Alcohol Policy UK

Alcohol use amongst children is rooted in complex societal issues, says DCSF report

The Department for Children, Schools and Families (DCSF) have released a comprehensive report; 'Use of alcohol among Children and Young People', and a summarising research brief, both available here. The full 373 page report explores influences and barriers to young people's involvement with alcohol and factors influencing various attitudes. The project also examined the role of current advertising and communication campaigns in the choices of children and young people whilst aiming to inform the design of interventions to young people and parents.

An overview of findings highlighted in the research brief include:

• For most children and young people (CYP), a high level of dissociation from problems alongside the high level of enjoyment from drinking itself, means communication and information about under-age drinking is of low/very low interest. However there is a role for communications and information aimed at CYP, but impact is likely to be limited without supporting work
• Parents and carers (PCs) are a critical audience. PCs do not have a sufficient understanding of the negative impacts of CYP's drinking and related issues. PCs also facilitate and often encourage CYP's drinking
• To engage effectively CYP with communications, targeted information needs to be supported by a broader re-framing of alcohol within society

A summary of findings examined a range of key issues including:

• Personal disassociation and defence against under-age drinking and associated harms, which was 'easy' and 'natural' to both CYP and PCs. A range of myths were used to enable a disassociated position including:
  • A widespread view that alcohol is 'not really a drug'
  • A perception of graduated ‘manageability’ of alcohol (as one grows in experience
  • A belief that 'you learn by your own mistakes'; both PCs and CYP
    assume drinking in this way leads to control being gained, and that getting drunk is a 'right of passage'
  • 'I am not at risk': The overall perception of control generated by the above myths gives rise to this specific belief and the worst that can happen is vomiting or embarrassment
  • A fear that 'over-parenting' is a problem in itself and therefore CPs do not have a role to play

The brief  further explores the implications of the complex and underlying issues associated with alcohol use by CYP and the roles of CPs. It summarises that the research indicates that 'the audience in England suspects – but doesn’t want to believe – that alcohol is a drug-like substance' which creates a complex challenge in order to deliver successful interventions. Multi-faceted strategies must therefore communicate messages at a broad over-arching level to prevent dis-association, whilst targeted and specialised interventions are needed to effect various sub-groups.

Domestic Violence news: Stella Project release new report and policy bank

The Stella project, the specialist London GLDVP project addressing drug and alcohol related domestic violence, have released several new reports and initiatives to support commissioners, DAATs and practitioners in improving service development.

A online Policy Bank has been set up to include strategies, reports and other resources that address the dual issues of substance use and domestic violence.

The new report Innovative responses: new pathways to address domestic violence and substance misuse across London has been written to highlight innovative and integrated joint working practice.  It raises key learning points including:

• Specific actions that are measurable and monitored should be attached to any strategic commitments on the dual issues, to ensure the efficacy of the strategy and to achieve changes in service delivery and practice
• Regular communication and strong working relations between statutory leads for domestic violence and substance misuse are a key factor for success in this work
• Evidencing need is crucial for attracting and sustaining funding for development work
• The precarious nature of funding can slow down the impetus to develop innovative pieces of work. This is reinforced when work is reliant on one lead person
• Attempts to address alcohol use without addressing the underlying dynamics inherent to domestic violence will not be sufficient to promote the safety of survivors and their children
• The Stella Project recommends that such pilots initiate staff training on how to work with men who are abusive and identify clear referral pathways into appropriate services. Good practice would engage with partners to promote their safety and to measure the effectiveness of interventions

Hard copies of the report can be obtained from info@gldvp.org.uk

Young People news and updates: Local approaches to reducing under-age drinking and disorder

Trade body releases tackling under-age drinking toolkit

The Wine and Spirit Trade Association (WTSA) have released a toolkit Community Alcohol Partnership: Cracking down on Public Under Age Drinking. The Community Alcohol Partnership (CAP) was reportedly successful in reducing alcohol related disorder in Cambridgeshire earlier this year, and has now been launched in Kent.

