Alcohol Policy UK

Funding opportunities for GP alcohol inteventions?

Ministers have put forward plans for  £50 million of clinical funding that would be partly used to pay for Screening and Brief Interventions (SBIs) by GPs. The funding would see the development of a number of Locally Enhanced Services for GPs, a framework by which GPs are paid to screen and offer appropriate interventions to patients.

The clinical funding, if approved, would also pay for enhanced services for GPs to address osteoporosis, heart failure, improved collection of ethnicity data and annual health checks for those with learning disabilities.

However a number of obstacles are likely to affect the implementation of any such clinical programmes within the development of GP services. These include the pay dispute involving the British Medical Association (BMA) and concerns over the position of such proposals in relation to the development of the Quality Outcomes Framework (QOF). Dr Ahmat Fuat, a GP in Darlington and deputy chairman of Primary Care cardio-vascular society, candidly rasied his concerns relating to alcohol treatment in primary care, stating: "You’d probably need £50m to tackle alcohol alone."

The Health Secretary Alan Johnson nonetheless highlighted the opportunities being made available within the new agendas, saying:

"‘This is about developing high-quality services with a strong focus on prevention. It’s a great opportunity for entrepreneurial GPs as well as social enterprises, voluntary organisations and the independent sector to develop innovative services."

Increasing numbers of PCTs are already commissioning alcohol enhanced services either through Choosing Health or other local funding streams such as in Lewisham.

For more information follow the Pulse medical journal for GPs.

Wirral sets up screeening and brief interventions in 56 pharmacies

Wirral PCT has launched Screening and Brief Interventions (SBIs) in 56 of the district's pharmacies, aiming to have all 86 covered as part of the 2007-2010 local alcohol strategy. The developments follow SBIs being set up across GP surgeries in Wirral last year, a setting well suited for SBIs and supported by national guidance. In pharmacy settings, people will be screened by being asked to fill in a short questionnaire and being provided with advice, information or onward referral as appropriate. Follow-up telephone calls will also be made to assess how clients may have responded to the intervention or to deliver any further support.

Wirral has amongst the highest rates for alcohol misuse in the country, with over half of men in Merseyside regualrly drinking more than the reccomended guidelines. According to the Liverpool Daily Post, Andy Mills, head of partnership and engagement at Wirral PCT, said:

“Wirral is leading the way nationally, and many pharmacists have already started running routine alcohol screenings. Wirral PCT is now looking to get all pharmacies involved in providing this service.”

Trusts across the country are increasingly commisisoning SBIs as part of local approaches to reducing alcohol misuse, particularly in primary care, A&E and criminal justice settings. Recently a guidance framework for commissioners was relesaed by the NHS, the Alcohol Primary Care Service Framework.

Happy hours are here again?

The British Beer and Pub Association (BBPA) has withdrawn its voluntary code on cheap drinks and happy hours following legal advice, the Morning Advertiser reports. It has been three years since the code was originally introduced, supporting the case that the industry are capable of self regulating. However there are reportedly serious concerns from within the industry given the overdue release of the KPMG report on the industry's use of voluntary codes, which will inform ministers' decision as to whether impose further laws to control the pricing and availability of alcohol.

In response to the withdrawal of the code, Mark Hastings of the BBPA said:

"We are currently taking legal advice on the status of the BBPA code.

"It's widely recognised that pubs have made enormous strides to tackle irresponsible promotions and we are confident they will continue to operate responsibly."

When asked about the timing of the withdrawal, Hastings said:

"The advice at the time was it was fine, but very recently other questions have arisen and we have to take them seriously. In the meantime, we have to withdraw [the code]."

The decision is a setback for ministers as they near the conclusion of a cross-departmental review of ways to change the drinking behaviour in Britain by tackling cut-price alcohol and drinks promotions, says the Financial Times, which reports that implementing several options favoured by ministers, including setting a minimum price for a unit of alcohol, poses significant legal challenges.

Withdrawing the industry rules on promotions compounds the legal problems facing policymakers, who were focusing on how to act against supermarkets and shops selling cheap alcohol. After the suspension of the standards, pubs and clubs will have independently to decide whether to avoid certain "irresponsible" promotions, rather than sign up to common standards.

Home Office launches £4 million Binge Drinking campaign

The Home Office has launched a 'new, hard-hitting national advertising campaign to drive home the serious consequences of binge drinking to 18 to 24 year olds'. The campaign was launched this week by the Home Secretary Jacqui Smith and will include television, print and online adverts.

In a Home Office press release for the campaign it was announced the centre piece would be 'two new television adverts that graphically highlight the consequences of binge drinking by reversing the sequence of a night out gone wrong. The adverts show a man and woman getting ready at home for a night out. They end with the man leaving home bloody and damaged and the woman closing her front door with smeared make-up and vomit in her hair.' One of the adverts can be seen in a Guardian article here.

The latest communications strategy comes shortly after the launch of  the Department of Health's £10 million 'Know Your Limits' campaign, aimed at raising awareness over units and supported by the units website. However we recently reported scepticism over such campaigns following a series of media reports and health professionals questioning their effectiveness.

A wide range of media campaigns are now being streamed, including Diageo's 'The choice is yours' campaign which is supported by a number of television adverts; to see one click here. The Department for Transport also recently launched a new Think! Summer drink driving campaign  focusing on the personal and legal consequences of drink driving. Add these to the range of local and regional campaigns and it seems the amount of alcohol messages has snowballed over the last year. However are these campaigns an effective use of resources? Let us know your thoughts below!

