Wellbeing and Health Partnership – Executive Group Website_0.pdfHowever, the view of the alcohol...

Wellbeing and Health Partnership

Alcohol strategy Board

Meeting to be held 21st July 2010, 2.00-4.00pm room 701 Civic Centre

Contact Officer: Jill Bauld Alcohol strategy co-ordinator

Tel: 2777453 Email:[email protected]

Membership: L Seery,R Hope, M Orange, H Wilding, J Bauld, S Savage, V Air, R Mould, B Gates, R Rogan, G Mitchell, P Stanley, D Hogg, S Taylor, O Batchelor

AGENDA

Time Item Lead Paper For

1. 5 min Introductions and Apologies for Absence SS

2. 20 min Balance Work Plan-Colin Shevills CS No Discussion

3. 10 min Government consultation on Alcohol CS Yes Discussion

4. 10 min ABG update JB Tabled Information

5. 10 min National Drivers/ minimum pricing LS Yes Discussion

6. 10 min Cardiff Model Update PS Tabled Information

7. 15 min Action Plan review JB Tabled Information

8. 10 min Partnership Issues MO No Discussion

9. 10 min Minutes of meeting held 30.6.10 SS yes

10. 10 min AOB SS

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11. 10 min Date and Time of Next Meeting: and meeting plan for year

JB yes Information/ discussion

A Balanced View on the Government Programme for Alcohol Introduction The new Government has prioritised tackling the problems around alcohol, evidenced by the fact that they are holding a review on alcohol taxation and a consultation on the wider alcohol proposals outlined in their document, ‘A Programme for Government’. This focus is to be welcomed and provides the North East with an opportunity to influence Government policy. This document outlines a holding position from Balance on what we anticipate will be included in those two pieces of work. We will provide further detail and advice once more detail emerges on the parameters of the review and the questions contained in the consultation. The positions taken in this document have been informed by advice provide by the alcohol Regional Advisory Group.

Political Background and Tone of Voice While the Government are keen to understand the views of people and organisations involved in tackling problems which are related to alcohol, it is clear that they do not favour the introduction of a minimum price per unit of alcohol at this stage. We may not get everything we want and Balance is looking at these conversations as one battle in a longer term war. The particular focus of this Government appears to be on crime and disorder and the negative impact of alcohol on young people. We need to play to these interests. They are also very careful to avoid any measures likely to unduly penalise businesses. Given that background Balance will be expressing a cautious welcome for Government plans in general, while commenting on the detail and asking them to go further than current plans indicate. We will be trying to get as much as possible this time around, while laying the groundwork for future battles.

What You Can Expect from Balance It is our objective to maximise the response to the review and consultation from the North East and to make sure, as far as possible, that we are consistent in our views. This will be difficult given the pressures currently faced by people working in the public sector, however, we cannot afford to miss this opportunity to influence Government policy. Balance will make it is as easy as possible for colleagues both to respond to the review and consultation as an organisation and to encourage support from their wider communities. Our plans for this period are currently being developed but will include:

Outline responses to the review and consultation to be shared with partners as early as possible

An outline plan with suggestions on how to get involved and engage your communities

A creative platform and campaign designed to make these conversations relevant to as many people as possible

A pack of material which you might find useful in informing your organisation and wider communities about these conversations around alcohol

We will be using two specific pieces of collateral to inform both the debate and our responses to Government:

A public opinion survey, the headlines of which will be available by the end of August

The topline results of a survey of the North East’s publicans which will indicate the economic pressures facing their businesses

In return, we would ask that you commit, on behalf of your organisation, to at the very least respond to the review on price and consultation on the wider alcohol proposals.

Outline views on Government Plans

We will ban the sale of alcohol below cost price.

Balance Comment ‐ This is the first time price controls have been considered to tackle alcohol misuse and although we welcome this move as a first step we will be advocating that the most workable way to stop below cost sales is a minimum price for alcohol. We will be arguing that banning below cost price wouldn’t work from a practical perspective (it would be impossible to police and monitor) and would have a minimal impact on price and therefore consumption levels. However, the view of the alcohol RAG was that looking at duty in relation to the strength of alcohol would be a step forward.

We will review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries.

Balance Comment ‐ An example of the combination of manifestos. The Liberal Democrats supported minimum price, the conservative party line was against. In coalition the parties have both sought compromise on the issue. Taxation will drive up prices for all alcoholic drinks ‐ a minimum price would be a more targeted measure towards cheap, strong drinks favoured by heavy drinkers and young people. There is also evidence that in the past supermarkets have absorbed such price increases. We will provide a more detailed analysis of the various options, but the alcohol RAG view is that looking at duty in relation to strength would be a step forward.

We will overhaul the Licensing Act to give local authorities and the police much stronger powers to remove licences from, or refuse to grant licences to, any premises that are causing problems.

