Alcohol Policy UK

'Protecting People, Promoting Health: A public health approach to violence prevention for England'

A new report has been released by the North West Public Health Observatory (NWPHO):

'Protecting People, Promoting Health: A public health approach to violence prevention for England' [pdf]

'The report describes the major roles public health and health care services can play in reducing levels of violence across the country alongside their functions in dealing with the impacts of violence on health. The documents contain new figures on the cost of violence, estimating national costs to the NHS of £2.9 billion annually and a wider cost to society of £29.9 billion each year.

The report draws on the latest evidence that many of the key risk factors that make individuals, families and communities vulnerable to violence are changeable. Interventions are now available to reduce violence through improving childhood and by adapting the cultures and environments in which we live, learn and work. The report details:

• The extent and nature of violence
• Its impact on short and long term health and wellbeing, education and antisocial behaviour
• Risk and protective factors for involvement in violence
• The range of evidence based approaches we now have for preventing violence
• Related national policy and programmes'

As recently reported, an e-learning resource - Reducing Violence in your Community: Emergency Department Datasharing - was released alongside an ED Datasharing report and a number of data sharing case studies.

The Department of Health also recently released broader guidance on Information Sharing to Tackle Violence (pdf). It highlights how Community Safety Partnerships (CSPs) can reduce violence in their community by encouraging A&Es to collect and share information on time, type and location of assault.

Home Office updates: New licensing powers come into effect 31st October; latest premises licences statistics

New Licensing powers will come into effect this week - see Home Office release. From the 31st October, local authorities will have the discretion to introduce Early Morning Restriction Orders (EMROs) and a 'late night levy' as part of plans to "re-balance" the licensing act through greater powers to councils and residents.

EMROs will allow local authorities to restrict the sale of alcohol between midnight and 6am - see EMRO factsheet. The late-night levy will allow charges to licences to contribute to the costs linked to late night drinking, such as extra policing and street cleaning - see late night levy fact sheet. Decisions on the powers were released earlier this year following a consultation.

The late-night levy and early morning alcohol restriction orders (EMROs) were set out in the Police Reform and Social Responsibility Act 2011. See here for the Government Alcohol Strategy or here for a series of factsheets on the licensing changes.

Premises license numbers 2011/12

The Home Office have released 2011/12 statistics for alcohol licensed premises and associated activities. The release highlights as "Headline figures":

• 202,000 premises licences, the same as on 31 March 2010; [up 3% on 2008]
• 15,900 club premises certificates, 6% fewer than in 2010; and
• 502,400 personal licences, 16% more than in 2010.

Of the 202,000 total premises licences, a Home Office briefing highlights:

• 35,500 premises were licensed for on-sales of alcohol only (up 1% on 2010);
• 51,100 premises were licensed for off-sales or supply of alcohol only (up 5%);
• 82,900 premises were licensed for on- or off-sales or supply (up 1%).
• The remaining 32,500 premises were not permitted to sell alcohol, down 9% on 2010

The statistics also show:

• An increase of 8% in the number of premises with 24 hour licenses
• An increase of 6% in 'Premises licences off-sales or supply of alcohol only'
• A decrease of 5% in 'Club premises certificates on-sales of alcohol only'

Download the full statistics here (xls) and full separate Home Office briefings here. See here for an interesting and perhaps still relevant 2009 report, 'Pubs aren't dying - they are evolving'.

News & updates Oct 2012: minimum pricing battles re-heating; warning over alcohol budgets; 'baby boomers' under fire; MPs to debate duty escalator & forthcoming events

Minimum pricing battles re-heating

The alcohol pricing battleground has been re-heating with the imminent release of the consultation on proposals within the alcohol strategy, and as Scotland attempt to implement a 50 pence per unit minimum price.

With the actual minimum price for England still to be set, arguments for and against minimum pricing are being re-stated. Supporters have recently claimed a new Canadian study provides further evidence it would have a beneficial impact - a notion much disputed by Diageo's Mark Baird.