The toolkit is reported to 'include model letters, leaflets and case studies that can be adapted for use by local CAPs to help them introduce partnership working in a cost effective way and ensure support across the community'. The framework of the CAP appears to be based on a partnership model, an approach largely accepted as the best way to reduce local alcohol related harm and disorder, reflected nationally by Safe, Sensible, Social national alcohol strategy update.

Police 'parent calling' initiative claims to reduce under-age drinking

A police initiative in Scotland that caught drunk under-16s and informed their parents claims to reduce drinking by the youngsters, a BBC news article reports. 'Operation floorsweep' was supported by researchers who questioned 100 youngsters aged 12-16 after their contact with Lothian and Borders Police officers. More than six in 10 (62%) of those surveyed said they had drunk alcohol since police caught them, but almost four in 10 (38%) said they had not. In total, 74% said they were drinking less and had changed what they drank.

Young people offered alcohol education course to reduce fines

Binge drinkers in Hertfordshire are being offered the chance to reduce their fines in exchange for a stint on an alcohol re-education course, a BBC news article reports. Young people issued £80 Fixed Penalty Notices are allowed to pay half if they attend the course provided by a local drug and alcohol agency. Police say it has helped contribute to a dramatic fall in alcohol-related disorder.

Know Your Limits festive campaign packs released

The national Know Your Limits campaign team have released a series of resources to help deliver a range of alcohol awareness messages to support unit awareness and responsible drinking. The resources include:

• Units: Christmas campaign pack which contains guidance on how to deliver a christmas campaign, press release templates and a quiz
• A general Units campaign resource pack that includes a range of guidance, press release templates and suggestions for delivering unit awareness campaigns
• A resource guide listing a range of available posters and leaflets that can be ordered from the DoH publications site 
• A summary document of the units campaign key messages
• A speaker presentation on the units campaign and on how to use the national campaign messages and resources to develop local campaigns

A binge drinking campaigns toolkit campaigns is also available from the Units site.

News updates: New arrest referral pilots; Public Health minister speaks; Scotland's minimum price?; alcohol sponsorship in sports

9 new arrest referral pilots announced

The Home Office is providing £1 million funding for a further nine pilots that will mean those arrested for alcohol-related offences will be referred for one or two sessions aiming to reduce their alcohol misuse. The pilots are aimed at non-dependant 'binge drinkers' who commit offences, contributing to the estimated £7.3 billion cost of alcohol related crime and disorder. For more details and the 9 pilot areas see a Home Office press release. A BBC report on the scheme can be found here.

Public Health Minister announces resources at 3rd national alcohol conference

The MP Rt Hon Dawn Primorolo, the minister for Public Health, recently spoke at the 3rd national alcohol conference and announced the governments commitments to supporting work and resources to continue to address alcohol related harm. You can read the full speech here, announcing key points including:

• 99 PCTs and 73 local authorities have made alcohol a priority, either in their local operating plans or local area agreements
• The announcement of the new Alcohol Improvement Programme
• Regional Alcohol Managers to be ‘partnership champions’ in helping PCTs make the right connections with SHAs, and providing a clear point of co-ordination to collaborate on the key indicators
• The announcement of those PCTs selected as Early Implementation sites receiving additional monies to trail blaze new approaches

Scotland may move first on minimum pricing

A BBC article has reported that the Scottish Justice Secretary has pledged to bring in minimum pricing to stop cut-price selling of alcohol in supermarkets and other irresponsible promotions. Kenny McAskill announced: "There's been clear evidence from academics from other countries that bringing minimum pricing can actually stop the abuse of alcohol." Meanwhile in England the government still seems to be reflecting on whether it will take the same route, pending the second part of the University of Sheffield Review (part 1) on the impact of price and promotion.

The Scottish government also published the full list of consultation responses to their national alcohol strategy.