Balance Comment ‐ This measure builds upon powers already available. As yet we don’t know what form the ‘stronger powers to remove licences’ will take. We expect it to either be a part of the Police Reform and Social Responsibility Bill or incorporated into an overhauled Licensing Act. There is little doubt that the any proposal to strengthen Licensing Powers to facilitate the removal of licenses where there are problems, and where it is appropriate to do so, is to be welcomed. However we would urge that any revised legislation embraces the current situation whereby, upon appeal against a decision to revoke a licence, a premises is allowed to continue to trade until such times as the appeal is heard. We would also urge that ‘sufficiency’ and ‘public health’ are considerations when granting new licences

We will allow councils and the police to shut down permanently any shop or bar found to be persistently selling alcohol to children.

Balance Comment ‐ Again, building upon powers which in theory are already available. This proposal would send out a clear message that under aged sales will not be tolerated and that persistent sales will bring about a swift and effective response. Whilst we recognise that ultimately the decision to permanently close any premises would need to be taken by the relevant Licensing Committee, we would ask that in drafting the legislation, a power is provided to facilitate the immediate and continued withdrawal of the alcohol licence pertaining to the premises pending the licensing committee hearing, and also during any subsequent appeal period.

We will double the maximum fine for under age alcohol sales to £20,000

Balance Comment ‐ Although such a proposal can only serve to further underline the seriousness of under age sales, it only becomes effective if significant penalties are applied in the event of conviction. The current maximum fine is already set at a significant level so it is therefore important that in addition to any rise in maximum fine that the Sentencing Guidelines Council reassesses the advice contained within the Magistrates’ Courts Sentencing Guidelines with specific reference to factors impacting upon offence seriousness and fine bands.

We will permit local councils to charge more for late‐night licenses to pay for additional policing.

Balance Comment ‐ We are concerned that this measure is heavily weighted towards the on‐trade when in actual fact many of the problems which we encounter here in the North East are associated with off licence outlets. We feel that the proposal to charge more for late night licences provides a seemingly inherent assumption that responsibility for violence in the night time economy lies solely with pubs and clubs and whilst this will certainly be true in some instances, we remain unconvinced that this is the root cause of current problems. There is an increasing body of evidence that the availability of cheap alcohol in off‐licence outlets (particularly supermarkets) has led to the proliferation of ‘pre‐loading’ across the country i.e. consuming large amounts of cheap alcohol at home before setting off for a night out to save money, resulting in many customers arriving in town centres already inebriated. Unless additional costs for late licences were only applied to problem premises, and not applied as a ‘blanket’ approach to an area, we believe that they would represent an unfair burden for on‐licensed premises to tackle problems stemming from alcohol purchased elsewhere. We certainly view publicans as being part of the solution as opposed to being part of the problems and we believe that the introduction of additional costs would only serve to alienate businesses and detract from true partnership working. We believe that a more effective approach would be the re‐introduction of sufficiency as a key consideration when assessing applications for licensed premises and in particular, off licences. The explosion in the numbers of outlets selling alcohol has undoubtedly contributed to current problems. Also we are firmly of the opinion that rather than seek to impose additional costs, a drawback from 24 licensing would provide better benefits – although the proposed costs are intended to fund additional policing, the fact is that resource availability has been stretched by having to police much longer licensing hours.

Other than those issues above which are quite specific to alcohol the only other things which have a link to the alcohol agenda within the document are as follows:‐ We will crack down on irresponsible advertising and marketing, especially

to children. We will also take steps to tackle the commercialisation and sexualisation of childhood (Families and Children Section)

Balance Comment ‐ This leaves the window open to challenge the marketing of alcohol as it impacts on young people. There is substantial evidence that children are influenced by alcohol advertising, particularly in terms of early onset of drinking, which is an indicator of problems later in life. The BMA has called for an end to alcohol advertising and Balance’s Alcohol Manifesto calls for the Government to address this issue. Balance will use Alcohol Awareness Week in October to further highlight this issue.

We will introduce a ‘rehabilitation revolution’ that will pay independent providers to reduce reoffending, paid for by the savings this new approach will generate within the criminal justice system. (Justice Section)

Balance Comment ‐ There is insufficient detail contained within the proposal to offer any meaningful comment at this stage. However it may give rise to the opportunity to raise funding to source brief advice interventions within the criminal justice system.

We will encourage NHS organisations to work better with their local police forces to clamp down on anyone who is aggressive and abusive to staff (Health Section)

Balance Comment ‐ Again there is insufficient detail contained within the proposal to offer any meaningful comment at this stage. However given the ongoing development of the Cardiff Data Sharing Model and the desire to promote enhanced working relationships there may be an argument for Acute Trusts to become responsible authorities within Community Safety Partnerships.

We will investigate ways of improving access to preventative healthcare for those in disadvantaged areas to help tackle health inequalities. (Public Health Section)

Balance Comment ‐ More lifestyle and alcohol support services may be made available from this measure. However, it is not yet clear what the Government means by preventative healthcare or public health. We are concerned that their definitions may end up being too narrow thereby missing an opportunity to tackle alcohol misuse.

Alcohol strategy delivery Board

21st July 2010

Report from: Jill Bauld Alcohol Strategy Co-ordinator

Topic: Update report re ABG funding

1. Background

1.1 In 2008 executive committee sanctioned the use of Flexible Area Based Grant monies to be used for gaps in strategic priorities such as the Alcohol strategy.

