Alcohol Policy UK

A&E Screening and Brief Interventions development findings

A report detailing the experiences and findings of instigating A&E Screening and Brief Interventions (SBIs) in a borough with some of the highest alcohol related hospital admissions has been produced by the Alcohol Nurse Specialist (ANS) at Charing Cross. 

Charing Cross Hospital is located in the London borough of Hammersmith and Fulham which has committed to reduce high alcohol related admissions by adopting NI 39 as part of its Local Area Agreement.

SBIs based on the St Mary's model started in Charing Cross A&E last year and figures show that from 17th December 2007 to 5th August 2008 there were:

• 436 patients screened
• 346 assessments and brief interventions
• 43 individuals seen on more than one occasion
• 90 directed towards specialist alcohol services
• 335 males; 101 females

The report highlights a number of issues and reccomendations relevant to developing the service including:

• Not all patients who would benefit from Brief Interventions are being screened and there is a tendency of staff to refer dependant rather than hazardous/harmful drinkers to see the ANS
• Higher number of male referrals may be related to perceptions around alcohol misuse
• Continued training, education and promotion of the benefits of SBIs will be important in raising awareness of staff
• Options to incentivise Senior House Officers (SHOs) to ensure they are screening need consideration with SHOs now rotating every 4 months
• Further opportunities for SBIs exist particularly with other hospital based services such as sexual health, fracture and maxillofacial clinics.

Charing Cross are also piloting self-screening leaflets that can be filled in while waiting in A&E, which also provides details of local services and the ANS contact details. The full report can be read here.

DPPOs come under fire from campaigning network

Designated Public Place Orders (DPPOs), often known as Alcohol Control Areas or Controlled Drinking Zones, have come under pressure as a report from a self styled 'pro-human campaigning network' the Manifesto Club . The group has urged the public to 'reclaim public spaces' with an organised event in Hyde Park, largely promoted on social network site facebook. A report by the group, called 'Against the Booze Bans and the Hyper-Regulation of Public Space', claims that local authorities have now put in place over 613 DPPOs and that many are being implemented excessively.

Part of the problem may be the common misconception of the DPPO as an alcohol ban, when actually it does not prohibit public drinking but in fact gives police and authorised officers powers to confiscate alcohol or arrest for non-compliance in specifically designated areas, as Alcohol Concern's Don Shenker correctly highlighted in a report in the Guardian.  A further report on the issue can be found in the Telegraph. However many local authorities have reported significant reductions in alcohol related anti-social behaviour following the implementation of the orders, albeit that vulnerable groups such as street drinkers should be provided with appropriate support and interventions.

For further information on DPPOs see the Home Office page here.

Voluntary off-license scheme set to launch in Watford

12 off-licenses have teamed up with Watford borough council, local police and trading standards to launch an 'Off-watch' scheme to address illegal alcohol sales, reports the Watford Observer. The voluntary code means the off-licenses have agreed to take on special measures in order to prevent sales to those who are drunk, 'proxy' sales where adults but alcohol illegally for under 18s, and also a 'challenge 21' scheme whereby anyone appearing under 21 is asked for I.D. Businesses will be supported by local statutory services through the delivery of training, advice and practical assistance.

The scheme, which has yet to be officially launched, is likely to be followed closely as local alcohol leads have often reported failing to engage successfully with the off-trade, instead being forced to take action under licensing act powers. Recently guidance was released by a trade body on the Community Alcohol Partnership (CAP) scheme, which claims to be a new successful approach to addressing public underage drinking associated with the off-trade.

Consultation is also underway as the government reviews its approach to the regulation of the alcohol retail industry including how alcohol is displayed in off-licenses and whether point of sale information on units should be displayed. See here for more information.