Local Authorities need to get to grips with the full spectrum of harm caused by alcohol misuse

Tom Smith, Policy Programme Manager at Alcohol Concern writes about Alcohol Concern’s latest report report on the priority given to tackling alcohol-related harm by local authorities.

Last year local authorities (LAs) took on a huge responsibility – that of looking after our public health and wellbeing. Many people saw it as a huge opportunity with local authorities best placed to understand and serve the needs of their local population. But with increasingly tightening budgets and so many competing health concerns it can be difficult for LAs to work out what their priorities and actions should be.

At Alcohol Concern we wanted to see where alcohol was sitting as a public health priority among local authorities so we carried out an audit of the focus on alcohol-related harm in Joint Strategic Needs Assessments (JSNAs), Joint Health and Wellbeing Strategies (JHWSs) and CCG Commissioning plans of 25 local authorities. 15 were from the top 25 authorities in the country for alcohol-related harm along with 5 each from the middle and lowest ranked authorities.[1]

So what did we find? Overall it was heartening to see that most of the documents we reviewed, address alcohol in some form. What was worrying however is that for many alcohol received only a brief mention – far from the ‘comprehensive section on alcohol harm’ that Public Health England recommends.

This is too important to get wrong. An estimated 1.6 million people in England[2] – one in 20 adults – are dependent on alcohol and many more are damaging their health by drinking at unsafe levels. But it’s not always easy to spot as there is no stereotypical dependent drinker.

Of course there are obvious targets, like tackling hospital admissions and providing treatment services but to focus only on these leaves LAs blind to the full spectrum of harms caused by alcohol misuse.

The report recommends that JSNAs need to be built on a wider dataset than the Local Alcohol Profiles for England (LAPE) data alone and hospital admissions specifically. This could include prevalence data, treatment data, licensing information, crime figures as well as specific local research.

To augment this Directors of Public Health should ensure that JSNAs consider the impact of alcohol on sub-groups within the local population including different wards, ethnic and language communities, people with mental health problems, unemployed people, offenders, women who have been the victims of abuse.

It also recommends that Directors of Public Health ensure that the needs of young people are not over-emphasised in comparison with other groups, leading to the danger of inappropriately stigmatising young people as a major cause of alcohol related harm. The needs of the larger group of young people who are at risk because of parental drinking should be considered. And let’s not forget that it is in fact middle and older aged harms that are the significant burden on public health budgets.

And please don’t be complacent; in England even the lowest risk areas will have considerable harm from alcohol. Directors of Public Health and CCG chairs in areas with lower national rankings for hospital admissions, morbidity and mortality in the North West Public Health Observatory (NWPHO) data should ensure that JSNAs, strategies and plans reflect the actual impact that alcohol is having not simply a lower ranking.

Health problems and costs associated with alcohol misuse are rising year-on year, with research increasingly showing clear links between harmful alcohol consumption and hypertension, cancer, stroke and other common illnesses. With the impact of harmful drinking being felt across so many conditions and at great cost to local health economies, responsibility must not be allowed to fall between the gaps of local bodies’ remits.

Without clear prioritisation for both treatment and prevention services, alcohol dependence and the effects of harmful drinking will continue to exact a toll on people’s lives and health at great detriment to the sustainability of the NHS and the ability of local health bodies to provide healthcare for their wider communities.

Download the report for free here.

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[1] The choice of areas was based on a notional ranking of the North West Public Health Observatory Local Alcohol Profiles for England (LAPE) data.

[2] Good practice in planning  for alcohol and drugs prevention, treatment and recovery – Public Health England 2013

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