1.2 The Alcohol Strategy allocation totalled £800’000 and was distributed by the Board to specific projects within the 3 themes of the Strategy. These areas to be funded were seen to be priority areas for development and delivery.

2 All project officers have been briefed today and have copies of paperwork which will link into the Board meeting dates.

2.1 A time table for all project officers will be devised and sent out once dates are finalised.

3. Progress

3.1 Projects are on track, letters have been sent out to all project officers in relation to their allocation.

3.2 Cost codes that have already been allocated will be revised and sent out again due to changes in the system. Quarterly expenditure paperwork will be used by project officers and Theme leads will sign this off and allocate to their theme budget code.

4 Prevention

4.1 At the Prevention Theme meeting the Youth Proposal element was discussed and all staff will be in place to commence delivery across the summer period.

4.2 It was decided to wait for information from Balance before proceeding with the Social Marketing element.

4.3 At the meeting it was noted that focus group work could be delivered across the summer period with the target age range 13-25 years in order to support the Social Marketing element if necessary.

5 Treatment

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5.1 IBA Launch delivered to over 85 key people from across local government, agencies and voluntary sector.

5.2 IBA workers ready to start in post at end of July which will mean increased capacity for delivering training across all sectors.

5.3 Domestic violence worker in post and already demonstrating positive outcomes in this field.

5.4 Joint work with Cyrenians around peer support is proving to be successful.

6 Law and policy enforcement

6.1 Street Pastors continue to deliver a service across the city centre supporting the most vulnerable and ensuring safety.

6.2 Taxi Marshalling is in place and continues to provide a valuable service and ensure people’s safety whilst waiting for taxis.

6.3 132 visits have been carried out over week ends to target off licences. Fixed penalty notices have been issued by police officers to adults buying alcohol (proxy sales)

6.4 Pre work relating to Off licensee training has been delivered. This includes creating an ‘underage sales booklet’, distributing questionnaires to all off licences and collating responses. The next stage is to deliver the training.

7 Partnership

7.1 Co-ordinator in post and currently meeting as many partners as possible.

Report written by: Jill Bauld

Tel: 2777453 Email: [email protected]

NHS Classification: Unclassified / Protect / Confidential

Minimum Unit Price for Alcohol Report to: Professional Executive Committee

Meeting Date: June 2010

Agenda Item No:

Sponsor: Dr Fu-Meng Khaw, Acting Director of Public Health for Newcastle

Contact Point: Lynda Seery, Public Health Specialist

Version Control: V1

What is the Professional Executive Committee being asked to decide? 1. The Professional Executive Committee is asked:

a. Consider and comment on the proposal to support the campaign for minimum pricing for alcohol led by the core cities health improvement collaborative (Newcastle is one of eight participating cities)

b. Endorse the approaches taken by the core cities health improvement collaborative to raise awareness

c. Consider the recent NICE guidance, ‘Alcohol-use disorders: preventing harmful drinking’ June 2010

d. Note the content of the report (pages 4-10)

Who will be affected by this decision? 2. NHS agencies and key partners 3. Supports the work of Balance, the regional office for alcohol

What are the key issues to consider? 4. The burden of disease and other impacts caused by excessive alcohol intake 5. The report outlines the size of the problem and comments on the societal and clinical

impact of alcohol misuse and considers the evidence-base to support the public health benefits of minimum pricing

6. The key issues are: a. Newcastle has one of the highest rates of binge-drinking in the UK b. Newcastle has the 2nd highest rate of alcohol-related admissions to hospital

in the UK (after Liverpool) c. There is good evidence for the reduction of alcohol intake by introducing

minimum pricing for alcohol (Independent Review of the Effects of Alcohol Pricing and Promotion: School of Health and Related Research, University of Sheffield 2008).

What are the resource and risk implications? 7. There are minimal resource implications as this work will be led by an external

communications company working as part of the collaborative. NHS North of Tyne communications team will be kept informed of the work of the collaborative.

8. The proposed work will contribute to other regional and local communications to raise awareness about the impact of alcohol and campaign for minimum pricing.

9. The risk of not doing this is that excessive alcohol consumption continues to rise.

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What are the timescales associated with this decision? 10. The Core Cities Collaborative is planning to run a campaign after the general

election, i.e. after 6 May 2010. Six of eight core cities have already endorsed this campaign through their partnerships and PCT boards.

11. Recent NICE Guidance supports the minimum unit price initiative and states, ‘making alcohol less affordable us the most effective way of reducing alcohol-related harm’.

Sources of further information a. Strategic Plan – prevention of ill-health b. Balance Big Drink Debate 2009 c. NICE Guidance June 2010 – ‘Alcohol-use disorders: preventing harmful

drinking’ d. Independent Review of the Effects of Alcohol Pricing and Promotion: School

of Health and Related Research, University of Sheffield 2008. e. NCL Core Cities Alcohol paper 26/04/10 f. Britain’s alcohol market: How minimum alcohol prices could stop moderate

drinkers subsidising those drinking at hazardous and harmful levels. Chris Record and Chris Day. Clinical Medicine 2009, volume 9, number 5: 421-5.

g. Coghlan A. WHO launches worldwide war on booze. New Scientist, 2730; October 2009.


