Presentation on licensing and health (final)

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Licensing, Alcohol and Health

Hertfordshire Licensing Committees Public Health Seminar

3rd April 2014

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SpeakersBrian Simmonds Head of Community Safety and

Health, East Herts [email protected]

Jim McManus Director of Public Health,

Hertfordshire County [email protected] Dawn MorrishHealth Improvement Manager,

Community Safety and Offender Health, Herts County Council

[email protected]

Michael NadasdyProgramme Officer - Anti Social BehaviourCounty Community Safety [email protected]

Sarah TaylorProgramme Manager; Domestic Violence,

Stalking, Harassment, and Hate CrimeCounty Community Safety [email protected] Cliff AustineResilience/CBRNE Support Technician,

East of England Ambulance Service NHS Trust

[email protected]

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AgendaIntroduction & Outline Brian Simmonds

• Health impacts of alcohol abuse Jim McManus

• Licensing, Health and Crime Dawn Morrish & Michael Nadasdy

• Domestic violence Sarah Taylor

• Ambulance, first on scene Cliff Austine

• Conclusion Brian Simmonds & Jim McManus

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Health Impacts of alcohol abuse•Deaths related to alcohol in 2001 5,476

in 2009 6,584

•Estimated cost of alcohol harm to the NHS in England in £2.7billion (2006-7 prices)

•In 2007 33% of men and 16% of women were classified as hazardous drinkers

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Health Impacts of Alcohol in Hertfordshire

Jim McManus, Director of Public Health

Licensing and Public Health Workshop

3rd April 2014

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Estimated economic costs in Hertfordshire 2008/09

£231 million£231 millionper yearper year

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National drug treatment statistics 2012/13

Good national performance:

• 29,000 people helped to recover from addiction

• Specialist services are easy to access: 98% wait under 3 weeks; average used to be 5 days.

Challenges:

• Ageing treatment population: over 40s are now the largest group starting& receiving treatment

• Particularly hard to help into lasting recovery – shown by levelling off of proportion of people successfully completing treatment

• Changing patterns in drug use incl. new psychoactive substances, and prescription or over-the-counter medicines

http://www.nta.nhs.uk/uploads/adultstats2012-13.pdf

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Numbers in structured treatment Q3 2013-14

Alcohol 1441 Up 18% from Q2

Opiates 1611 Up 5%

Non-opiates 803 Up 22%

Drugs total 2414 (was 2195 in 12/13)

Up 10% (compared to -1.5%

nationally)

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Key alcohol indicators from DOMES report

Indicator Local Comparison

Clients waiting over 3 weeks to start

treatment

1.2% (3.9% in Q2)

National: 7.1%

Successful completions as a proportion of all

in treatment

36.1% (was 33.1% in Q2)

National: 36.6%

Re-presentations within 6 months

6.9% (was 7.5% in Q2)

National: 11.2%

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Key messages

• Aging population, reflected in treatment population

• Changing landscape requires service flexibility

• Access to treatment is positive

• Need to focus on

– re-presentations particularly non-opiates

– those who are longest in treatment

–18-24 year olds

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Trends in Violent Crime in Hertfordshire 2010-2013

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Hertford-shire

Steven-age

Brox-bourne

Welwyn-Hatfield

NorthHerts

EastHerts

Watford Dacorum Herts-mere

StAlbans

ThreeRivers

East & North CCG Herts Valleys CCG

Vio

len

t Cri

me

Inci

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r 1,0

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Violent Crime Trend

In both England and Hertfordshire the reported rates of domestic violence have not varied significantly between 2010-13. Although East Herts has the lowest rates of domestic violence it was the only district to show a significant increase over that period.

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Young people’s Health Related Behaviour Survey 2012• 67% of pupils in years 5&6 (age 9-11)had tasted

alcohol at some point

• 38% said their parents knew when they drank

• 25% of pupils in years 8&10 (ages 12-15) had an alcoholic drink in the previous week

• 8% of pupils got drunk on at least one day in the last week (13% year 10 pupils)

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Domains of Response

Control and Enforcement

Prevention Treatment, Support and

Care

Police

Probation

PCC

Licensing

Need to do better here

Public Health

NHS

Social Care

Third Sector

Brief Interventions

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Systems thinking – Why Licensing is Important to Public Health

The wider determinants of Health and Local Government functions (Must adopt a Lifecourse approach!)

