The Scottish Government

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Jo Armstrong, Diane Dixon and Jane Saren (The Saren Dixon Partnership)

The Scottish Government funds ASH Scotland for the contribution it makes to the development and implementation of national policy designed to reduce smoking levels in Scotland. In August 2007, the Scottish Government commissioned The Saren Dixon Partnership to undertake an external review of ASH Scotland. The research sought to examine ASH Scotland's performance in relation to the funding provided by the Scottish Government.

Main Findings

• ASH Scotland has enjoyed a remarkable period of internal growth and external achievement since 1997 and now needs to consider its future direction whilst maintaining its reported strengths.
• The contribution of ASH Scotland to advances in tobacco control is acknowledged by all stakeholders. The close working partnership between ASH Scotland and the Scottish Government was regarded as a strength by the majority of stakeholders surveyed.
• Stakeholders expressed concern that, with the legislation restricting smoking in enclosed public places on the statute book, the battle will be seen as having been won.
• ASH Scotland's strengths include its evidence base, ability to form and lead coalitions, working in partnership, consistency, single focus, courage, clarity and accessibility of its messages, and independence from government.
• A continuing and high priority is to focus on specific groups in which smoking is most prevalent, such as people living in areas of high deprivation, Black and Minority Ethnic ( BME) communities, people with mental health problems, young people and young pregnant women. This may require different approaches, strategies, partnerships and communications.
• An economic value for money ( VFM) exercise was not possible with the available data, but ASH Scotland clearly delivered a significant contribution to the development and implementation of tobacco control policy and the National Tobacco Action Plan.
• Despite good financial management practice, which is consistent with the Langlands Report's ( OPM and CIPFA, 2004) ¹ approach to good governance in public practice, forecast budgets were highly correlated to the actual expenditure for the previous year and this brings risks in an uncertain funding climate.
• ASH Scotland faces funding challenges in the current climate and, with an external view that may see its work as complete, needs to address a series of issues in its fundraising strategy.
• More formal recording by the Scottish Government against grant award fulfilment requirements is recommended.

Context

The Health and Wellbeing Directorate of the Scottish Government ² funds ASH Scotland for the contribution it makes to the development and implementation of national policy designed to reduce smoking levels in Scotland.

The review of ASH Scotland was part of the rolling programme of external reviews at 6 year intervals of agencies and organisations in receipt of major recurring grants of £100,000 or more. These are required under the Scottish Compact of Good Practice Guide "Advice on Scottish Executive relations with the voluntary sector" ³.

This stand-alone project was closely linked to the external review of Partnership Action on Tobacco and Health ( PATH), which was commissioned separately.

Aims and objectives

The overall aim of the work was to examine ASH Scotland's performance.

Specifically, the external review was to:

• examine ASH Scotland's performance in providing value for money in relation to the funding made available by the Scottish Government both to support its core activities and specific projects/initiatives it has been taking forward;
• assess ASH Scotland's short and long term strategic planning processes and the organisation's performance in and contribution to developing and delivering national tobacco control policy;
• assess the effectiveness of ASH Scotland's standing financial instructions and the internal and external audit, and
• identify key strengths, which can be built upon, and propose solutions to any weaknesses which need to be addressed, value for money ( VFM) and cost-effectiveness being a key feature.

Period of scrutiny

The review focused in particular on the 3 year funding period 2004-07.

However, cognisance was taken of the significant advances in tobacco control policy and implementation which took place from 1998 onwards.

Methodology

• Data was compiled from extensive documentation, including Scottish Government, NHS Health Scotland and ASH Scotland publications, professional journals and web-based information.
• 50 semi-structured interviews were held with stakeholders.
• A member of the review team attended an initial meeting with the Board of ASH Scotland and its 2007 AGM.
• Data was collected and staff interviewed from the selected benchmark organisation (the Scottish Drugs Forum).
• A Steering Group was established to guide the review and met twice.

Figure 1.1 illustrates the breakdown by category of the stakeholders interviewed.

Figure 1.1 ASH Scotland Stakeholder Survey Participants by Field

Following a preliminary value for money assessment and identification of issues, key issues were reviewed with key stakeholders and further data collection and analysis took place.

Main conclusions and recommendations

Data limitations have meant a traditional VFM analysis has not been possible. However, the outcome from the review's interviews allowed the team to conclude that ASH Scotland provided VFM in respect of financial support from the Scottish Government in the 3 year funding period 2004-07, in terms of delivery of the objectives and priorities set out in ASH Scotland's strategic plan.

Partnership/alliance working was seen as a key strength. In addition to national alliances, ASH Scotland is active in the creation, building and support of local tobacco control alliances.

ASH Scotland should maintain its partnership/alliance work as a priority, whilst continuing its assessment of its partnerships and alliances to ensure they best fit the current environment and needs of their membership.

The Information Service and evidence base are regarded, both internally and externally, as central to ASH Scotland's modus operandi.

The overwhelming view is that ASH Scotland contributed to the set of conditions which enabled the passage of the Smoking, Health and Social Care (Scotland) Act 2005.

ASH Scotland has made a significant contribution to a period of remarkable progress on tobacco control in Scotland. The organisation is now facing some challenges of success and maintaining momentum may be an issue.

Internally, ASH Scotland experienced a dip in morale in the immediate aftermath of the achievement of the smoke free public places legislation and an untypically high staff turnover in 2006-07.

Externally there could exist some perception that ASH Scotland's work is substantially complete.

Work on Tobacco and Inequalities is considered an important aspect of ASH Scotland's work.

Work with harder to reach groups where smoking remains prevalent, such as people living in areas of high deprivation, Black and Minority Ethnic ( BME) communities, people with mental health problems, young people and young pregnant women, may require different approaches, strategies, partnerships and communications. This work is a continuing and high priority.

Some reservations exist about the appropriateness for health boards of the current accredited smoking cessation training. ASH Scotland has remedial actions in place and should continue its work to adapt the accredited training to the needs of health boards.

ASH Scotland appears to have robust business and strategic planning processes in place. There exists a need to diversify its funding base, continue developing and implementing the organisation's fundraising strategy as a priority and extend the membership of its Board to better reflect the skills match required.

In the light of the far tighter public sector financial climate and the need to diversify its income sources, ASH Scotland should consider adopting a zero-based budgeting approach ( i.e. where budgets are not assumed to be based on last year's baseline figures but assumed to be zero and only increased as agreement to continuing activities is independently established).

While the existing ASH Scotland risk register is comprehensive, the next review of this should involve a statement of the resources that are needed to manage key risks and specify the timescale for any contingency arrangements to be put in place.

It is important that ASH Scotland ensures that the fundraising strategy is regarded as a "whole organisation" responsibility.

ASH Scotland should formalise the external reporting of its achievements to ensure a clear and auditable trail against grant terms and conditions.

The Scottish Government should institute a more formal recording of ASH Scotland outputs against Scottish Government targets for its investment to aid on-going performance tracking against grant award requirements and any follow-up evaluation exercise.

The tenure of a new Chief Executive in January 2008 offers ASH Scotland an opportunity to reflect, review and regroup in order to embark on the next phase of its mission of "liberating the people of Scotland from the harm caused by tobacco". ⁴

This document, along with "External Review of ASH Scotland" the full research report of the project and further information about social and policy research commissioned and published on behalf of the Scottish Government, can be viewed on the Social Research website at: www.scotland.gov.uk/socialresearch. If you have any further queries about social research, please contact us at socialresearch@scotland.gsi.gov.uk

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