PROFESSIONAL EXECUTIVE COMMITTEE REPORT TITLE:

SUPPORTING INFORMATION (All sections to be completed)

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Links to World Class Commissioning Competencies

Statutory Reporting Requirements

Locally lead the NHS Use of Resources Work with community partners Standards for Better Health Engage with public and patients NHSLA Collaborate with clinicians Manage knowledge and assess needs Prioritise investment Stimulate the market Promote improvement and innovation Secure procurement skills Manage the local health system Ensuring Efficiency and effectiveness of spend

Other (Please specify)

Links to NHS North of Tyne Corporate Objectives Protect the public’s health and reduce variations in health and well-being Commission and deliver a range of safe, high quality services Involve patients and the public in helping to shape health gain and health care services and in

decisions about their health Provide patients with choice about their treatment Have strong and effective working relationships with our partners Involve health professionals actively in influencing commissioning Sound financial management, making the best possible use of public resources Meet the challenges of becoming world class commissioners

Equality, diversity & human rights (EDHR) Proposed communication process Item for Commissioning Board meeting

Item for ECT

Item for FET

Impact on Health Inequalities Item for PEC Screened as positive EDHR impact

Feature in internal bulletin Screened as neutral EDHR impact Publish on website Screened as negative EDHR impact Press release Next Steps: Proactive sharing with key partners Do Equality Impact Assessment Resource implications Review screening with EDHR Lead Staffing No further action Finance Other (Please specify) Buildings

Equipment Minimal resource implications

Risk Register Does this issue affect a rating in the risk register? Yes No If yes, which principal risk: Suggested

likelihood scoreSuggested consequence score

Suggested rating score (likelihood x consequence)

Suggested acceptance level


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Core Cities Minimum Unit Price for Alcohol

1 The Core Cities Health Improvement Collaborative

The Core Cities Health Improvement Collaborative is a new network established to improve public health in England’s eight biggest regional cities.

Built upon an existing network of local authorities, the Health Improvement

Collaborative has been established to boost collaboration and share best practice between those working to tackle health inequalities, not only from primary care trusts but also colleagues in local authorities, a variety of public and third sector agencies and other stakeholders.

Local government participants to date have included:

- Senior Elected Members with a specific interest or role in health

improvement; - Chief Executives and Directors, including Joint Directors of Public

Health - Chairs of Local Strategic Partnerships; - Policy and Strategy Officers; - Community Safety and Neighbourhood Teams; - Environmental Health, Trading Standards and Licensing specialists;

and - Lead officers in Adult Social Care and Education.

Furthermore, joint directors of public health and partnership are involved with

the steering group making joint decisions and contributions on the direction of the programme. The Collaborative has established close working relationships with the Core Cities Local Government Network which is a cross city, cross party collaboration of more than ten years’ standing and which primarily focuses on economic development.

2 Profile of Alcohol Misuse in the Core Cities.

Alcohol misuse creates harm to the individual’s health, to their families and to society. A higher proportion of people in the core cities drink at harmful levels than in England as a whole: this is defined as men drinking more than 50 units, and women more than 35 units a week.


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Table 2: * NWPHO Mid-2005 synthetic estimate: from Health Survey for England, Hospital Episode Statistics, Office for National Statistics mid-year population estimates and mortality data and the Census of Population 2001.

These harms generate huge costs for public services. Table 2 shows the costs incurred in the core cities local health economies. Local Authority

Alcohol Related Hospital Spells

All Hospital Spells

Per 1,000 Hospital Spells

Total tariff

Nottingham 1,705 67,907 25.1 £2,334,950 Sheffield 1,979 139,447 14.2 £3,055,992 Newcastle upon Tyne

2,369 78,229 30.3 £3,112,702

Bristol 2,322 109,871 21.1 £3,599,664 Leeds 3,756 184,350 20.4 £4,984,826 Manchester 3,923 122,934 31.9 £5,192,181 Liverpool 5,549 143,521 38.7 £7,176,573 Birmingham 5,761 267,078 21.6 £7,606,435 Core cites 27,364 1,113,337 24.6 £37,063,323 England 223,143 12,697,802 17.6 £286,962,870

Table 2

Alcohol-related crime in the core cities runs at levels well above the national average (Table 3). Excessive drinking in the night-time economy means that many of our city centres are perceived as no-go areas for many families, older people and people vulnerable to attack from drunks. The concentration of the youth-based alcohol industry in the centres distorts the local economy, making them less diverse and less resistant to the economic downturn. As recession affects these businesses they are more likely to compete with irresponsible cut price alcohol promotions.


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Home drinking, where alcohol is bought cheaply from supermarkets, is also a major factor of alcohol-related crime, contributing to anti-social behaviour, violence in the home and ‘pre-loading’ where people drink to excess before going out for the night.

