shape the alcohol communications strategy has been shared with ADATs whilst the Scottish Social Attitudes Survey has given further insight into alcohol cultures in Scotland.

5. Each ADAT should make prevention, education and communications an integral part of its local strategy.

Prevention, education and communications are integral parts of all local alcohol plans. The Executive has given individual feedback to ADATs on these plans as part of its ongoing accountability processes. The plans demonstrate that many ADATs have implemented successful communication campaigns which lend support and extend the reach of national preventative campaigns.

6. Joint planning to meet the prevention, education and treatment needs of children and young people.

Local plans show evidence of joint planning of drug and alcohol action and children's services. The Executive's response to the Advisory Council for the Misuse of Drugs' Hidden Harm report extended its reach to children of parents with alcohol problems and is leading to a series of practical actions to improve service integration and planning.

7. All schools to become Health Promoting Schools by 2007.

The Scottish Health Promoting School Unit was established in 2002 to provide strategic and practical support to partner organisations, councils, schools, NHS health boards, community planning partnerships, integration managers and other stakeholders in supporting schools to become health promoting by 2007. The Unit supports a whole school approach to the physical, social, mental and emotional well-being of all pupils and staff. This ensures not only that health education is integral to the curriculum but also that school ethos, policies, services and extra-curricular activities foster mental, physical and social well-being and healthy development.

8. Alcohol problems will be included in the indicative list of priority objectives for the Changing Children's Services Fund.

Alcohol problems have been included in the list of priority objectives since April 2002. Projects are currently being supported in a number of areas including Angus, North Lanarkshire and Fife. Children affected by or at risk of alcohol problems will be identified as a specific group within guidance on local children's services plans which will be issued in August 2004.

9. Work with NUS in Scotland to develop ways of targeting responsible drinking messages to students, in line with the overall communications strategy in the plan.

AFS, in partnership with NUS in Scotland, has developed responsible drinking materials for students, promoted alcohol awareness training for student counsellors and provided training in responsible drinking practice to student bar managers.

10. To commission new resources for parents on alcohol and young people which will be widely disseminated.

The Parents Guide on Alcohol was launched in January 2003. The Guide, which was developed by NHSHS in partnership with the Executive and AFS, provides information to help parents decide what to discuss with their children and how and when to do it. 250,000 copies have been distributed to secondary schools, NHS Board health promotion departments, pharmacies, GP practices, Local Health Care Co-operatives ( LHCC) and local authorities. The guide is also available though the Drinkline helpline and was publicised through local and national press.

11. To consider organising health promotion activities that address alcohol problems or potential problems, in the context of delivering other health promotion advice. They should publicise that these services are available, in ways that are appropriate to the target client group.

The Executive's Improving Health in Scotland - The Challenge published in 2003 identified action on alcohol problems as one of the core "subject based" improvement programmes. The plan challenged stakeholders to pursue these programmes in an integrated way with a particular focus on early years, teenage transition, workplace and communities. NHSHS are continuing to support CHPs in developing their role in improving the health of their local communities with a particular focus on reducing health inequalities.

12. Thiamine in beer. The relevant UK scientific advisory committee to consider the complex issues involved in introducing this measure in the UK.

On the basis of their experience of folic acid fortification, the Food Standards Agency have indicated that statutory thiamine supplementation would be unlikely to be supported. The Scientific Advisory Committee on Nutrition also raised doubts about the desirability of this measure and we have agreed with SMACAP that we will not progress action in this area.

13. To work with other organisations to help employers to develop better workplace alcohol policies within their occupational health strategies and plans. Aim to double participation by small and medium sized enterprises in their scheme. Aim to cover 40% of the Scottish workforce.