Further developments in Scotland's action on alcohol misuse

The Scottish Government last month released a strategic document outlining proposals to reduce alcohol misuse. The document is titled Changing Scotland's relationship with alcohol: a discussion paper on our strategic approach' and follows an announcement earlier in the year of £25 million for alcohol misuse.

Scotland has also recently launced the alcoholdebate.com site, an interactive website exploring a range of health and social issues linked to alcohol.

Alcohol Primary Care Service Framework released

The NHS have released Primary Care Service Framework: Alcohol Services in Primary Care, designed to support commissioners, practitioners and providers in setting up alcohol interventions in primary care.

The document is likely to be welcomed across the country as increasing numbers of PCTs and local authorities are setting up Screening and Brief Intervention programmes within primary care settings, particularly with General Practitioners and in cases other settings such as pharmacies.

Previously there had been no specific frameworks to help local commissioners and practitioners set up such programmes, despite national guidance such as Models of Care for Alcohol Misusers (MoCAM) and Alcohol Misuse Interventions: Guidance on developing a local programme of improvement. The Alcohol Services in Primary Care Framework may be particularly useful in helping commissioners and practitioners:

• Scope and define suitable services
• Identify key agendas and frameworks
• Identify suitable evidence bases and local need
• Identify service objectives and intended health outcomes
• Set up suitable governance, monitoring and evaluation arrangements
• Identify suitable contract management
• Identify suitable review, variation and recommissioning process
• Find supporting documents, guidance, definitions and Read codes

Where commissioners may still be stuck is around pricing of services with no recommended or nationally agreed prices.

The new framework comes as part of 6 new Primary Care Service Frameworks falling within objectives of providing enhanced, localised service provision within the Practice Based Commissioning agenda.

Best Bar None schemes now total 90

In 2007 an agreement was reached between Greater Manchester Police, the Home Office and BII, the professional body for the licensed retail sector, to develop Best Bar None (BBN) nationally. An independent board has now been formed and is currently chaired by Lord Rupert Redesdale. BII's role in Best Bar None is to help and foster future development of the scheme.

The number of BBN schemes is now running at 90, with the Chief Executive John McNamara further promoting their development, an article in the Morning Advertiser reports. However McNamara was keen to highlight that schemes should not become mandatory, and that the emphasis should be on local schemes adapting a bottom up approach. The article also highlighted the paperwork necessary for BBN participation was also being reduced, one of the concerns highlighted by some local authorities regarding the scheme.

However more serious questions have been raised in the past relating to evaluating the effectiveness of the schemes, which have been suggested in some cases as costly and time consuming. An evaluation of Croydon's BBN scheme showed that while some positive partnership outcomes were apparent, a number of issues meant effectiveness was difficult to demonstrate.

For further information on BBN and examples of schemes across the country see here

To visit the official BBN site see here

Portman group responds to criticism about lack of action on cheap alcohol

The Portman Group has responded to recent criticisms against its lack of action over the cheap availability of alcohol in supermarkets, as reported by the Morning Advertiser. The Portman Group's head of communication, Michael Thompson, emphasised the need to change the drinking culture rather than concentrating on price, stating:

We need to change the drinking culture by making drunkenness socially unacceptable. Proper enforcement of alcohol laws by police, better education and a crackdown on the minority of rogue traders who serve alcohol to children should be our priorities.

We have never claimed to talk on behalf of the whole industry. We represent the major drinks producers on social responsibility.

I understand how frustrating it must be for pubs when they are being driven out of business by supermarkets. But our view remains that changing the culture through proper police enforcement of alcohol laws, better education and tackling a minority of rogue retailers should be priorities.

We are not convinced that price is the major determinant in harmful drinking. On the Continent, where alcohol is far cheaper, they don’t have the same health and social problems associated with alcohol.

The UK Government has commissioned an independent review of the link between price, promotions and harm, which is due to report in the autumn. If this does find evidence of a definite link, however, we’d want to be involved in discussions about what could and should be done.

Scotland proposes ban on under 21s purchasing alcohol

A controversial action plan is expected to be launched this week by Scotland's Justice Secretary, Kenny McAskill, raising the legal age of purchasing alcohol from off-licenses and supermarkets to 21. Under 21s would still be able to purchase alcohol in pubs and bars, but the move is aimed to reduce the availability and misuse of alcohol by young people.

However, the New Scotsman reports significant controversy regarding the proposals, particularly from the industry that claimed the move would 'demonise and mystify' alcohol for young people.   The move is reportedly linked to the apparent success of a pilot scheme in West Lothian, which was linked to significant reduction in alcohol related violence and disorder. Along with the increase in the age limit, the Justice Secretary will also reportedly propose setting minimum prices for alcohol and banning three-for-two and buy-one-get-one-free deals. A recent Times article looks further at the proposals and possible implications.

The new tough line may be defended by the Scottish government's announcement earlier in the year that they would invest £25 million in the screening, prevention and treatment for alcohol misuse.

Jobs: 3 alcohol health promotion posts in Camden -18th of June deadline

Three alcohol Health Promotion Speciailists are to be recruited in the London Borough of Camden to deliver improvements in health and the reduction of inequalities relating to alcohol misuse. The posts wil lead on developing prevention and intervention campaigns, help co-ordinate education and support programmes and work with council colleagues and the alcohol industry to promote sensible drinking.

There are to be three specific areas for each of the jobs:

1) Alcohol and young adults
2) Adults and the workplace
3) Alcohol and children 

For further details please see the NHS site here

The deadlinr for applications is 18^th June 2008

Successful applicants selected for interview will be notified on Monday 23^rd June 2008

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Interview Date: 26^th June 2008