Table 3 *(NWPHO from Home Office recorded crime statistics 2007/08)

Balance, the North East regional office for alcohol carried out ‘The Big Drinking Debate’ in June to July 2009. The online debate generated approximately 13,000 responses, the top line results from which are detailed below: Nearly 9 in 10 of the sample drink alcohol. Personal choice is the leading reason for not drinking alcohol, followed by

health reasons. The frequency of alcohol consumption varies – drinking 2-3 times weekly is

most common amongst respondents and unit consumption is higher at weekends than during the week.

1 in 10 drinkers do so ‘daily’ or ‘almost daily ‘and 1 in 20 drink [at least] twice the maximum daily recommended amount of alcohol ‘daily’ or ‘almost daily’.

The majority of respondents drink at home or in bars / clubs / pubs Approximately 1 in 2 alcohol drinkers purchase their alcohol in supermarkets. The main motivations to drink alcohol are to ‘relax, unwind and socialise’ but a

sizeable proportion also drink for more negative reasons such as ‘forgetting worries / concerns’ and to ‘get drunk’.

Approximately 2 in 5 alcohol drinkers felt that ‘more information on the health risks’ would reduce the amount of alcohol they drank and the same proportion felt that increased alcohol prices would reduce the amount consumed.

For approximately 1 in 3 drinkers, discounts and drinks promotions were felt to increase the amount of alcohol they consumed.

Family, friends and GPs were the preferred sources of help for alcohol related problems.

1 in 3 drinkers reported that they had got into a risky situation as a result of drinking too much alcohol.

The negative social impacts of alcohol appear to be more of a concern than personal impacts.

Under-age drinking and alcohol related violence were the leading social concerns.


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A summary of the findings for Newcastle is attached, but the key messages were consistent with the regional overview.

3 The Rationale for Choosing a Minimum Unit Price as a Preferred Approach to Influencing Alcohol Consumption There is a lively national debate about the most effective way to address the harmful effects on alcohol in society. A minimum unit price would require all retailers of alcohol to charge a certain amount per unit and would not allow them to offer further reductions or discounts. From a public health point of view this has the advantage over an increase in taxation of alcohol which would still leave retailers free to offer cheap alcohol as a ‘loss leader’ by subsidising its costs from other products.

Whilst local authorities have some ability

to take action on alcohol availability in their area through licensing and other measures, this could complement rather than replace a national, population wide initiative such as a minimum unit price.

4 Evidence Base that a Minimum Unit Price for Alcohol is an Effective Harm Reduction Measure

Research shows that alcohol responds to price increases like most consumer goods on the market, ie when other factors remain constant, an increase in the price of alcohol leads to a decrease in the consumption and visa versa. Over the past 50 years the real price of alcohol (how much it costs in relation to household income) has declined steadily.


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The number of premises licensed to sell alcohol in England and Wales has also increased dramatically over the last 30 years. The School of Health and Related Research at the University of Sheffield has produced an independent review of the international evidence base about alcohol pricing. It found that there is strong and consistent evidence to suggest that price increases and taxation (assuming price increases are passed through to the retail price) have a significant effect in reducing the demand for alcohol. This evidence base is derived from studies in the United States of America, Australia, Switzerland and the United Kingdom. This independent review also found strong evidence to suggest that young drinkers, binge drinkers and harmful drinkers tend to choose cheaper drinks. There is evidence to suggest that minimum pricing for alcohol may be effective as a targeted public health policy in reducing the consumption of cheap drinks. A large number of studies suggest an association between increased prices for alcohol and reductions in the harmful effects of drinking. The aim of minimum unit pricing for alcohol is to ensure that retailers are unable to sell alcohol below a base line cost even when retailers are offering price promotions and discounts. The Chief Medical Officer of England, Professor Sir Liam Donaldson recommended a 50p per unit price for alcohol in his annual report in 2008.

“As an immediate priority, the government should introduce minimum pricing per unit as a means of reducing the consumption of alcohol and its associate problems. Consideration should be given to setting the minimum price per unit of 50 pence.”

Research from the School of Health and Related Research at the University of Sheffield found that a minimum unit price of 50p would


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lead to 100,00 fewer hospital admissions each year and reduce consumption per drinker by 7% on average

reduce underage drinking by 7% reduce harmful drinking by 10% reduce violent crimes by 20,000 per year.

A minimum unit price for alcohol of 50p would also reduce the consumption of moderate drinkers by 3%. The policy is a powerful one because it reduces overall consumption of alcohol and also has a differential effect on young drinkers, binge drinkers and those who drink at harmful and hazardous levels. Research by Alcohol Concern has suggested that moderate drinkers, ie those who drink within recommended limits, will experience a small increase in their alcohol bills of around £15 a year per person as a result of a minimum unit price.

5 Influencing the Debate about Alcohol Pricing

In order to secure a legislative increase in the price of alcohol to a minimum of 50p per unit, it will be necessary to influence the opinion of a myriad of people, from the key lawmakers in Parliament to the general public, and from healthcare professionals to some of those working within the alcohol industry. Our strategic objectives include:

Building strong relationships with all MPs with constituencies within the Core

Cities.

