3.1       Use can be categorised in 3 ways:

• Experimental – Trying drugs or alcohol as a one off out of curiosity.
• Recreational – This may be regular use but at specific times, when socialising or relaxing.
• Problem use – When people need the drug or alcohol to feel ‘normal’ and find it hard to go without it for any length of time.

• 4.1       The Practice recognises that the workforce is a community in itself.  It is also part of the wider community and the community’s health concerns will be reflected in the workplace. This includes alcohol and drugs. Individuals – employees, managers, anyone may be affected, as users of alcohol/drugs, or maybe have family members affected by alcohol/drugs.
• 4.2       It is estimated that in the UK 35% of people under 40 have experimented with drugs and 25% of these are in employment.
• 4.3         Alcohol is a positive part of life for many people. Alcohol is something which can be enjoyed and most of the time drinking alcohol doesn’t cause any problems.
• 4.4         93% men and 86% women aged over 16 drink alcohol in Britain.
• 4.5       Alcohol and drug use can result in loss of productivity and poor performance; lateness and absenteeism; safety concerns; effect on team morale and employee relations as colleagues have to ‘carry’ colleagues whose work declines because of their drinking; bad behaviour or poor discipline; adverse affects on company image and customer relations.
• 4.6       Drugs and alcohol alter the way the brain works affecting judgement, concentration and physical co-ordination. This has implications for health and safety, risk of accidents, ability to do the job and general health and well being in the longer term.
• 4.7       Between 8.8 and 14.8 million working days are lost to industry each year through alcohol related illness – not including hangovers.

• 5.1       Early identification by the individual or any other person will help the employee to deal with and possibly prevent the tragic physical, social and financial consequences of prolonged alcohol or substance abuse.
• 5.2       Managers and colleagues should look out for the following factors as possible symptoms of alcohol or substance misuse:

1. 1. 1. • Increased absenteeism or increased sickness
         • Changes in behaviour pattern or inappropriate behaviour and appearance
         • Alcohol on breath
         • Deterioration in working relationships
         • Abnormal fluctuations in mood and energy
         • Deterioration in work performance
         • Dishonesty or theft (arising from the need to maintain an expensive habit).

• The fact that employees drink alcohol or take substances in itself is not the problem – it is the effects on their behaviour and conduct at work which are an issue for the Practice.
• 5.3         Employees with a problem may find it difficult to admit to that they need help. All employees are encouraged to advise immediate line managers of concerns they may about others (or in fact themselves) however the dignity and privacy of that person should be considered as priority before taking action.
• 5.4         Whilst these factors may be the result of alcohol or drugs, there could be any number of reasons for poor performance, e.g. stress, divorce, separation, bereavement or mental illness.  It could be that a member of the family who is affected by drugs or alcohol is the cause of worry or concern to an employee and may be affecting their work.  Managers need to be able to spot problems, tackle the employee concerned and make the offer of appropriate help.

• 6.1       There are two possible scenarios, which may require action to be taken:

1. 1. 1. 1. The immediate situation where the employee presents for work either visibly intoxicated or smelling of alcohol
         2. Long term deterioration or symptoms which cause concern over an employee’s health and / or performance, which you are aware of.

• 6.2     Immediate Situation:
  • • • An employee who arrives at work visibly intoxicated, or smelling of alcohol should be sent home, or removed to a place of safety if their behaviour and conduct renders them unsafe or a danger to other staff and clients.  Depending on the circumstances the Practice’s Disciplinary Procedure and suspension may be applied (see section 1.4 of the Policy for guidance).
• 6.3       Long Term Health Issue: The employee’s immediate line manager should conduct a frank and sensitive discussion on the presenting problem with the employee.  The aims of the discussion should be to:
  • • • Clearly state and explain the problems, which are presenting themselves in the workplace.
      • To allow the employee to explain their situation and the extent of their problem.
      • To advise on the availability of advice, help and support (see section 11 of this Policy).
      • To encourage the employee to accept such help as is necessary and assist where possible, i.e. with appointments, time away from the workplace.
      • To inform the employee of the possible outcomes if the situation continues.
      • To discuss any amendments or adjustments to the employees job or working pattern which are reasonable and applicable.
      • Managers should proceed with any absences as a result of an alcohol/drugs problem as they would in accordance with the Practice Sickness, Leave & Other Absence Policy.
      • In cases where the employee will not acknowledge they have a problem, the manager should make any reasonable attempts to help, but will have no option other than to manage the effects of the employee’s performance in the normal way either via the Capability Guidelines or the Disciplinary procedures.
• 6.4         Disciplinary Procedure
  • • • Whilst it is quite clear that employees with alcohol or other drugs problems should be regarded as suffering from an illness and treated accordingly, there may be some occasions when their behaviour has resulted in an offence of misconduct for which disciplinary action is the necessary outcome.   Clear reference is made in the Practice Disciplinary Rules to ‘being under the influence of alcohol, illegal drugs or some other substance’ and this could be regarded as an offence of gross misconduct. It should be recognised however that every attempt must be made to treat alcohol and other drug related problems as sickness cases and the Disciplinary Procedure is to be used only as a last resort or if the offence is serious enough to warrant it.  Dismissals under these circumstances may be deemed unfair if an employer makes no attempt to help an employee whose work problems are related to alcohol.
• 6.5         Confidentiality
  • • • Employees with alcohol or drug problems have the right to confidentiality as they would with any other medical condition.  It is vital that employees realise this in order to encourage them to seek help.

