The following guide forms part of the standard for workforce policies. These policies apply to all eligible staff within NHS Scotland, regardless of the board you are employed by.

What is the purpose of the Alcohol and Other Substances Policy?

This policy aims to:

• raise awareness of alcohol and substance use
• support employees with experience of problematic alcohol or substance use
• create a culture where you feel confident asking for help
• create a safe working environment for all staff and service users.

Who is covered by this policy?

This policy applies to all employees and workers, including those on bank, agency, or sessional contracts. In this guide, 'employee' includes all these groups.

Definitions

For this policy, a substance includes:

• Drugs controlled under the Misuse of Drugs Act 1971 (as amended). 
• Misused prescription or over-the-counter medication.
• All synthetic or herbal products, previously known as new psychoactive substances (NPS).
• ‘Legal highs’, included under the Psychoactive Substances Act 2016 (as amended).

Misuse is defined as using a substance in a way that:

• Affects your ability to do your job safely and effectively.
• Is illegal.
• Damages the organisation's reputation.
• Negatively affects working relationships.

The World Health Organisation recognises substance dependency as a health condition. Affected employees should receive the support they need, just like any employee with another health issue.

Manager responsibilities

As a manager, you should:

• Assess the risk and take appropriate action when a situation occurs.
• Manage the situation sensitively and provide the employee with appropriate support.
• Seek advice from HR and occupational health.
• Make management referrals to occupational health and support the employee as required by the relevant policy.
• Make sure employees know what support is available to them.
• Follow the correct workforce policy as needed.

Identification

You may become aware of a substance misuse problem in several ways:

• An employee asks you for help directly.
• You or a colleague notice signs, such as changes in behaviour or performance.
• A concern is raised by someone outside the organisation.

Signs that might lead you to have a supportive discussion include:

• multiple unauthorised absences
• frequent sick leave
• often being late or leaving early
• appearing to be under the influence of alcohol or other substances
• smelling of alcohol
• physical signs like hand tremors or sweating
• a decline in personal appearance
• frequent accidents
• difficulty recalling instructions or handling complex tasks
• changes in mood or behaviour.

It is important to remember that these signs could also be due to other issues.

Initial actions

If you suspect an issue or an employee has raised a concern, you must meet with them to discuss the support available. This may include seeking advice from HR or referring the employee to occupational health.

If you suspect an employee is under the influence of alcohol or other substances, you must take immediate action. Your priority is the safety of the employee, their colleagues, and service users. This may involve removing the person from the workplace.

If you send an employee home, you must make sure they can get home safely. You may want to arrange a taxi or, with their agreement, contact a relative. You should arrange to meet with the employee on the next working day.

You should remind the employee that driving under the influence of alcohol or other substances is a criminal offence. You must take reasonable steps to prevent them from taking charge of a motor vehicle. If you cannot stop them, you must report the matter to the police.

Following Identification of a problem

Once you have identified a problem, you should arrange to meet with the employee as soon as possible to:

• discuss the concerns
• confirm the standards of behaviour expected at work
• agree on a plan of support and action using the Agreement template
• explain the potential consequences if the situation does not improve
• consider the appropriate next steps

You should always take a supportive approach. However, some situations may require further action through other relevant NHS Scotland Policies. Support can be given alongside these processes.

You should make an occupational health referral to get expert advice on how to support the employee. If the employee refuses to engage, you should carry out a risk assessment to decide on the next steps, which may include regular reviews.

The following template can be used to document the support measures agreed upon. Download the Alcohol and Other Substances Policy : supportive plan form.

You may grant leave for an employee to attend appointments, in line with the Special Leave Policy. If the employee is unfit to attend work, their absence should be managed through the Attendance Policy.

Find out more about the Attendance Policy.

Useful Links

• NHS Inform - Healthy Living
• Substance use - supporting employees with lived and living experience: guiding principles
• Alcoholics Anonymous
• Drink Aware
• FRANK – Honest Information about Drugs