Alcohol Policy UK

DrugScope briefing 'Public Health Reforms: What they mean for drug and alcohol services' & RCGP briefing on Primary Care treatment

Drugscope, the national organisation representing the drug treatment sector, has published a briefing exploring the public health reforms and their expected impacts on drug and alcohol services.

Download The Public Health Reforms: What they mean for drug and alcohol services [pdf]

The briefing explains the key changes including:

In April 2013, the National Treatment Agency for Substance Misuse will be abolished and its key functions transferred into Public Health England. Most of the current budget for drug and alcohol services will be transferred to Directors of Public Health employed by Local Authorities, who will also be statutory members of the new Health and Wellbeing Boards.

Directors of Public Health (DPH) will be responsible for delivering public health outcomes in their local area, will control the bulk of drug and alcohol funding and will oversee a department or directorate that will be responsible for delivering the outcomes from the local Health and Wellbeing Strategy. Health and Wellbeing Boards (HWBs) will set out local strategies through the development of Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs). A new executive agency, Public Health England (PHE), will take the national lead on public health issues from April 2013.'

The briefing also gives a detailed exploration of key issues such as 'What will happen to Drug (and Alcohol) Action Teams (DATs)?' and 'what will be the role of Public Health England (PHE) in providing the sort of national co-ordination that the NTA has provided?'.

On the subject of 'How much will be invested in drug and alcohol services in the new system' the briefing details:

On 10 January 2013, the Government announced the ring fenced public health grants for upper tier and unitary local authorities for 2013-14 and 2014-15. A total of £2.66 billion in 2013 -14 and £2.79 billion in 2014-15 will be available to local authorities to spend on public health services for their local populations. This money absorbs an estimated £800 million to a £billion plus of current drug and alcohol funding. This means that approximately a third of the local authority grant for public health will be comprised of money that has to date been invested in drug and alcohol interventions, including what was contained in the 2012-2013 pooled treatment budget and the former health support component of DIP (total around £460 million).

RCGP & SMMGP briefing on primary care treatment commissioning

A briefing on Primary Care Drug and Alcohol Treatment: Commissioning and Provision Against a Backdrop of Localism has been produced by The Royal College of General Practitioners (RCGP) and Substance Misuse Management in General Practice (SMMGP). The briefing considers the future impact of the changing commissioning environment on primary care drug and alcohol treatment.

The Cabinet Office and the LGA are launching an academy to help senior public servants improve commissioning, reports the Guardian.

Ten communities recieve DCLG funding to tackle binge and underage drinking

The 10 communities that will receive funding for work to tackle binge and underage drinking have been announced by Communities and Local Government. The fund was opened for bids earlier this year by Baroness Newlove, the government's Champion for Active, Safer Communities. 

The CLG press release states:

Over the next two years these innovative grassroots projects, backed by local authorities, police and retailers, are expected to deliver real results to end the fallout of problem drinking. Other communities will hopefully be inspired to follow their lead. The projects will address separate issues that are the greatest challenges in their neighbourhoods, with measures of their success that will include:

• a reduction in the number of anti-social behaviour incidents related to alcohol consumption
• fewer A&E admissions to local hospitals or fewer ambulance call outs as a result of drinking
• the consumption of alcohol by young people reducing to safe levels; and
• a reduction in purchasing of alcohol made on behalf of under 18s ("proxy purchasing").

Among the projects that will receive funding are:

• The City of Lincoln. Among their proposals is the development of social media to link up evening safety wardens, street pastors and local police to better address weekday problem drinking and anti-social behaviour in the city centre. They will tackle the repercussion of the rapid expansion of students and visitors to the city centre.
• The local community in Moseley, Birmingham that wants to establish a lasting solution to the stubborn issue of street drinking and its associated problems of begging, littering and rough sleeping by giving local people a direct say in deciding how their project develops and how the budget is spent.
• Newcastle that wants to work with young people and their families to address crime and anti-social behaviour in two inner suburbs: Elswick; and Benwell and Scotswood, where local surveys suggest that a third of people polled, consider drunk and rowdy behaviour to be a problem.
• Shropshire, whose project will focus on five of the county's public parks which experience seasonal summertime issues around underage drinking and anti-social behaviour. The Shropshire Safer Stronger Communities Board will work with local police, trading standards and retailers to confiscate alcohol from minors, tackle proxy buying and work with young people on developing positive park-based activities.

The DCLG report, Building Safe, Active Communities: strong foundations by local people sets out  tackling alcohol harms as one of Baroness Newlove's key priorities. A report which captures progress on innovative projects to make communities safer was also released earlier this year.

