Recommendations

People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

1.1 Planning alcohol education

Organising alcohol education

1.1.1 Plan and deliver alcohol education (universal and targeted interventions) as part of a whole-school approach to relationships education, relationships and sex education (RSE) and health education or personal, social, health and economic education (PSHE). Do this by using, for example:

1.1.2 Ensure those planning and delivering relationships education, RSE, health education or PSHE have the materials, planning time and training they need to support, promote and provide alcohol education. Be aware that there are resources available that can be used for planning and delivering alcohol education (see the Department for Education's guidance on relationships, sex education and health education).

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on organising alcohol education.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

Planning alcohol education content

1.1.3 Use a spiral curriculum when planning and delivering alcohol education.

1.1.4 When planning alcohol education:

  • ensure it is appropriate for age and maturity and aims to minimise the risk of any unintended adverse consequences (see the recommendation on structuring alcohol education).

  • tailor it to take account of each pupil's learning needs and abilities

  • tailor it to the group's knowledge and perceptions of alcohol and alcohol use

  • take into account that those aged 18 and over can legally buy alcohol.

1.1.5 Think about how to adapt alcohol education for pupils with special educational needs and disabilities so that it is tailored to the pupil's learning needs, abilities and maturity (see chapter 6 of the Department for Education's SEND code of practice: 0 to 25 years).

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on planning alcohol education content.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

Confidentiality and safeguarding

1.1.6 Ensure all involved in giving the alcohol education sessions are aware of the school's process for handling confidential disclosures.

1.1.7 Ensure pupils understand:

  • how they can raise any concerns and how they will be supported

  • that any information or concerns they disclose will be dealt with at an appropriate level of confidentiality

  • how disclosures will be handled if there are safeguarding concerns.

1.1.8 Use safeguarding arrangements to refer pupils for extra support if they have:

1.1.9 Use existing school policies to deal with problems (such as bullying) that may arise if a pupil's disclosures are inappropriately shared by other pupils.

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on confidentiality and safeguarding.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

Referral for further support

1.1.10 Use clear referral pathways, for example into school nursing, school counselling, early help services, voluntary sector services, young people's drugs and alcohol services or to a youth worker, as needed.

1.1.11 Involve the pupil and their parents or carers, as appropriate, in any consultation and referral to external services.

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on referral for further support.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

1.2 Delivering universal alcohol education

Structuring alcohol education

1.2.1 When delivering alcohol education, aim to:

  • use a positive approach to help pupils to make informed, safe, healthy choices

  • encourage pupils to take part in discussions

  • avoid unintended consequences (for example the pupil becoming curious about alcohol and wanting to try it, or substituting it with another substance)

  • avoid using scare tactics

  • avoid only giving out information, for example by lectures or leaflets.

For a short explanation of why the committee made the recommendation and how it might affect practice, see the rationale and impact section on structuring alcohol education.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

Using additional support for alcohol education

1.2.2 Use school nurses, local public health officers and drug and alcohol services or other external providers to provide additional support for alcohol education.

1.2.3 If using external providers to supplement alcohol education:

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on using additional support for alcohol education.

Full details of the evidence and the committee's discussion are in evidence review A: universal interventions.

1.3 Targeted interventions

Selecting pupils for targeted interventions

1.3.1 When selecting pupils to offer a targeted intervention to, avoid treating them in a way that could:

  • stigmatise them or

  • encourage them to see themselves as likely to use alcohol or see it as normal behaviour or

  • have a negative impact on their self-esteem.

1.3.2 When using targeted interventions, always seek to involve the pupils in decisions about them and the interventions offered to them.

1.3.3 Seek consent to include a pupil in a targeted intervention. This should be from the pupil themselves, or the pupil's parent or carer, as appropriate to the situation.

1.3.4 Offer a targeted individual or group intervention (for example counselling or a brief intervention) to pupils who are assessed as vulnerable to alcohol misuse.

1.3.5 Ensure a targeted group intervention is appropriate for the age and maturity of the pupils and aims to minimise the risk of any unintended adverse consequences and stigma (see recommendation 1.3.7).

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on selecting pupils for targeted interventions.

Full details of the evidence and the committee's discussion are in evidence review B: targeted interventions.

Tailoring targeted interventions

1.3.6 For each person or group offered an intervention, identify their specific risk factors, vulnerabilities and any concerns about their behaviour so that the intervention can be tailored to their needs. Use, for example:

  • formal sources of information about risk factors (for example information provided by a level of needs assessment, children's services [including children's social care] or through the whole-school approach)

  • informal sources of information about pupils' behaviour (for example reports from the local community informing the school after witnessing pupils drinking alcohol).

For a short explanation of why the committee made the recommendation and how it might affect practice, see the rationale and impact section on tailoring targeted interventions.

Full details of the evidence and the committee's discussion are in evidence review B: targeted interventions.

Avoiding unintended consequences of group interventions

1.3.7 Avoid normalising unhealthy drinking behaviours when delivering targeted group interventions (for example by not mixing different age groups).

For a short explanation of why the committee made the recommendation and how it might affect practice, see the rationale and impact section on avoiding unintended consequences of group interventions.

Full details of the evidence and the committee's discussion are in evidence review B: targeted interventions.

Terms used in this guideline

Level of needs assessment

An agreed threshold document from the local children's safeguarding board or safeguarding partnership that sets out risk factors and considerations for what to do when worried about a child. From September 2019, all local authority areas in England should have completed their transition from local children's safeguarding boards to safeguarding partnerships.

School

All schools (including academies, free schools and alternative provision academies) and pupil referral units (see the Department for Education's explanation of types of schools) and further education and sixth-form colleges as set out under the Further and Higher Education Act 1992 (see the Department for Education's keeping children safe in education).

Spiral curriculum

A course of study in which pupils study the same topics in ever-increasing complexity throughout their time at school to reinforce previous lessons.

Targeted intervention

Interventions for children and young people who are not necessarily seeking help but who have risk factors that make them vulnerable to alcohol misuse.

Universal alcohol education

Education that addresses all pupils in the school. It is delivered to groups of pupils without assessing their risk.

Vulnerable to alcohol misuse

This may include children and young people:

  • whose personal circumstances put them at increased risk

  • who may already be drinking alcohol

  • who may already be regularly using another harmful substance, such as cannabis.

Whole-school approach

An ethos and environment that supports learning and promotes the health and wellbeing of everyone in the school community. The aim is to ensure pupils feel safe, happy and prepared for life in and beyond school. It covers:

  • curriculum subjects

  • general school policies on social, moral and spiritual wellbeing

  • cultural awareness.

It also promotes a proactive relationship between the school, children, young people and their parents or carers, outside agencies and the wider community.

  • National Institute for Health and Care Excellence (NICE)