External Review of ASH Scotland 2014

10 Comparison with Other Organisations

10.1 A light touch comparison of Alcohol Focus Scotland, Scottish Drugs Forum, and ASH Scotland was carried out to inform the review, and to draw out learning which may be useful to ASH Scotland and to the Scottish Government. The two other organisations were selected as they receive comparable core funding from the Government, and have some similarities in terms of activities and objectives with regard to alcohol and drug use.

10.2 As each organisation uses different financial reporting conventions, it is not straightforward to compare expenditure on different areas such as research/information, training, policy/advocacy. We therefore focus on areas of difference, similarity and learning opportunities. Information was taken from annual reports, accounts, strategies and performance reports provided by the different organisations and from information available on their websites.

Comparative overview of income and staff 2012/2013

	FTE employed staff	Total income 2012/13	Core funding from Scottish Government 2012/13	Project funding from Scottish Government 2012/13
Alcohol Focus Scotland	13[11]	£905,750 £964,054	£472,000	£38,999
Scottish Drugs Forum	24.5[12]	£1, 566,703	£351,000	£359,986
ASH Scotland	21.3[13]	£1,158,315	£255,000	£605,000

Scottish Drugs Forum (SDF)

10.3 The Scottish Drugs Forum has three main aims which are to:

• improve the quality, range and effectiveness of service and policy responses to problematic drug use in Scotland
• reduce future and recurring problematic drug use
• promote and sustain recovery from drug problems

10.4 The SDF works through "informing, supporting, leading and representing". While the work of SDF is partly focused on influencing policy ("representing" and "leading"), the majority of its funding is for specific projects to support and improve practice in delivery organisations, and providing help and information to individuals, through training, quality improvement, supporting user involvement, website and directory provision. Local health boards and councils are significant funders of this work, as well as The Big Lottery Fund and the Scottish Government. It differs from ASH Scotland and Alcohol Focus Scotland in that its work is much more directed to service users and practitioners, as well as to commissioners of support to improve capacity and quality.

Alcohol Focus Scotland (AFS)

10.5 AFS has a single overarching aim to help to reduce harm by bringing about a significant reduction in alcohol consumption across the population. It does this through:

• Communication and information dissemination
• Policy, research and advocacy
• Learning and development (including training and training resources)

10.6 Learning and development are an important part of AFS's role, but it also has a very strong focus on producing and publicising evidence and research through its website and policy work. AFS works closely with some local organisations such as alcohol and drugs partnerships, licensing forums and nursery school staff. Funding comes from the Scottish Government for core and project activities, support from donors/trusts such as Comic Relief for specific projects and voluntary donations.

ASH Scotland

10.7 ASH Scotland has a single overarching aim to reduce harm from tobacco. It does this through:

• Training and education
• Tackling inequalities
• Influencing and policy
• Alliances and partnership working

10.8 ASH Scotland has a strong focus on publicising evidence, policy influencing and information, as well as providing training. It also works to achieve greater reach and depth through partnerships such as youth alliances, NHS boards and with alliances such as SCOT and STCA. Funding comes from the Scottish Government, the British Heart Foundation, Cancer Research-UK and funding for individual projects.

Comparing and learning from each other

Vision, strategic direction

10.9 Both AFS and ASH Scotland have a well presented strategy, published on their websites. AFS' strategy has been more recently updated (2013) and benefits from this through providing clear overall objectives and summary of activities which it undertakes. The logic model AFS uses is similarly useful in giving a high level message about its aims and intended outcomes.

10.10 SDF, possibly reflecting a different target audience, emphasises its vision and values, sets out what it wants to see change in society and how it will engage with people. SDF does not publish a strategy, although it has a detailed work plan.

10.11 The ASH Scotland strategy 2010-2015 combines both past achievements and forward plans. It is relatively detailed for a strategy document which needs to provide a clear framework for the direction of travel and defined outcomes.