The fund was included in the recent Government Alcohol Strategy which committed to introducing minimum unit pricing. However the strategy has also been criticised of being overly crime and disorder focused, with insufficient attention to treatment and prevention.

Lessons from South East Alcohol Innovation Programme

Over recent years the South East Alcohol Innovation Programme (SEAIP) delivered a variety of projects aiming to reduce alcohol-related harm across the South East. The programme was commissioned by the Government Office for the South East and delivered by the Centre for Public Innovation.

The evaluation, supported by Lundbeck pharmaceutical company, covers 10 projects, assessing their performance and potential for cost savings over the period between 2009-2011. Key findings support recommendations from the Alcohol Improvement Programme's list of High Impact Changes.

Download the South East Alcohol Innovation Programme Evaluation Report [pdf] or see the CPI press release.

The most potentially cost effective projects were those which addressed so-called Frequent Flyers, where intensive case management of patients with serious alcohol conditions can result in better management in the community. This can result in admissions avoidance and reduced unnecessary A&E attendance. Alcohol Identification and Brief Advice (IBA) by Pharmacy staff has also shown potential for cost savings. This project, together with some of the Frequent Flier projects, has been adopted as a QIPP initiative in the South East.

Less tangible potential cost savings were demonstrated by some of the other projects, including those which promoted Self Help, an IBA training project for health workers and 2 other Frequent Flier projects. However, even where cost-benefits were not immediately identifiable, the SEAIP state that other benefits were clearly obtained, such as improved working relationships and local "Champion" development.

Recommendations from the evaluation call on commissioners to gain an in-depth picture of local alcohol harm, adopt a multi-disciplinary approach to problems, ensure adequate data capture and sharing, and allocate adequate staff time to deliver on initiatives to reduce alcohol harms.

Further alcohol projects, reports and guidance can be found from the Alcohol Learning Centre, including a report on the findings from the Alcohol National Support Team. A full suite of NICE alcohol guidance is also now available.

Alcohol Research UK launched to continue work of the AERC

This month saw the launch of Alcohol Research UK, which takes over the work of the Alcohol Education and Research Council (AERC). The AERC will be abolished in 2012 as part of the Government’s review of ‘Arms Length Bodies’. 

Alcohol Research UK is an independent registered charity, governed by a board of trustees who are assisted by a small dedicated staff team and a number of associates who sit on the Grants Committee. The AERC’s assets and activities were transferred to Alcohol Research UK in March 2011.

During its near 30-year existence, the AERC awarded over 500 project grants and around 200 studentships, with a total value of more than £12 million. It was recognised as a vital funder of research into alcohol-related harm, often being the only source of funding available to institutions and individuals working on important studies in this specialised field.

Alcohol Research UK has three goals for the next five years. They are:

1. To increase the quantity of research that we fund
2. To increase the quality of the research that we fund
3. To create a significant profile amongst and influence over policymakers, practitioners, scientists and general stakeholders

See the Alcohol Research UK blog for comments and insights into the field, or sign up to the newsletter. See here for information on grants, or visit the alcohol library for previously funded research projects and findings.

Alcohol Improvement Programme ends

The 3 year Alcohol Improvement Programme (AIP), funded by the Department of Health, has now come to an end. The AIP provided support to the NHS and third sector in delivering on alcohol harm reduction, particularly around the High Impact Changes. Investment was delivered though Early Implementer areas, Regional Alcohol Offices and an alcohol National Support Team (NST) - legacy document here. 

The AIP also included the Alcohol Learning Centre (ALC) which will no longer be updated until further notice. An independent evaluation found the ALC to be highly successful in sharing information and resources, with over 5,000 people completing the IBA e-learning. Funding for the 'HubCAPP' database had also ended and been integrated within the ALC under local initiatives.

New bidding round for alcohol best practice projects: working with offenders

Since 2006 NOMS has provided about £250,000 funding to 15 projects to help to identify, develop and spread best practice relating to the aims and objectives of the alcohol strategy, Working with Alcohol Misusing Offenders.

Learning points from these projects have been disseminated to staff at national conferences and seminars and practical guidance e.g. manuals, training materials, made available on the probation intranet (EPIC) to facilitate wider implementation. Along with findings from independent research, best practice from the projects has also informed NOMS alcohol interventions guidance due to be launched at events to be held in London and Manchester on the 7th and 16th September.

Around £100,000 is available during 2009/10 to support entirely new project work and/or further developmental work in existing projects. See the invitation letter here. Information about the process for applying for funding and the criteria by which bids will be assessed is here, along with a bid proforma which should be completed and returned to Robert Stanbury at Robert.Stanbury@noms.gsi.gov.uk by Friday 4th September. If you have any queries please contact Robert Stanbury on 020 7217 0767.