The Lives people lead and whether LA functions help or hinder healthy lifestyles (policy, service quality, access, behavioural economics, behavioural sciences)

The services people access such as primary care (high quality, easy access, good follow up, behavioural and lifestyle pathways wrap around)

•Our health and our offending occurs in a system•Criminology and public health/epidemiology share some concerns in the literature

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Health and crime is a system issue – Licensing is a key part of the system

• Pervasive health inequalities and poorer outcomes in offender communities

• Multilevel issues – requires interventions across all levels of public health

• Partnership across new responsibilities

• Links between health and offending behaviour

Levels of Public Health Action

•Social

•Environmental

•Biological

•Behavioural

•Legislative

•Structural

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Domains of Response – where is the licensing role?



Care

Licensing has a clear enforcement and control role

Licensing can have a prevention role

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Domains of Response – where is the licensing role?



Care

Need to do better here

Public Health

NHS

Social Care

Third Sector

Brief Interventions

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Some issues to think through

• Can we adopt the Suffolk model of voluntary high alcohol controls?

• Can we use licensing more effectively within the law as a public health tool?

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• [email protected]

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Alcohol, Licensing, Health and Harm

Dawn MorrishHealth Improvement Manager,

Community Safety and Offender Health,

[email protected]

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Public Health and Licensing

• The Director of Public Health has a statutory obligation, Public Health being a Responsible Authority

• We receive copies of all new licence applications, variations and licence reviews from all 10 Local Authorities

• Public Health can present health-related evidence to licensing committees

• Contribute evidence to support licence reviews

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Public Health evidence• ‘Cardiff model’- sharing of non-confidential data

from A&E departments on assaults associated with alcohol

• Core information: date, time, location and type of assault, weapon used

• Sharing this information with Community Safety Partnerships

• Enables more effective targeting of problematic premises and aims to reduce alcohol related burden on A&Es

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Sample of monthly raw data

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Other sources of health evidence

• Health profiles

• Local alcohol profiles

• Alcohol related hospital admissions

• liver disease mortality

• Local information of areas of high vulnerability eg homeless hostels

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Alcohol-related Crime

2011-12 645

2010-11 787

2009-10 856

2011-12 – East Herts ranked 3rd highest in the county for alcohol-related crime

5,488

6,022

6,866

East Herts Hertfordshire

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Violent Crime – East Herts 2012/13

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Night time violent crimeAll violent crime between 9pm & 5am

2011/12

2010/11

2009/10

539

669

649

2011-12 – East Herts ranked 3rd highest in the county for night-time violent crime

4,601

4,891

5,517

East Herts Hertfordshire

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Applications by District 2012 (Apr - Dec)

10

18

4

13

1517

2

9

13

14

Broxbourne Borough Council

Dacorum Borough Council

East Herts District Council

Hertsmere Borough Council

North Herts District Council

St Albans City & DistrictCouncil

Stevenage Borough Council

Three Rivers BoroughCouncil

Watford Borough Council

Welwyn Hatfield BoroughCouncil

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Applications by District 2013

19

24

21

13

3036

13

6

24

19

Broxbourne Borough Council

Dacorum Borough Council

East Herts District Council

Hertsmere Borough Council

North Herts District Council

St Albans City & DistrictCouncil

Stevenage Borough Council

Three Rivers BoroughCouncil

Watford Borough Council

Welwyn Hatfield BoroughCouncil

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0

5

10

15

20

25

Broxbourne Dacorum East Herts Hertsmere North Herts St Albans Stevenage Three Rivers Watford WelwynHatfield

Application for New Premise Licences

2012 (Extrapolated from 9 months of data) 2013

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0

5

10

15

20

25

Broxbourne Dacorum East Herts Hertsmere North Herts St Albans Stevenage Three Rivers Watford WelwynHatfield

New applications versus Variations 2013

Application for a premises licence Application to vary a Premises Licence

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East Hertfordshire Breakdown of On trade & Off Trade

Of 21 applications received in the year 2013 the breakdown was as follows:

On trade: 9

Off trade: 12

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Some Successes

• Evidence supplied to 3 licence reviews in Watford

• Led to closure of a night club for 3 months and a additional 34 clauses added to the licence

• Revocation of a shop licence

• Licence review of an on licence premises which has subsequently closed down

Presentation on licensing and health (final)

Health & Medicine

Transcript of Presentation on licensing and health (final)