Alcohol policies are being promoted under the auspices of Scotland's Health at Work where it is a requirement of the silver level scheme. In April 2005, SHAW became an integral part of the newly formed Scottish Centre for Healthy Working Lives, which is charged with delivering the actions contained within the Healthy Working Lives - A Plan for Action strategy published in August 2004. This strategy provides a single policy framework for ensuring the workplace setting is used to drive positive change and reduce health inequalities. Key to the Centre's success will be the facilitation of access for employers/employees and potential employees to a wide range of services and networks delivered through a national telephone helpline, website and team of field advisors. Following contact, individual (or organisational) needs will be assessed and arrangements made by the centre for appropriate services to be delivered. This will include support to develop workplace policies on both drugs and alcohol as well as the range of health, social justice and lifelong learning issues that are needed to support a healthy working life.

14. To consider with knowledgeable representative groups whether it would be helpful to develop materials for equality groups within the overall communications strategy.

The Executive ran a specific Women and Alcohol Campaign in Spring 2005 with supporting material developed in conjunction with GINA. In June 2005, GINA launched Get the Full Bodied Facts, a guide for professionals working with women with alcohol problems and a supporting booklet which provides women with accessible information about alcohol problems.

15. ADATs to include, as part of local prevention, education and communications, action targeted at the needs of significant local equality groups.

Local plans report a wide range of action in relation to black and minority ethnic communities, sensory impaired groups, older people, Lesbian Gay Bisexual Transgender ( LGBT) groups, those experiencing or at risk of domestic abuse, carers, homeless people, rural communities, people with learning difficulties and prisoners.

16. To develop a framework for alcohol problems support and treatment services.

The Alcohol Problems Support and Treatment Services Framework was published in September 2002. The framework provides a template for local commissioners and providers of services to agree priorities for development and assess progress.

17. Clinical Standards Board for Scotland to consider including a standard for alcohol services in their work programme.

NHSQIS held a discussion forum in December 2004 which concluded that the focus of relevant organisations should be on how to raise general awareness of the HTA and SIGN guideline, identify and address training needs and support the implementation of such guidance, rather than the setting of standards.

18. To consider the need for additional statutory resources for all types of action on alcohol problems including support and treatment services.

The Executive provided specific additional resources of £3m for 2004/05 and £5m for 2005/06 to help support the implementation of local alcohol action plans. An additional £5m for alcohol treatment services in 2005/06 was announced on 1 July 2005.

19. To consider whether a Scottish alcohol problems helpline is needed.

The Drinkline helpline is being provided on a UK basis. AFS materials are available through the line. The contract is managed by the Department of Health and the Executive will continue to participate in monitoring discussions.

20. ADATs in rural areas should ensure that local strategies take into account the particular difficulties that their service users may experience.

Progress continues to be monitored through ADAT annual accountability arrangements.

21. Local authority homelessness strategies should indicate how homeless people and people at risk of becoming homeless because of problems with alcohol will be supported and helped out of homelessness.

All local authorities have submitted Homelessness Strategies to the Executive. These strategies have been assessed by a Panel on behalf of the Homelessness Monitoring Group. Assessment includes ensuring that, where a specific cause, such as alcohol problems, is identified as contributing to homelessness in the area, there are actions in place to address that cause. In addition and integral to the Homelessness Strategies are Health and Homelessness Action Plans prepared by NHS Boards in partnership with local authorities. The delivery of agreed strategies will be monitored through the Homelessness Monitoring Group, NHSScotland's Performance Assessment Framework and ADAT annual accountability arrangements.

22. To set up an expert group to review models and approaches to providing services for people with alcohol-related brain damage.

A Fuller Life, the report of the expert group was published in April 2004. The update includes action to progress this (see forward action point 19).

23. The Executive is the scope for a wider local authority administered smartcard scheme with local authorities and NHSScotland.

All young people aged 12-18 are now offered the Young Scot smartcard which has a PASS hologram. The Executive is funding a Trading Standards Officer to raise awareness of the card and all retailers are being encouraged to accept only cards bearing the PASS hologram as proof of age.

24. Alcohol-fuelled violence will be examined at the Executive's anti-violence conference.

The subject of alcohol-fuelled violence was well represented at the Towards a Safer Society Conference held in September 2002. This subject was further developed as one of the major themes of the second Safer Society Conference in autumn 2004.