Home Office funds extra enforcement for "top 50" alcohol blackspots

Eleven London boroughs will each receive £30,000 to tackle specific local troublespots of alcohol-related crime and disorder. Hackney, Islington, Westminster, Tower Hamlets, Barking and Dagenham, Hammersmith and Fulham, Lambeth, Waltham Forest, Ealing, Newham and Southwark will be given a share of a new national Home Office £1.5 million fund.

This money is available to the 50 priority areas which have the highest levels of alcohol-related crime and disorder and public concern about drunk and rowdy behaviour. This money will be used to tackle underage sales, confiscate alcohol from under 18s and to carry out tougher alcohol enforcement work.

Home Office Minister Alan Campbell said

This money provides a timely boost to law enforcement as we approach the festive period.  In many areas police and local authorities are effectively using the range of tools and powers we have provided to tackle alcohol related crime and disorder. 

We have backed that with £3 million in every part of England and Wales and an additional £1.5 million for our priority areas. This means a third of a million pounds in 11 London boroughs. I fully expect this will boost the drive against alcohol-related crime and disorder, and help reduce alcohol related problems in London.

In addition to the £1.5 million for the 50 priority areas, a further £3 million has already been awarded to 190 crime and disorder reduction partnerships across England and Wales to enforce the law against alcohol-related crime and disorder. This £3 million fund will be spent on supporting local, multi-agency campaigns to tackle alcohol related crime and disorder. Home Office

The top 50 list (see top 10 below) appears to have been derived using perceptions of alcohol-related anti-social behaviour and rates of "less serious wounding" crimes as a proxy for alcohol-related violence.  Blackpool tops the list, with Newham in second spot, yet these are two very different places, with contrasting night time economies (Newham's is minimal) and drinking cultures.  According to the indespensible North West Public Health Observatory's Local Alcohol Profiles for England, Newham has the 17th lowest synthetic estimate of binge drinking in England whilst Blackpool has the 26th highest. 

Can we rely on proxy measures to determine priority areas for enforcement?  No; what we need is better data on alcohol-related crime.  Better flagging of police records to denote the involvement of alcohol in incidents would be a start.

1. Blackpool
2. Newham
3. North East Lincolnshire
4. Southampton
5. Thanet
6. Lincoln
7. Burnley
8. Wakefield
9. Weymouth & Portland
10. Mansfield

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. 

Drinkaware: new grants programme

In what appears to be a major shake up of its grants programme and a rebranding of the Drinkaware Trust, Drinkaware is soon to release details of grants schemes offering dedicated funding to local and national projects working to tackle alcohol misuse, promote responsible drinking and raise awareness about the negative effects of alcohol. The schemes are open to projects working primarily with under 18s and 25-44 year olds in any part of the UK and will encompass three levels of award:    

• Ideas Fund, sums up to £2,000
• Drinkwise Projects, sums up to £25,000
• Big Impact Award, sums up to £100,000

Project costs are available for many types of alcohol awareness projects including community based work, alcohol education, including peer-led education, and awareness raising work with disadvantaged people who are at risk of harm from alcohol misuse. 

Funding will focus on work that delivers the most impact for beneficiaries and work that contributes to learning, for example the development of replicable models of effective working. Detailed funding guidelines and the application form will be available from the end of October from the Drinkaware website: www.drinkaware.co.uk.

Drinkaware aims "to positively change public behaviour and the UK’s drinking culture to help reduce alcohol misuse and minimise alcohol-related harm".

Alcohol-related partnership activity funding available from Home Office

Funding of up to £30,000 has been made available to local councils and police forces for specific projects to help address local alcohol related issues. The Home Office funding is available to local Crime and Disorder Reduction Partnerships (CDRPs) and police Borough Command Units (BCUs) following the reported success of previous Home Office campaigns such as the  Alcohol Misuse Enforcement Campaign (AMEC), the Tackling Under Age Sales of Alcohol to Children (TUSAC) and the Responsible Alcohol Sales Campaign (RASC).

Funding for this campaign is available from the Home Office with each CDRP or CSP being able to submit one partnership bid for up to £30,000 to support local activity during the campaign period. The bid letter outlines that projects should support the strategic principles of the updated national alcohol strategy 'Safe, Sensible, Social.'

For the bid letter see here.

For the funding application document see here.

Completed bids should be submitted to ARPA@homeoffice.gsi.gov.uk by 1700 on the 7th November 2008. Any questions about the campaign should be directed to Chief Inspector Paul Kinzett at the Home Office on 0207 035 8644 or via email Paul.Kinzett@homeoffice.gsi.gov.uk .