The National Institute of Clinical Excellence (NICE) have released a new quality standard for preventing harmful alcohol use in the community, QS83.
NICE quality standards set out 'high-priority areas for quality improvement in a defined care or service area' - in this case for approaches at a community population level to prevent harmful alcohol use. The new QS83 are separate to QS11 on treatment and interventions for harmful alcohol use and dependence, released in 2011.
Four standards make up the new population level QS83:
- Statement 1. Local authorities use local crime and related trauma data to map the extent of alcohol‑related problems, to inform the development or review of a statement of licensing policy.
- Statement 2. Trading standards and the police identify and take action against premises that sell alcohol to people under 18.
- Statement 3. Schools and colleges ensure that alcohol education is included in the curriculum.
- Statement 4. Schools and colleges involve parents, carers, children and young people in initiatives to reduce alcohol use.
NICE - evidence based approaches?
NICE quality standards are expected to reflect the evidence base, as comprehensively reviewed for previous NICE prevention guidance PH24 and treatment guidance CG115. Indeed the value protecting children from underage sales cannot be questioned given potential harm to children and adolescents, hence CMO guidelines for an alcohol free childhood. The picture around underage sales is unclear though as it is not nationally monitored, though recent data suggests test purchasing failure rates range from 17- 54% depending on premises type.
With regards to local authorities using crime and trauma data to inform local action, this area of work has been regarded as valuable following the "Cardiff model" of A&E data sharing (full report). The Department of Health released guidance and e-learning resources to support A&E data sharing back in 2012. However in terms of using the data to steer licensing policy, this area is still very much in development following Pubic Health becoming a 'Responsible Authority' in 2012 - see 2014 PHE guidance here.
Perhaps more controversially, the new quality standard includes a firm recommendation to 'ensure that alcohol education is included in the curriculum'. Alcohol education in schools has long been a controversial area - whilst seemingly a no-brainer to the public, evidence for effectiveness appears minimal at best, especially as a single component. A 2012 Cochrane review cautiously suggested some multi-component programmes may have value, particularly where 'life-skills' approaches are a key focus. However a recent evaluation of Drinkaware's In:tuition programme found no evidence of impact on primary outcomes.
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