25. The Executive to consider policy and guidelines for social workers and sentencers, on structured work with those receiving deferred sentences.

Guidelines were issued in January 2004 and local authorities subsequently submitted plans to run pilot programmes. Three Executive funded pilots commenced in spring 2005 to trial the use of periods of structured work during deferred sentences. Located in Kilmarnock, Arbroath and Forfar and Inverness, the pilots have generated around 60 structured deferred sentences to date. The pilots will continue for two years and will be independently evaluated.

26. Support given to pilot arrest referral schemes that tackle drug and alcohol problems amongst others.

Effective Interventions Unit published guidance on arrest referral schemes in March 2002 and a national seminar was held in March 2003 to build on the guidance and detail experience from existing arrest referral schemes. A new power to fund arrest referral schemes was included in the Criminal Justice (Scotland) Act 2003 and local authority groupings and ADATs submitted joint applications to run schemes. Successful bids were announced in October 2003 and schemes will run as pilots from February 2004 - January 2006, when they will be evaluated and decisions taken as to future funding. Six pilots have received funding from the Justice Department under Section 27 of the Social Work Scotland Act 1968. The pilots include both existing and new arrest referral schemes and are principally but not exclusively focused on drugs accused.

27. The UK Government is considering:

• The current drink drive limit in the context of proposals from the European Commission;
• Responses to a consultation paper, issued in December 2000, on proposed changes to penalties for road traffic offences, including drink and driving;
• Legislation to introduce targeted breath testing and roadside testing to provide admissible evidence in court.

The UK Government announced in March 2002 that it had decided not to change the current drink drive limit (80mg/100ml). The Government believes that the present limit, combined with severe penalties, provides an effective deterrent in most cases, and prefers to emphasise the importance of enforcement of existing laws, combined with extended publicity campaigns, including the targeting of specific groups. The police's enforcement capability has been strengthened by introducing legislation to enable them to obtain blood specimens from unconscious suspects in hospital. Most recently, the Serious Organised Crime and Police Act 2005 provides for the police to carry out evidential roadside breath testing, subject to type approval of appropriate equipment. Other measures in the Road Safety Bill, currently proceeding through Parliament, include the introduction of a breath alcohol ignition interlock device and a new court disposal for discouraging re-offending. The Bill also requires all offenders disqualified for two years or more, including repeat drink drive offenders, to retake the driving test and contains improvements to the successful drink drive rehabilitation scheme.

28. Raise issues surrounding alcohol advertising from the evidence for the plan, with the UK Government and the alcohol industry.

The UK view, which is set out in the English Alcohol Harm Reduction Strategy, is that the evidence is not sufficiently strong to suggest that a ban on alcohol advertising or tightening existing restrictions about scheduling should be imposed by regulation. What was accepted however, was that the system was not sufficiently tightly drawn up and enforced. The advertising standards code was revised by Ofcom and the new rules came into force on 1 January 2005. This should ensure that advertisements do not target under 18s, encourage or celebrate irresponsible behaviour, cause offence or encourage alcohol problems.

29. Will participate in discussions on labelling issues at UK level.

The Scottish Executive is continuing to participate in alcohol industry liaison meetings hosted by the Department of Health and has developed a series of independent contacts into leading producers.

30. Will work with the industry and licensed trade and AFS to improve and promote training in responsible serving of drinks.

In the three years from April 2002 to March 2005, the AFS ServeWise programme provided training in responsible serving practice to 7,145 licensed trade persons across Scotland and increased the number of Centres registered to deliver its training to 67. The Licensing (Scotland) Bill will require mandatory server training.

31. To put in place accountability arrangements for local delivery.

The Executive issued a framework in July 2002 to inform ADATs of the information that should be included in 3 year local alcohol action plans. The current template for annual ADAT reporting places more emphasis on an outcome based approach, focuses on a reduced number of priority areas and combines reporting requirements for alcohol and drug action. In addition, ADATs were required to set out how additional resources for 2005/06 will support service improvements.