Raising awareness among other relevant parliamentarians of the link between alcohol pricing and harm - including all relevant select committees, party and cross-party groups.

Building relationships with other potential supporters already active on this

issue – or likely to support it. Potential partners already identified include Alcohol Concern, the British Medical Association, the Royal College of GPs, the Alcohol Health Alliance, and Association of Chief Police Officers.

Raising public awareness of the link between pricing and alcohol harm, and

associating Core City PCTs/local authorities as sponsoring the issue.

Collating and publicising new evidence linking price to harm.

We will consider a range of suitable tactics to raise awareness of the campaign, ranging from organising one-to-one meetings between PCT chief executives and target influencers to encouraging members of the public in the eight core cities to write to their constituency MPs. Initiatives to produce new evidence will also be considered, building on the success of the recent snapshot poll of unit prices conducted as part of Alcohol Awareness Week. A fuller ‘shopping list’ of potential tactics will be produced for the steering group’s consideration once the campaign has board support from all PCTs and associated local authorities. Further, more reactive opportunities will then be considered on an ad hoc basis as they arise.


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The Core Cities Health Improvement Collaborative Steering Group consists of PCT and local authority nominees from each core city. This reports to the Core City PCT chief executives. It is proposed that the collaborative produces an annual report on activities in support of a minimum unit price for alcohol to be considered by the relevant partnership in each city and by the core cities chief executives and leaders meeting.

6 Ensuring this Work Stream is Complimentary with Each Core City’s Alcohol Harm Reduction Programme The strength of the public affairs campaign is dependent on the support of all cities, at all levels. The campaign was initially conceived at the Core Cities Health Improvement Collaborative learning event on alcohol harm, and has since been given strong support from attendees at the event on all-age, all-cause early mortality. All Core Cities alcohol harm reduction leads are involved with the campaign steering group, and are involved in ensuring that the campaign complements their local work programmes. Every core city has a comprehensive alcohol harm reduction strategy and action plan which includes widely targeted health promotion including work in schools, with Universities and local communities. early intervention, and a variety of treatment programmes. Core cities are uniquely well placed to make the link between focussed actin on treatment and prevention with population-wide measures such as alcohol pricing. Professor Ian Gilmore, President of the Royal College of Physicians advocates for this combination of interventions.

“Over the next decade alcohol misuse is set to kill more people than the population of a city the size of Bath. Confronting the culture of low prices and saturation advertising, along with investment in accessible, effective treatments for harmful and dependent drinkers could make a big impact on what is becoming a public health emergency”

Monday, 19 October 2009. Professor Ian Gilmore, President, Royal College of Physicians


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Safe, Sensible and Social in Newcastle upon Tyne Newcastle has provided a concerted partnership response to the harms relating to alcohol misuse and delivery against the four main objectives of the strategy:

Objective 1 - Developing a preventative approach to alcohol misuse

Objective 2 - Providing services for problem drinkers and their families and carers

Objective 3 - Protecting the public through law and policy enforcement

Objective 4 – Partnership working (a cross cutting theme) Working in close collaboration with partners funding has been secured with the NHS North of Tyne investing over £1m in community service development in the past two years and the Local Authority investing over £800k across the strategy themes over 2010/2012. Following the launch of the strategy in December 2008 there have been parallel work-streams established across prevention, early intervention/treatment as well as legislation and enforcement. The development plans have identified a package of interventions that begin to effectively deal with alcohol related health problems in Newcastle by increasing the number of referrals into community based treatment services, reducing dangerous levels of alcohol consumption and subsequent hospital admissions and increasing awareness of health implications attached to alcohol misuse. The interventions identified address the gaps which exist in the system and include prevention, harm reduction, early intervention/ treatment and recovery, legislation and enforcement, across 3 of the 4 tiers of service delivery. Current areas of work include:

Education – increased awareness sessions with children and young people across all schools in the city

Identification and Brief Advice training strategy IBA Training programme across multi agency settings (including Health Trainers,

Behaviour Support staff, Learning Mentors, School Health Advisors, social care, custody suite officers, probation and police)

Established new Community Alcohol Team (ACTS – Alcohol Care & Treatment Service). The team is a multi agency innovative initiative designed to create ‘wrap around’ services for those people experiencing multiple hospital admissions.

Community Open Clinics are being developed in targeted areas where individuals will have the opportunity to seek support around alcohol problems

Implementing the Cardiff Model in Newcastle. 20 new placements for Alcohol Treatment Requirements (ATRs). Alcohol Arrest Referral post to ensure that post arrest brief interventions are offered

Criminal Justice, Legislation and Enforcement Whilst public health sits on the decision making groups, our partners within the local authorities lead on this area of work and a number of initiatives are underway within specific locations i.e.

the use of polycarbonate glasses taxi marshalling to reduce potential violence whilst people are waiting in taxi queues supplying additional buses and extending the times they are available (11.00pm – 3.00am) Street Pastors who go out on to the streets at the busiest times and try to ensure

individuals do not put themselves in vulnerable situations Implementation of the Cardiff Model, which is a Violence Prevention Model based on the

sharing of key information between Emergency Departments and the Police. Specific information is used to identify hot spots in areas where violence is occurring


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Minimum Unit Price for Alcohol – there is work underway under the the Core Cities Health Improvement Collaborative as well at BALANCE, the regional alcohol office (Attached are recent documents which have informed local support for the development.