Alcohol sports sponsorship directly linked to hazardous drinking

A report by the University of Manchester has found a direct link between alcohol sponsorship in the sports industry and hazardous drinking among sportspeople. Professor Ian Gilmore, President of the Royal College of Physicians and chair of the UK Alcohol Health Alliance said: "Alcohol producers and retailers have worked long and hard to align themselves to the positive and healthy image of sport, and we now have evidence that this is not only proving effective but also potentially damaging to those that participate. Some countries like France have already banned alcohol-related sports sponsorship and it is time we had that debate in the UK". Source: Medical News Today.

Alcohol perceived less risky than illegal drugs, Observer poll reveals

The Observer's drugs poll has revealed that alcohol is still perceived as far less risky to health than illegal drugs, with a clear 47% majority of respondents ranking it as having the 'least level of risk'. Tobacco, the number one cause of preventable death in the UK (alcohol is the 3rd), was ranked as the second least harmful, demonstrating the strong role legality has on the perception of drug harms. The findings come despite a high publicity Lancet report earlier in the year which ranked alcohol as the 5th most dangerous drug, ahead of ecstasy and tobacco but behind heroin at number 1. The Lancet rankings were intended to inform potential reclassification of illegal drugs, though received an interesting critique from Transform Drugs Policy Foundation.

The full Observer feature 'Drugs uncovered' can be found here.

online resource "alcohol learning centre" launched

As part of the Department of Health's Alcohol Improvement Programme, a new online resource was launched last week at the Safe. Sensible. Social. conference in Nottingham.

The Alcohol Learning Centre "aims to provide online support and resources to commissioners, service managers and practitioners with a responsibility for, or an interest, in the prevention and treatment of alcohol misuse or alcohol-related ill health."

 It has been established by the Department of Health with the support of Alcohol Concern, the NWPHO, and SIPS to support the commissioning and delivery of effective front-line services to identify and provide advice and support to NHS patients whose alcohol consumption is, or may, in the future put them at risk.

The main thrust of the site is the reduction of alcohol-related hospital admissions (which are called Ar-HAs throughout - will the name catch on?).

For example, in the High Impact Changes section, the ALC answers the question How can Primary Care Trusts best reduce alcohol admissions?

"Based on the best available evidence the Department of Health has identified key actions that Primary Care Trusts (PCT's) can take which will make the highest impact on reducing alcohol related harm and admissions. DH calculates that the following specific actions are calculated to be most likely to impact on the PSA target within the PSA period:

• Prioritise the alcohol Vital Sign (VSC26) within NHS Operational Plans and NIS39 in LAAs
• Improve specialist treatment access, capacity and effectiveness
• Implement Identification and brief advice (IBA) in - Health: A&E, Specialist Clinics, Primary Care - Criminal Justice
• Provide local implementation of national media campaigns
• Identify local champions & build the case for investment
• Work with local partners to develop activities to control alcohol misuse

Clearly alcohol related harms and therefore needs differ significantly between localities and local NHS & other public sector actors will prioritise investment between these actions in accordance with local priorities."

Policing report highlights impact of alcohol misuse and prompts new minimum pricing calls

The publication this month of a Home Affairs Committee report, 'Policing in the 21st Century' has highlighted the impact of alcohol related disorder and prompted further calls for action on minimum pricing. The report says that '70% of police officers believe that attending alcohol-related incidents diverts them away from tackling other kinds of crime.'

The report identifies key findings and makes a number of points and recommendations to improve police effectiveness of addressing alcohol related crime including:

• Police forces perceive alcohol related violence to be on the increase, whilst the 2003 licensing act has spread alcohol related disorder over longer periods
• There should be more done to ensure local authorities are using the powers available to them under the 2003 licensing act to address irresponsible license holders, who are putting increased pressure on police resources
• Increased police powers and tools have not had a significant impact on their ability to reduce alcohol related crime, particularly in relation to Penalty Notices for Disorder (PNDs) and alcohol arrest rerral schemes
• Voluntary partnerhsip schemes such as Pubwatch are encouraged but whilst the principle of Alcohol Disorder Zones is supported, concerns over potential levels of bureacracy exist
• The cheap availabilty of alcohol in the off-trade is fuelling alcohol-related crime and disorder and under-age drinking. A miminum price basis should be set and supermarkets should be prevented from using alcohol as a loss-leader
• Following the KPMG reports damning verdict on the lack of adherence to the industries voluntary code, the standards should be re-issued on a compulsory basis, based on a series of findings from other reviews
• There is not support for the move to increase the minumum legal age of purchasing to 21 from the off-trade, as has been piloted and proposed in Scotland

