Public Health England (PHE) have released an alcohol CLeaR self-assessment tool which aims to 'bring together all those working to reduce alcohol-related harm in a locality to think through what is working well and to identify the opportunities for further improvement'.
CLeaR stands for 3 linked domains in local alcohol strategy planning, adopted from a similar model for smoking:
- Challenging services - looking at key aspects of local delivery against the evidence base, identifying local innovation and learning
- Leadership - reviewing the local vision and governance supporting this, planning and commissioning arrangements and evidence of collaboration between partners
- Results - examining outcomes achieved locally and considering progress against local priorities
The resources include the main Self-assessment tool (xlsm) which includes a number of thematic areas for local partnerhsips to explore by assessing whether there is evidence of achievement. The leadership section for example allows areas to assess their approaches to governance and partnership, followed by sections on delivering communication approaches and interventions at various levels. Results and outcomes sections are also detailed, whilst a CLeaR handbook (pdf) provides guidance as well as the CLeaR good practice and resources (pdf).
PHE piloted the alcohol CLeaR tool in four unitary authorities last year and report positive feedback - a PHE blog says they are confident the CLeaR process 'will kick-start local conversations between key stakeholders about how to improve the wide range of outcomes affected by harmful drinking' and 'act as a vehicle through which partnerships can develop new approaches to delivery at local level.'
PHE have previously released a number of resources including a more concise alcohol Self-Assessment Stocktake tool, a JSNA support pack and liver disease profiles. A recent resource harmful drinking and dependence set out the invest to save case alongside resources to support the development of hospital based alcohol services.
A short history of modern local alcohol strategy
Local alcohol strategies first came to prominence with the advent of 'PSA 25', several 'national indicators' including hospital admissions, and the requirement for local areas to address alcohol harms through crime strategies in 2008. This was supported by the second of new Labour's national alcohol strategies, the extensive 'Safe.Sensible. Social' and supporting implementation toolkit.
Since then, an ever broadening policy base of documents, including full NICE guidance, and various initiatives such as the Alcohol Improvement Programme have taken place, although the current national policy position arguably has limited support. Other local or regional alcohol strategy approaches had come before, themes of which include the interaction of national and local alcohol policy as explored last year at a Centre for History in Public Health event.
Implementation in the age of cuts and localism?
Whilst PHE make no pretences that their role is one of supporting local areas in implementing partnership strategies, the scale of cuts and ultimately choice local authorities have not to spend money on alcohol interventions is of concern to many in the field. However detailed and ambitious local strategies may be, there is only so much 'doing more with less' that can be achieved. There may be some hope for alcohol service providers though; a recent Kings Fund survey found alcohol to be one of the few areas where commissioners stated an intention to increase spending. Many will be sceptical though, especially where services have already faced pressures, mergers or closure.
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