Gaps within the current system are being addressed and development support has been made available from area based grant funding and the initiatives include the following:

Dissemination of key information and facts Development of further resources for drug and alcohol work within school settings across

the city Establishment of an alcohol education and prevention worker post A domestic violence initiative End to End Mentoring project Increased carer support Establishment of a Health Link Worker for young people Training and Proxy sales initiatives Street Pastors Taxi marshals (requiring more support) Establishment of an Alcohol Strategy Co-ordinator (recently appointed)

The delivery of the strategy depends on the effective delivery of work by all delivery partnerships within the LSP. However, primary responsibility lies with an Alcohol Strategy Delivery Board which is part of the Wellbeing and Health Partnership governance arrangements. The Strategy was a local response to a growing issue that has a national dimension and was developed to provide a comprehensive partnership approach to the problem incorporating action on many fronts.

Wellbeing and Health Partnership – Alcohol Delivery Board

21st July 2010

Report from: Paul Stanley

Topic: Cardiff Model Developments

1. Background

1.1 The Cardiff Model uses depersonalised data collected at Accident and Emergency Departments (AED) to better inform activity aimed at preventing and reducing alcohol-related violence

1.2 Information that is gathered by the AEDs can be utilised by Community Safety partners to identify trends in activity, and gain a wider perspective on a range of offences that may not appear in the police statistics, but have wider impacts on personal and community safety.

1.3 Research indicates that 25% of offences which lead to treatment in AEDs appear in police records, indicating significant levels of violent incidents hidden from police records.

1.4 BALANCE NORTH EAST is co-ordinating the regional development of the Cardiff Model

1.5 A regional Minimum Dataset has been adopted. Each Hospital Trust is working towards implementing the collection of this dataset as per local capability

2 Current Picture

2.1 Newcastle General Hospital has adapted their Patient Recording system by creating additional data collection fields to incorporate the Cardiff Minimum Dataset

2.2 AED Staff has received awareness training on the Cardiff Model by Sue Taylor (BALANCE North East) and Paul Stanley (Northumbria Police)

2.3 Data being collected by AED Staff as a matter of routine

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2.4 Technical issues identified with the transfer of data to the Newcastle Hospitals Data Warehouse, which is geographically located in the USA. These should be resolved by the end of July, when Data Sharing can begin. The first data shared will be retrospectively dated to April 1st 2010

2.5 Newcastle Hospitals Trust Information Security are establishing the validity of ‘The Vault’ as a secure data storage hub for the Cardiff data. The Vault has been approved by all other Hospital Trusts within the Northumbria Police area for use

2.6 Monthly data transfers to The Vault will take place following approval. No issues anticipated

2.7 Licenses for staff from SafeNewcastle, Northumbria Police and Newcastle Hospitals Trust for ‘The Vault’ will be issued by Northumbria Police once it has been confirmed ‘ The Vault can be used

3. Recommendations

3.1 Data sharing to begin July 2010

3.2 SafeNewcastle to begin planning as to how best utilise the Cardiff Data

Report written by:

Paul Stanley

Harm Reduction Co-ordinator

Northumbria Police

Tel: 01661 88375 Email: [email protected]

Wellbeing and Health Partnership – Alcohol strategy Delivery Board

21st July 2010

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Report from: Jill Bauld Alcohol Strategy Co-ordinator

Topic: Action Plan closure and review

1 Progress- Prevention

1.1 A closure document for the current action Plan has been completed.

1.2 A meeting is being arranged to bring key agencies/ orgs together to look at the closure document and to work on the new action plan.

2 Treatment

2.1 An action plan review meeting has been arranged for next week as this was the earliest time partners could get together.

2.2 Partners have been e mailed a closure document to add to in readiness for the meeting to follow.

3. Law and Policy enforcement

3.1 A meeting of key partners has been held and a start has been made on the closure of the old action plan and creation of the new plan

3.2 New licensing arrangements will enable the Alcohol Strategy to influence new policy for Newcastle which will be built into the action plan

4 Partnership

4.1 Action plan closure document completed, new action plan to be drafted with input from partners.

5 Next Steps

5.1 Closure documents and new Draft action Plans to be presented to the board in September.

Report written by: Jill Bauld

Tel: 2777453 Email: [email protected]

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Wellbeing and Health Partnership

Alcohol Strategy Delivery Board

Meeting held on 30 June 2010, 2.00 – 4.00pm

Minutes

Item No Item Action

1. Present:

Viv Air, Head of Environment & Public Protection

Ollie Batchelor, Director of Quality and Development

Barbara Gates, Funding Programme Officer (ABG)