In summarising its position, the report states: 'We are concerned at the amount of police time spent dealing with alcohol-related crime, with forces now deploying officers for longer periods owing to changes in the licensing laws. We remain unconvinced that Alcohol Disorder Zones will have the desired effect but support the principle of mandatory contributions to policing from alcohol retailers. The practice of loss-leading should be ended and compulsory, enforceable standards for the industry should be introduced.'

A BBC feature on the report, which includes links to several broadcasts on the issue can be found here.

Alcohol community orders under-used, new report shows

A House of Commons report, The supervision of community orders in England and Wales has highlighted the low level of alcohol related community orders, partly as a result of a lack of available treatment. The report claims that 'despite alcohol misuse being shown to cause a quarter of offenders to commit offences, only 2% were given an alcohol treatment requirement.' Research by King’s College cited in the report argues that the use of alcohol (as well as mental health and drug misuse requirements) did not correspond with the incidence of offenders exhibiting these needs.

A section of the document summarised:

'The National Probation Service considered an alcohol requirement to be appropriate only for offenders with chronic alcohol addiction. In less severe cases, probation staff had the option of addressing problematic drinking through offending behaviour programmes, supervision or referral to other agencies, such as Alcoholics Anonymous. Core training for probation staff included training on dealing with alcohol issues and the National Probation Service was piloting a low intensity alcohol programme. For those with a chronic alcohol problem, an alcohol treatment requirement may be their best hope of obtaining help to beat their addiction and reduce the likelihood of reoffending.'

A local initiative was also highlighted where Wiltshire Probation service funded its local Primary Care Trust to provide 176 alcohol-related offender assessments and 1,232 alcohol treatment sessions at a cost of £79,000.

The report makes recommendations including:

• Require Probation Areas to report the percentage of community orders which end before sentence requirements have been completed and the reasons for noncompletion
• Implementation of new data collection system
• Increase the provision of alcohol and mental health treatment
• Assess the effectiveness of the National Probation Service’s work with alcohol misusing offenders
• Make the Lower Intensity Alcohol Programme available across the National Probation Service

Changes to the QOF for 2009/10 see a small mention for alcohol

The General Medical Services (GMS) contract is the UK-wide contract between general practices and primary care organisations to deliver primary care services to their local communities. Within GMS, the Quality and Outcomes Framework (QOF) sets out a range of national standards based on the best available research evidence. The standards are divided into four domains:

• clinical standards linked to the care of patients suffering from chronic diseases
• organisational standards relating to records and information, communicating with patients, education and training, medicines management and clinical and practice management
• additional services, covering cervical screening, child health surveillance, maternity services and contraceptive services
• patient experience, based on patient surveys and length of consultations

A set of indicators has been developed for each domain to describe different aspects of performance. Practices are free to choose the domains that they want to focus on. QOF is a mechanism for delivering substantial financial rewards for high-quality care.

NHS Employers and the General Practitioners Committee have agreed changes to the GMS contract for 2009/10. The changes will give a fairer distribution of resources across practices, and will ensure that the contract rewards those practices that continue to develop services to meet local patient needs. The changes include reallocating 72 QOF points - these are being reallocated to seven new clinical areas. One of these, cardiovascular disease in people diagnosed with high blood pressure, awards points for giving advice on safe alcohol consumption. Details here.

This follows news of a new Directed Enhanced Service (DES) for alcohol that pays out £2.33 for each newly registered patient screened by their GP.   We are hearing mixed reports of the DES - some colleagues say £2.33 is too small a payment, others say it is acceptable.