An evaluation of a national led programme to reduce alcohol-related hospital admissions and improve local level action has been published.
It finds although the Alcohol Improvement Programme (AIP) was not found to have impacted on national level hospital admissions, it did help improve the prioritisation and delivery of local action.
The 3 year £22 million AIP was funded by the Department of Health and ran from 2008-2011. It provided support to the NHS and third sector in delivering alcohol harm reduction, particularly around identified 'High Impact Changes' such as IBA and hospital liaison. Investment was delivered primarily through Early Implementer areas, Regional Alcohol Offices, NWPHO alcohol figures, the Alcohol Learning Centre (ALC) and the alcohol National Support Team (ANST).
The primary aim of the AIP was to contribute to a reduction in the rate of increase of alcohol-related hospital admissions (ARHAs), which it was not shown to have achieved. However the evaluation identified a number of issues with measuring this aim, including the wider and longer term context of rising admissions, despite falls in consumption since 2004. Other possible problems with this measure were the potential for increased coding or referral of alcohol-related problems, although it noted this should be regarded as a positive outcome.
Asides, the AIP and its aims were regarded positively, particularly as a 'change agent' for instigating local level action. Areas that received 'Early Implementer' support were regarded to have significantly strengthened strategic development of local actions. Indeed the ongoing prioritisation by many local areas in the new policy context may be regarded as part of the AIP's legacy. The Alcohol Learning Centre remains a useful 'one stop shop', and efforts around IBA and alcohol hospital liaison have continued or even increased.
The evaluation recommends that many such aspects of the AIP should be retained and built into the new policy context. In particular, actions to support and foster 'virtuous' partnership approaches and strategic leadership are crucial. This may be undermined by a decrease in specific strategic level alcohol roles and the absence of alcohol-specific funds. Retaining targets such as those to reduce hospital admissions is also advised as, if nothing else, they provide an incentives and focus for action. However under the current localism agenda, this recommendation may fare less well.
The report also calls for the need to maintain a strong policy focus on alcohol and attention to service development. These areas are now being led by action from Public Health England (PHE), who having incorporated the former NTA, are keen to ensure continued prioritisation and support around alcohol. Recently PHE released an alcohol stocktake tool which clearly reflects key approaches set out in the AIP.
The report highlights the AIP was always a time limited programme, so it's ambition to maintain a legacy of an improving evidence base, infrastructure and capacity for alcohol harm reduction should be recognised. Continuing falls in consumption are certainly likely to reflect economic difficulties, but the alcohol harm reduction agenda can surely also take some credit. Nonetheless, such evaluations cannot truly answer to what extent alcohol harm reduction efforts have - or will - impact on drinking, its impacts and trends.
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