Roger Mould, Development Officer NCVS

Margaret Orange, Treatment Effectiveness & Governance manager (alcohol and Drugs)

Ruth Rogan, Head of Strategic Partnership

Steven Savage, Director of Regulatory Services and Public Protection

Lynda Seery, Public Health Specialist/Drugs & Alcohol

Jean Browne, NCC Funding Programme Officer(ABG)

Chief Inspector Julian Bowran, (to rep Gillian Mitchell)

In attendance:

Emma Burton, Administrative Assistant (Minute Taker), Jill Bauld, Alcohol Strategy Coordinator

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Apologies:

Helen Wilding, Wellbeing and Health Partnership Coordinator

Rachael Hope, Development Officer

Gillian Mitchell, Superintendent

Paul Stanley, Northumbria Police

Sue Taylor, Balance

2. Report on Action Plan closure and review.

New Action Plan format

Actions

2.1 The meeting began at 2pm

Jill referred to the Theme leads meeting which took place on 24th May. Outcome focused paperwork was distributed as a possible template to be used for the new Action plan, a discussion took place and the following points were made:

The group are keen to close off the old action plan and will try out this paperwork

The closure will be general not specific itemisation of each part of the old plan.

Some of the headings may need to change to make it useful for our specific needs; the Theme Leads will work on this with their groups.

The paperwork was welcomed as it helps us to keep focus on the overall strategy.

2.2 It was agreed the Theme Leads would work with others to populate the action plan and circulate to the board to make comments. Hopefully to be circulated by the 21st but it was noted that the next meeting was on the morning of the 21st and the Board sits in the afternoon.

RR

V.A.

M.O.

2.3 Ollie Batchelor entered the meeting at 2.20pm

2.4 Jill informed the group that an internal audit was due to be done, and that the auditors are happy to look at the new work rather than the old plan. Also Scrutiny wants to look at work on Alcohol as a topic.

3. ABG update

3.1 Jill referred to the updated ABG report and gave the group an overview of progress, a discussion took place and the following points

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were made:

It was noted the Social Marketing strand of the Prevention Theme needed some work. The Assessment Document needed revision due to changes to the ‘in kind’ element of the proposal.

Projects that had been identified to use up any under spend (such as Operation Ginger) would have to be put on hold until we have some clarity about the Social Market element of the programme.

Barbara and Margaret had a discussion about carry over of ABG fund for recent post. Issues re 1 year contracts starting late and will need to carry over past March 2011.

ACTION: Review carry over, all theme leads to get information to Jill to indicate carry over. Jill to pass on to Stephen and Barbara to discuss with Paul woods.

It was agreed that ABG issues would in future be kept to 1 agenda item

There was concerns around the Balance work plan if they include Social Marketing we need to make sure we don’t duplicate what they have planned

ACTION: Linda Seery to circulate Balance work plan for 2010/2011

Terms of reference to be agreed with Balance so that Board can be pro active around suggestions for future work plan.

ACTION: Linda Seery to request report from Balance

RR,MO,VA

JB

LS

LS

3.2 Discussion was had about making sure that all aspects of the strategy was discussed at Board meetings as NHS fund a lot of work outside of ABG

3.3 Jill suggested that the new paperwork should help this process as the Progress sheet will allow traffic light reporting on all aspects of the Strategy and aid discussion at future Board meetings.

4. Wider Governance of Alcohol Strategy

4.1 Jill referred to the Governance of Alcohol Strategy it was noted that the Adult Commissioning Group was not going ahead

ACTION: Jill to revise document and to bring to next meeting

JB

4.2 A discussion took place and the following points were made:

We need to be clear on our relationship with Safe Newcastle/ Children’s Trust Fund and Health Partnership and get clarity on

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strategic links.

ACTION: Jill to discuss issue with Gillian Tullock and feed back to Board at next meeting

JB

5. Minutes of meeting held 24th May

5.1 The minutes were agreed as a correct record, apologies were made to Ruth Rogan who’s name was not shown on those listed as attending the meeting

6. Sharing Successes

6.1 A DVD was shown to the group of the Ad Campaign put together by young people. This is part of the Prevention Theme and will be developed further into resources that can be used in schools and other settings, Sandra Davison to advise.

6.2 It was agreed each board meeting in the future would have 1 agenda item to share good practice.

7. AOB

7.1 IBA Strategy Launch

7.2 It was noted that there had been a poor response from Education and Youth services to attend the event on 16 July.

7.3 Board members were asked to follow up and ensure good representation at the launch

All

8. Core Cities Work

8.1 A discussion took place regarding core cities work and the following points were made:

It was highlighted that the Local Government and Police had not signed up ACTION: Linda Seery to send out letter

LS

9 Cardiff Model

9.1 Stephen wondered where we were with this piece of work? Jill had been contacted by Dave Fanning for contact details of lead for this work.

9.2 ACTION: Jill to contact Paul Stanley and ask for update for next meeting.

JB

10 Date and time of next meeting:

21 July 2010, 2.00 – 4.00pm Room 701,Civic

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