Meanwhile opposition to Scotland's minimum pricing plans is focusing on claimed legality issues given the SNP has passed it's minimum pricing bill. This week a court challenge led by The Scotch Whisky Association was delayed after a late submission of evidence. See here for a BBC analysis of the legal challenge to Scotland's minimum pricing.

Health and treatment

Alcohol spending must not lose out, the Guardian reports ahead of the public health reforms taking effect from 2013. It warns of real threats to drug and alcohol budgets being passed to local authorities without protected 'ringfencing'. It points out that the 'localism' agenda may undermine drug and alcohol spend if new GP-led commissioning groups and Health and Wellbeing boards do not give it adequate recognition. See here for updates on Public Health England.

Baby boomers are draining NHS resources through alcohol misuse, reported Alcohol Concern as it released it's new alcohol harm map. The story attracted media reports, but a fullfact article questioned the data as being at odds with national statistics.

Alcohol abuse and obesity care causing rising liver disease in the North West, reports the BBC. The story follows a report from John Moores University on the Burden of Liver Disease and Inequalities in the North West of England.

Homeless people are 'drinking themselves to death' from super strength alcohol, reports the Guardian. Homeless charities are continuing to call for more action to address the low-price high-alcohol content of such drinks, which will be hit heavily by a minimum price. Last year a report was published warning against the dangers of white ciders.

There is a need to better address drinking problems in older age, a Guardian article highlights. A Daily Mail article has reported 'Alcohol kills you quicker than smoking' following research in Germany.

Trade and industry news

MPs will debate the future of the beer duty escalator on 1 November after a petition to scrap it passed 100,000 signatures. The news came as the BBPA announced further falls in beer sales, and warned of the policy as damaging to the pub industry and jobs. Pressure will therefore be on the new Community Pubs Minister, Brandon Lewis.

An MP is calling on parliament to ban liquid nitrogen cocktails after a teenage constituent had to have her stomach removed after she downed two of the drinks, see Guardian report.

New data showing how supermarket pub prices threaten the pub trade is claimed in opinion piece from a pub operator in the MA.

Events

An Alcohol Liaison Seminar will take place at St George's Hospital, London on 22 November, 2012. The seminar is designed to focus on the Alcohol Nurse Specialist and Alcohol Health Worker role in hospital liaison - see here for more info.

An event on Implementing NICE treatment guidance within PbR is being hosted by DrinkWise on 15th November 2012 in Manchester. Free for commissioners, providers, and alcohol leads in the North West - or for a nominal fee of £40 plus VAT for other regions. See the flyer and conference agenda here or to book email Drink Wise with any dietary requirements.

Alcohol Awareness Week (AAW) 2012 will take place from 19-25 November on the theme of "It’s time to talk about drinking" - details here. A set of conversation starter cards are available to download.

London Health Improvement Board's alcohol priority takes shape

Since 2011, the shadow London Health Improvement Board (LHIB) has been working with a variety of partners to improve the health of all Londoners and reduce inequalities in health outcomes. The LHIB aims to deliver city-wide action to generate better outcomes for Londoners, with a particular focus on key areas of alcohol, obesity and cancer.

For the alcohol priority, work has been developing to deliver action on:

• Vision and Partnership - developing a London-wide vision for how London should view and relate to alcohol and a partnership framework t support action across sectors
• Licensing and Enforcement - supporting local authorities and their partners in creating a well-managed night time economy by developing a set of licensing and enforcement standards
• Early Intervention - ensuring that Identification and Brief Advice (IBA) is delivered effectively across a wide range of key settings in London including criminal justice, acute and primary care.

As part of the 'Early Intervention' work programme, an IBA Practitioners Network is currently being established to develop leadership and peer support around IBA delivery. The Network is currently seeking London practitioners from a range of health, social care and criminal justice settings who are committed to supporting IBA delivery. If you are a London based health or social care practitioner and committed to IBA delivery please get in touch.

In 2013, an Early Intervention and Prevention Leadership Summit event will take place to support the programme and ensure strategic buy-in and leadership.