32. Review progress in delivering the plan with all the agencies and interests involved.

The updated Plan for Action was developed in consultation with the SMACAP and other interested parties. This appendix represents one of the key outputs from the review process.

33. To review the membership of SACAM, now SMACAP, to make sure that it represents key interests and priorities within the plan.

Membership reviewed in 2002 and extended to include young people, service user, research and prison interests. A further review is currently taking place.

34. To ensure that alcohol problems are highlighted and addressed in other relevant strategies and plans.

Ongoing - alcohol problems are highlighted and addressed in the Improving Health in Scotland - The Challenge publication, the national strategy and action plan to prevent suicide and in Getting Our Priorities Right guidance on working with children and families affected by substance misuse.

35. Arrangements for co-ordination of alcohol, drugs and other substance misuse issues should be determined locally under the broad community planning umbrella.

Being monitored through ADAT annual accountability arrangements.

36. Where Alcohol Action Teams ( AATs) are combined with Drug Action Teams ( DATs) to form ADATs alcohol issues should be given higher priority on the agenda than at present.

Guidance issued to NHS Boards, local authorities and other key partner agencies in March 2002 asks them to review the priority given to tackling alcohol problems in light of the Plan for Action.

37. ADATs should form effective working links to other local co-ordinating structures, under the broader community planning umbrella.

All ADATs report links with other local planning processes are currently in place or being developed. The review of drug and alcohol action teams identified in this update will consider the future role of ADATs in the light of new and emerging local planning structures.

38. Local authority departments, including social work and education departments, NHS boards and the police should provide representatives at elected member or chief executive level as members of ADATs.

The guidance referred to in action point 37 asks partner agencies to review their representation on ADATs. Local plans indicate that the majority of ADATs now have senior representation from most relevant sectors although some gaps in representation still exist.

39. Each ADAT should have at last one forum or reference group to make sure that community, voluntary sector and individual views are voiced and heard.

All ADATs report structures currently in place or being developed to promote community, user and carer involvement.

40. Each ADAT should draw up, publish and subsequently implement a local strategy covering a period of at least three years.

All 22 ADATs have submitted action plans to the Scottish Executive.

41. ADATs should "sign off" plans by constituent agencies for providing and commissioning services, using both existing resources and any new funding that becomes available in future.

Progress continues to be monitored through ADAT annual accountability arrangements.

42. Provision of new funding to strengthen support for ADATs as soon as details of enhanced support have been agreed.

Funding to support the ADATs increased from £450K pa to £1 million pa from 01/04/02 and has been maintained at this level in each subsequent year. A further £100k per annum has been provided to support SAADAT (see 43).

43. Provision of funding for a new national alcohol liaison post to support all ADATs in delivering local strategies.

A National Alcohol Liaison Officer was appointed in February 2002.

44. Ensure that the National Associations of ADATs and DATs work together on linking the delivery of the plan and the national drug strategy.

There is representation from the DAT Association on the National Alcohol Liaison Officer advisory group and a series of regular meetings between the national officers of each Association have led to joint working on issues such as a Training Needs Analysis. The National Associations have now merged.

45. Programme of leadership training for ADAT members.

Scottish Leadership Foundation training provided in 19 ADAT areas.

46. Provision of communications expertise to support local communications action.

A National Communications Co-ordinator was appointed in February 2003 with the Scottish Executive as Marketing and Communications Group.

47. STRADA to revise and update its training material in the light of this plan.

Ongoing review of work programme.

48. The Executive is discussing medical education on addressing alcohol problems, which is required at both undergraduate and postgraduate level, with relevant Scottish professional bodies.

A seminar on Alcohol and the Health Service was held at the Royal College of Physicians in February 2002. This allowed discussion of the role of alcohol problems amongst healthcare staff, particularly doctors. A further Royal College of Physicians and Surgeons ( RCPS) of Glasgow symposium was held in June 2004. RCPS also now funded by the SE to train healthcare workers.

