Blackpool Alcohol Strategy 2013 - 2016

Blackpool Alcohol
Strategy
2013 - 2016
How the strategy was developed
Public Health Blackpool and partners have been working on this Alcohol Strategy since April
2011. We have undertaken a number of pieces of work asking agencies what they think the
problems and issues are and what they would hope to see addressed in this strategy, and
collating and analysing data as part of the Joint Strategic Needs Assessment. This gave us
useful feedback on the current alcohol strategy, our achievements to date and ideas on the
priorities for this, the next alcohol strategy.
The Health and Wellbeing Board held an alcohol Thematic meeting to identify priority actions
which have been incorporated into this strategy.
Acknowledgments and Contributors
Alcohol Concern
Alcohol Health Alliance, UK
Blackpool Clinical Commissioning Group
Blackpool Council
Blackpool Health & Wellbeing Board
Blackpool Pub Watch
Blackpool Teaching Hospitals
BSafe Blackpool
Central Lancashire Local Pharmaceutical Committee
Drinkwise North West
Lancashire Constabulary
Lancashire Probation
North West Ambulance Service
Prof. Chris Bentley
Public Health Blackpool
2
Contents
How the strategy was developed ............................................................................... 2
Acknowledgements and contributors .......................................................................... 2
Strategy Summary ...................................................................................................... 5
Action Plan Summary .................................................................................................. 6
Structure of the strategy ............................................................................................. 7
Introduction ................................................................................................................ 8
Vision ................................................................................................................. 9
Aim ..................................................................................................................... 9
Objectives .......................................................................................................... 9
Alcohol Harm ............................................................................................................ 10
Alcohol harm .................................................................................................... 11
Government guidelines .................................................................................... 11
Alcohol Harm in Blackpool ....................................................................................... 14
Alcohol harm in Blackpool ................................................................................ 15
Links to other strategies ................................................................................... 16
How will we make the strategy happen? .................................................................. 17
How will we make the strategy happen? .......................................................... 18
Accountability structure ..................................................................................... 18
Reduce alcohol related ill health .............................................................................. 19
Successes from last strategy ............................................................................ 20
National Policy & Drivers ................................................................................. 20
Why we need action ......................................................................................... 20
Evidence base for actions ................................................................................ 27
Reduce alcohol related anti-social behaviour and crime .......................................... 28
Successes from last strategy ............................................................................ 29
National Policy & Drivers ................................................................................. 29
Why we need action ......................................................................................... 29
Evidence base for actions ................................................................................ 33
3
Improve Blackpool’s cultural attitude to alcohol, providing a safe, enjoyable
and sustainable environment for visitors and residents to improve the town’s
economy .................................................................................................................. 34
Successes from last strategy ............................................................................ 35
National Policy & Drivers ................................................................................. 35
Why we need action ......................................................................................... 35
Evidence base for actions ................................................................................ 39
Provide a safe alcohol-free environment for children and empower young people to
make informed decisions in relation to alcohol ........................................................ 40
Successes from last strategy ............................................................................ 41
National Policy & Drivers ................................................................................. 41
Why we need action ......................................................................................... 41
Evidence base for actions ................................................................................ 44
4
Strategy Summary
5
Action Plan Summary
6
Structure of the strategy
This strategy is set out in sections that highlight the many areas of our lives touched by
alcohol misuse. These sections relate to each of the objectives, and each has its own action
plan.
Each section identifies:
 Some of our achievements from the 2008-2011 strategy
 National Policy and drivers
 Local and National facts on the real cost of alcohol misuse
 Local data indicating the impact of alcohol misuse
 What we will do next to address alcohol-related problems in the form of an action
plan
7
Introduction
90% of adults drink alcohol and the majority of those who do drink do so with no problems
for most of the time. However, 70% of people think the UK would be a ‘healthier and better
place to live‘, if the amount of alcohol consumed were reduced. This strategy does not aim to
promote complete abstinence but it does aim to address drunkenness and associated
problems to the individual, their family and the community.