Latest from the IBA blog: first INEBRIA 2012 report; 'mystery shopping' for IBA?; Brief Advice 'bullets' & more

A selection of recent posts from the IBA blog, which aims to promote news, links and ideas relating to alcohol brief interventions are included below:

• INEBRIA 2012: research into practice?
• IBA ‘mystery shopping’ experiences: the good, the bad and the…
• ‘Mystery shopping’ for IBA in Primary Care?
• How intense an intervention is IBA? And competencies needed?
• How ‘opportunisitic’ can IBA be – a step too far?
• Brief advice bullets: try lower strength drinks?
• Brief advice bullets: alcohol disrupts sleep
• Is IBA ‘girly’?

The blog also inlcudes an about IBA page and quick reference IBA tools & resources page. Previous popular posts include:

• IBA for children and young people: evidence, guidance and resources?
• Extended Brief Interventions: who, when, where, and other questions?
• Is self-completing the AUDIT OK for IBA?

The IBA blog was set up to promote learning, understanding and the delivery of IBA through news, links and ideas on IBA from a range of contributors. It also aims to highlight other resources and links such as INEBRIA and the Alcohol Learning Centre IBA pages.

Latest Findings alcohol bulletins: 'positive psychology' aids recovery?; lessons for Payment by Results?; improving treatment systems

Recent bulletins from the drug and alcohol bank:

Upbeat positive psychology: overlaps with recovery movement and first UK trial
A first review has identified overlaps and possible synergies between the contemporary recovery movement in addictions and the positive psychology movement in the broader field of psychological health focused on strengths and wellbeing. The sole effectiveness trial to date was conducted in England, a small pilot study which found substantial remission in alcohol dependence despite the non-substance focus of the therapy.

A related bulletin explores Applying positive psychology to alcohol-misusing adolescents: a group intervention.

US payment-by-results scheme did not improve engagement with treatment
In 2007-08 the US state of Maine introduced a scheme linking funding for outpatient treatment services to performance in terms of waiting times and retention, but financial and service delivery impacts were negligible. Were incentives too weak, or were services already doing as well as they could - and what are the implications for UK payment-by-results [PbR] schemes?

Improving treatment systems?

A bulletin exploring how to generate better outcomes from treatment systems is available covering:

• Expert advice on how to get the treatment system working better
• Global performance feedback no use to counsellors
• Feedback on individuals helps counsellors reverse poor progress
• Common treatment quality yardstick poor reflection of patient progress
• US payment-by-results scheme did not improve engagement with treatment
• Acid test for implementing evidence-based treatment

See here for current NICE alcohol treatment guidance and commissioning resources.

Reducing violence through data: Emergency Department data sharing e-learning; DH Guidance on information sharing

A&E data sharing e-learning

An e-learning resource - Reducing Violence in your Community: Emergency Department Datasharing - has been released to support data sharing between the Accident and Emergency Departments (EDs) and Community Safety Partnerships (CSPs). In addition, an ED Datasharing report and a number of data sharing case studies are available.

The 30 minute e-learning course is designed to support better understanding of what information sharing is and how it can be used to support violence reduction. It may be useful for ED staff - from receptionists to consultants, CSP staff - from managers to analysts, Police and Crime Commissioners, Directors of Public Health, Staff in Clinical Commissioning Groups or Health Wellbeing Boards.

Guidance on information sharing to reduce violence

The Department of Health have released broader guidance on Information Sharing to Tackle Violence (pdf). It highlights how Community Safety Partnerships (CSPs) can reduce violence in their community by encouraging A&Es to collect and share information on time, type and location of assault.

It identifies that CSPs, made up of local authorities, the Police and other local agencies, can share information to identify where violence is happening and inform local interventions to tackle it. It suggests interventions such as restricting alcohol licensing and targeting policing can have a big impact on community safety.

Securing and sharing good local data has long been a key challenge of effective local alcohol strategy to reduce related crime and disorder. As of this year, health authorities have also become a 'responsible authority' for local licensing decisions and the guidance states:

"Health bodies can present health-related evidence (where relevant to the licensing objectives), such as data on violence-related A&E attendances and ambulance callouts, to licensing authorities." (p.7)

Importantly health is still not a licensing objective, therefore any evidence still has to meet existing objectives such as prevention of crime and disorder. Many health authorities appear to have been struggling to contribute any new data to the process - alcohol-related A&E data has historically been difficult to collect, and ambulance of police data often not specific or detailed enough. The "Cardiff model" of A&E data sharing (or full report) was considered a groundbreaking project in this area.