Partnership working

10.12 All three organisations work with alliances related to their subject area.

10.13 ASH Scotland's work with the STCA and SCOT however appears to be the strongest example of working with others to influence thinking and debate as well as to develop a national aligned approach to reducing smoking and harm from tobacco. For both AFS and SDF partnership work focuses more on bilateral relationships with NHS boards, local authorities and other local organisations. SDF in particular works extensively with health boards, local authorities and local service providers and advocacy groups, and has project funding from some NHS boards and local authorities. For ASH Scotland, there are fewer ongoing direct relationships with health boards and councils.

10.14 For these reasons, AFS and SDF appear to have greater practical local engagement than ASH Scotland. AFS local work has been supported by Government funding for a new member of staff since 2012 as part of its support to the national delivery programme. This is in contrast to ASH Scotland where funding for the local alliance officer ended in 2010.

Comparison of ASH in Edinburgh with ASH in Cardiff and ASH in London

10.15 The Scottish Government agreed to a light level of comparison with the two equivalent ASH organisations based in London and in Cardiff which involved a review of published data and phone interviews with the relevant CEOs.

10.16 ASH in London specifically focuses on policy, advocacy and evidence, and does not provide support to local organisations, although it has offered this recently, on a time limited basis, in response to the 2012/13 changes in public health responsibilities in England. In general it undertakes no direct training delivery. It is smaller in terms of staff numbers and expenditure than ASH in Edinburgh. ASH in London works on matters relevant to the whole UK and England; where policies and activities are devolved to Scotland, Wales, Northern Ireland these are addressed by the ASH organisations for the relevant administration. For instance, the health service and local government are both devolved: HM Revenue and Customs (HMRC) and the Medicines and Healthcare Regulatory Agency (MHRA) are not. ASH in London, like ASH in Edinburgh, is a member of the Framework Convention Alliance (FCA). ASH in London leads the UK-wide Smoke Free Action Coalition (SFAC) as a key part of its influencing work; the other ASH organisations lead on devolved matters within their own administrations in the SFAC.

10.17 ASH in Cardiff is the most recently established of the three organisations (established in its own right as separate from ASH in London in 2007). ASH in Cardiff has more limited resources than ASH in Edinburgh, and fewer core staff. It provides no training, which is provided by Public Health Wales (PHW). ASH in Cardiff receives a small pot of funding from the Welsh Government and engages in policy through the Welsh Government Tobacco Control Delivery Board. ASH in Cardiff has links with 7-8 local groups of Health Boards and local authorities, which it sees as very important in promoting local engagement and informing their influencing work with Welsh Government and PHW. The extra capacity provided by a three-year Big Lottery youth project grant for new project staff has enabled greater local engagement than previously. ASH in Cardiff supports the Welsh Tobacco Control Alliance of 35 local organisations through Cancer Research UK funding it receives and sees these partners as critical to influencing policy in Wales.

10.18 We conclude that the three different ASH organisations work appropriately to their local political and resource context, and have developed slightly different remits. ASH in London has a clear focus on UK-level, England-level, and international policy and influencing work as well as on publishing evidence; it prioritises engagement in UK-wide consultations and strategies, which shape the context for tobacco policy. Local training and influencing across the much larger number of local authorities and health organisations in England can be more cost effectively undertaken by other organisations which has been recognised by ASH in London. ASH in Cardiff, working within a smaller administration, has to integrate local and national working which are much more closely linked. With more limited resources, it focuses on a narrower range of activities. ASH in Edinburgh combines the national and local; as for ASH in Cardiff, active engagement with local organisations contributes to influencing and policy work, and to the alignment of activities on reducing harm from tobacco. As with ASH in London, there is strong engagement in UK-level policy, and in international activities, such as the Framework Convention for Tobacco Control. However, the political priority given to reducing harm from tobacco and tackling health inequalities by the Scottish Government also requires a more significant engagement with central and local government and with local alliances.