• 7.1    Self Referral: 
  • • • Employees concerned about personal misuse of alcohol or any other substance can should seek confidential specialist help e.g. through self referring to their own GP, Department of Occupational Medicine, Stress Counselling service or other voluntary organisation offering specialist help and support. All self referrals will be confidential. Specialist organisations will not report to management details of the nature of their problems.
• 7.2      Referral
  • • • Employees referred to the Department of Occupational Medicine or accepting treatment will be deemed to be absent from work on medical grounds, until such time as they become medically fit to resume.  If their incapacity renders the employee permanently unfit to resume his/her occupation, retirement on ill-health grounds will be considered.
      • Treatment may be prolonged and involve in or out-patient treatment.  Treatment may be in progress whilst the employee remains at or resumes work and should be regarded in the same way as absence for treatment for any other illness.
      • It must be accepted that relapse is a common, but not inevitable feature of alcohol/substance abuse. Should relapse occur, every encouragement and a positive attitude to the employee obtaining/continuing to accept help will be maintained for as long as is reasonably possible.
• 7.3      Job Security
  • • • Employees should be advised that in the event of them undergoing treatment, their job security will be maintained and certified absences from work will be treated the same way as absences for any other illness. If medical advice suggests that alternative employment should be sought then every effort will be made to find this in accordance with the Practice’s Sickness, Leave & Other Absence Policy.

• New Directions – 01274 026023 or Bradford.info@cgl.org.uk
• Occupation Heath – Sugarman Health – a referral is needed from Ashcroft, please speak to your manager
• Leaflets and information on alcohol, drugs and other health issues are available from Bradford District Health Promotion Service, Tel: 01274 223900 or library.lynfield@bdct.nhs.uk

The PCT Occupational Health service which the practice can access maybe the first point of contact to help guide the employee to the correct help and support.

Monitoring of the effectiveness of the policy will occur jointly by the Partners, Practice Manager, Assistant Practice Manager and where different line manager.

• 10.1    Staff are reminded that any consumption of alcohol prior to duty, whilst on duty and during meal breaks can cause offence to patients and will affect work performance.  This may result in patient complaints or misconduct.
• 10.2    Within some services provided by the Practice, staff involved in therapeutic activities may, whilst on duty be required to accompany patients into licensed premises.  Staff on duty who are responsible for patients must only consume non-alcoholic drinks in these circumstances.  Staff are reminded that they are expected to set a good example of sensible drinking and that they continue to be responsible for the patients care.  Failure to fully discharge that responsibility would constitute a disciplinary offence.
• 10.3    At all functions organised by the Practice and at which the Practice proposes to provide alcoholic refreshment, an equal quantity of equivalent and attractive non-alcoholic drinks such as fruit juices, carbonated soft drinks and alcohol free wines beers and lagers should be supplied.
• 10.4      All functions organised and held on Practice premises shall have a full range of non-alcoholic drinks on offer in addition to alcoholic beverages (if the latter agreed).  Employees should exert judgement based on whether they are on or off duty following the function.

• For some staff groups within the Practice, it is an essential requirement of their jobs that they undertake driving duties, e.g. GPs, district nursing, health visitors, etc.
• Some staff may also be required to operate equipment or machinery as an essential part of their role.
• In the above cases and any other where there are essential requirements which may be affected by employees under the effects of alcohol or drugs, then no alcohol should be consumed at all whilst on duty to safeguard the interests of clients, patients and other staff.  Staff should also be aware of alcohol levels as a result of consumption prior to coming on duty.

• 12.1         Saving Lives:  Our Healthier Nation identifies the workplace as a significant vehicle through which the nation’s health can be improved.  In particular, the White Paper refers to coronary heart disease and stroke, cancers, accidents and mental health as national priorities.  Alcohol and drug use can have an influence on each of these health areas.
• 12.2         The Government’s strategy ‘Tackling Drugs to Build a Better Britain’ aims to improve enforcement, increase prevention and education and improve and increase treatment for drug users.
• 12.3         The local Health Action Zone and Health Improvement Plan identify alcohol and drug misuse as areas of concern in addition to the nationally identified priorities

The Policy is set within the context of the following legislation:

1. 1. 1. Health & Safety At Work Act 1974.
      2. Health & Safety At Work Regulations 1992.
      3. The Road Traffic Act 1988.
      4. Disability Discrimination Act.
      5. Misuse of Drugs Act 1971.