A list of Home Office factsheets on the licensing changes are available.

New 'alcohol harm map' released by Alcohol Concern

Alcohol Concern have released a new alcohol harm map. It aims to 'reveal the real harm and cost of alcohol at a local level, so that local authorities and local health providers can ensure that alcohol prevention and treatment services are available to those with drinking problems.'  

The map allows the user to click on a region and select a local authority to uncover how many people are drinking at risky of harmful levels and the imapact it has. This includes data on population prevalence, hospital costs and alcohol-related deaths.

Some of the methodology for alcohol-related hospital admission uses the same 'attributable fractions' data set as the Local Alcohol Profiles for England (LAPE), which also gives estimates for areas such as violence and crime. However the alcohol harm map also provides methodologies to calculate outpatient attendances, A&E activity and alcohol-related deaths. See here for more information on the data set.

Launching the map, Alcohol Concern released a press release stating Baby boomers are draining NHS resources through alcohol misuse. It states the inpatient cost of the 55-74 age group, closely aligned to the baby boom generation, is over ten times greater than the 16-24 age group depsite press attention being focused on the latter.

Alcohol Concern partnered with pharmaceutical company Lundbeck Ltd in the production of the Alcohol Harm Map. Within the guidance of the Association of the British Pharmaceutical Industry code of practice, Lundbeck provided Alcohol Concern with an educational grant; project management support from communications consultancy Munro & Forster and funding for the design and development of the map and collation of the data.

National level data is collated in the Statistics on alcohol for England 2012.

Keith Humphreys on alcohol policy, recovery and politics: new FEAD video clips

A series of video clips featuring Professor Keith Humphreys have been released by the Film Exchange on Drugs & Alcohol (FEAD). The clips were filmed at the New Directions in the Study of Alcohol Group (NDSAG) 2012 conference. 

Keith Humphreys is one of the most respected minds in the addiction policy fields, recently working as an adviser on drugs policy to the White House. He has recently been working in the UK advising on alcohol policy including minimum unit pricing and the Mayor of London's sobriety scheme project now being piloted.

The series of clips, mostly a few minutes long, include Humphreys' views on issues such as science, Alcoholics Anonymous and prejudice, the achievements of UK addiction psychologists and alcohol, research funding, and hopes for the future.

Recently video clips featuring Steven Rollnick, one of the founders of Motivational Interviewing, were also posted on FEAD. Other renowned alcohol experts available to view include Professor Nick Heather, Professor Betsy Thom, Professor Robin Davidson and many others.

Alcohol Research UK reports: In:tuition 'life-skills' evaluation; ESPAD young persons trends; glass size influences consumption; Alcohol industry influence on policy; 'Mystery shopping' for alcohol services

Reports recently published from Alcohol Research UK include:

Process evaluation and feasibility study of In:tuition, a life skills education programme for young people aged 9-14 years

In:tuition is an evidence based, life skills education programme for young people aged 9-14 developed by Drinkaware. 

Substance use among 15-16 year olds in the UK: Key findings from the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD)

Every four years ESPAD collects comparative data on trends in substance use among school pupils people across Europe, to assist in the design and targeting of interventions supporting healthy adolescent development.

Glass Shape Influences Consumption Rate for Alcoholic Beverages 

Participants were 60% slower to consume an alcoholic beverage from a straight glass compared to a curved glass. This may represent a modifiable target for public health interventions. See BBC report.

Alcohol Industry Influence on Public Policy: A Case Study of Pricing and Promotions Policy in the UK

Whilst much of the literature on alcohol policy exhibits a clear assumption that industry actors are extremely powerful, we know relatively little about the processes through which alcohol policy is made and the specific role played by industry actors in these processes.

Developing “Mystery Shopper” capacity for alcohol services

Mystery shoppers are paid to use shops and services to determine the quality of customer experience, can this be applied to an alcohol treatment system?

See here for the Alcohol Research UK library.