49. The need to address changes to nurse education in alcohol problems as an early priority will be put to the Nursing and Midwifery Council (which will have responsibility for the pre-registration education of nurses) and the new Special Health Board for post registration of nurses in Scotland.

Alcohol problems are well addressed within the majority of midwifery programme curricula. Substance misuse is included in the pre-registration nursing programme of Bell College and Robert Gordon University. The nursing programmes of Glasgow Caledonian, Glasgow, Paisley and Napier Universities have modules in substance misuse. Glasgow Caledonian University ( GCU) also have a BSc Specialist Nursing Programme with an SVQ in Substance Misuse Nursing. There is limited curriculum content in programmes provided by Edinburgh University and Queen Margaret University College ( QMUC) and this is currently being reviewed. There will be substance misuse input in all Community Mental Health SVQs.

50. The Executive will bring forward proposals to enhance professional social work education. This will require a higher level of specialised training in areas such as the identification and assessment of people with alcohol problems.

The Framework for Social Work Education in Scotland was published in January 2003. The Framework sets out the standards which must be met on completion of the new Honours degree which came into effect in 2004. The Scottish Institute for Excellence in Social Work Education has been set up to ensure that the new degree meets the needs of practitioners. The Institute and the Scottish Social Services Council will be ensuring that the new courses are of a sufficiently high standard to enable new practitioners to cope with complex demands. The Institute has already established links with STRADA to ensure their teaching expertise in tackling problem substance misuse is available to new degree courses.

51. The new Scottish Social Services Council will register social workers. It will require a programme of continuous professional development ( CPD) for them to maintain their registration. CPD will include options in providing services for people with alcohol problems.

Ongoing. The Council commenced registration of social workers in April 2003 and is on target to complete registration of all social workers linked to the introduction of Protection of Title in September 2005. All social service workers including social workers have to comply with a Code of Practice which requires them to update their knowledge and skills relevant to their area of practice. Registered social workers have to undertake 15 days (90 hours) of post registration training and learning over 3 years before re-registration, of which 5 days (30 hours) will focus on working effectively with colleagues and other professionals to identify, assess and manage risks to vulnerable people, some of which may be focused on alcohol problems.

52. To consider how a limited number of specialist networks might be set up and supported.

GINA was launched in June 2003 to focus on and has focussed on the specific issues of women and alcohol in the first instance. The Executive is funding a full time Network Support Officer who is based at AFS.

53. Provide resources to underpin development of a national alcohol information service.

NAIR was established at ISD in April 2002. NAIR is the national centre for statistics and expert advice on alcohol information in Scotland and leads on the development, co-ordination and dissemination of information on the nature and extent of alcohol problems. NAIR have:

• launched the Alcohol Information Scotland website in March 2004 to facilitate dissemination of statistics, national policy, guidelines and research on alcohol;
• issued local information profiles to ADATs to assist with local planning and delivery;
• established close partnership working with ADATs and the SAADAT; and
• commissioned and developed the Scottish Schools Adolescent Lifestyle and Substance Use Survey ( SALSUS) to address local and national planning needs.

54. To consult on standard definitions of a range of alcohol problems to be used in data collection by relevant agencies.

NAIR are contributing to the development of national data standards for collection of alcohol information which is being taken forward as part of wider initiatives such as Joint Future.

55. To explore the potential for quantitative measurement of alcohol, and other substance misuse issues and problems, among minority ethnic groups in Scotland, alongside other survey activity.

NAIR are exploring the enhancement of reporting of alcohol information amongst equality groups as part of wider work on improving information reporting in the general population.

56. The Public Health Institute for Scotland, on behalf of the Executive, will lead a review in Scotland starting early in 2002, of gaps in research knowledge and evaluation practice, in the light of the action in this plan.

The review has been completed.

57. The Effective Interventions Unit ( EIU) work on identifying and disseminating effective practice in tackling drug misuse will be made routinely available to the alcohol field.

EIU publications were made available to the alcohol field. The Unit has now been disbanded but the Executive remains committed to the dissemination of effective practice and will be introducing an alcohol problems research programme from 2005/06.