Blackpool has a thriving and vibrant night-time economy, and like many UK towns and cities,
that economy centres around entertainment premises licensed to sell alcohol. Once seen by
planners as the answer to troubled town centres, pubs, clubs and bars are a major focal
point for alcohol related harm; alcohol is having a significant negative impact on health,
crime and the economy. Blackpool has 130 on-licensed premises in a compact town centre,
an area of approximately one square mile. A total of 1,900 licensed premises exist in the
entire town: approximately one for every 72 residents.
Alcohol misuse in the northwest region of England is the worst in the UK, and Blackpool has
high levels of alcohol related harm (health, disorder, violence) for the size of the population.
The health and wellbeing of the community and local services are strained. The alcohol
industry brings some economic prosperity through employment, yet paradoxically 105,000
working days a year are lost in Blackpool due to alcohol misuse, at an estimated cost
upwards of £10.5mn per year.
Blackpool has widespread deprivation within the central wards of the town, and it is here that
alcohol related early death and illness are the highest. A combination of poor quality
housing, lack of appealing employment, and low aspiration within the resident population
makes alcohol a convenient pastime. Of the 180 off-license premises (50% higher than the
national average), half are in five of the six most deprived wards of the town. Alcohol related
domestic abuse is concentrated in these central wards, and southern residential areas of the
town.
There are clear links between alcohol consumption and crime, particularly violence.
According to the Blackpool Domestic Abuse Service alcohol was a factor in 76% of domestic
abuse incidents during 2011. In Blackpool, over half of all assaults are classified as alcohol
related, and in Talbot, Claremont and Bloomfield this peaks at 65%. Alcohol related crime
has a negative impact on the individual (victim or offender) and places huge burdens on
wider society and public services, to an estimated national annual cost of £7.8bn.
The 2003 revised licensing system in this country did not challenge the food retail laws that
protect a supermarket’s right to sell alcohol at a loss, itself having an impact on other
retailers’ behaviour. Government monopoly on alcohol, adopted by other European countries
is unlikely in the UK. The recent decision by government to include health as a responsible
licensing authority, the consultation on a multi-buy deal ban, minimum unit pricing and
inclusion of public health as a licensing objective are all a welcome change of government
approach. There is however, still a drive to normalise excess alcohol consumption, and little
sign of intent by the alcohol industry and retailers to take significant action towards becoming
responsible retailers.
Alcohol misuse is not a new phenomenon to Blackpool. According to local historians,
Blackpool in the Victorian era hosted destination drinking. The challenges facing us today
are a powerful alcohol industry, an above average prevalence of harmful attitudes towards
alcohol, and an environment and culture that support excess alcohol consumption. Since
2005 Blackpool has taken significant steps to reduce alcohol related harm despite this tide of
normalisation. This is the third Blackpool Alcohol Strategy, following the successes of
implementing effective treatment, marketing campaigns, enforcement activity and other
interventions. However, despite this the alcohol harm has failed to reduce in the town. This
8
strategy and its interventions aim to not just slow down the harm but reverse the tide of harm
by engaging all stakeholders, including residents, to work together to reduce alcohol related
harm in Blackpool.
The strategy identifies a vision, an aim and four measurable key objectives.
Vision
By 2016 Blackpool will be a safer, healthier, and enjoyable place to live, work and visit free
of excess alcohol harm.
Aim
Reduce alcohol related mortality and increase Blackpool’s average life expectancy.
Objectives
1. Reduce alcohol related ill health (Target: Reduction of 5% in alcohol specific hospital
admissions);
2. Reduce alcohol related anti-social behaviour and crime;
3. Improve Blackpool’s cultural attitude to alcohol, providing a safe, enjoyable and
sustainable environment for visitors and residents to improve the town’s economy;
4. Provide a safe alcohol-free environment for children and empower young people to
make informed decisions in relation to alcohol. (Target: delay the average age of first
drink to 16).
9
Alcohol
Harm
10
Alcohol Harm
Drinking above recommended drinking guidelines, especially when done regularly and over
a long period of time, causes risks to health and contributes to crime and disorder. The
more alcohol consumed, the greater these risks.
Government Guidelines
Low risk drinking is drinking alcohol in a way that is unlikely to cause yourself or others
significant risk of harm. It involves a personal assessment of particular risks and
responsibilities at the time, eg. if pregnant, before work, before driving or operating
machinery, during a period of ill health, and when taking certain medicines. The Government
advises that:
 Women should not regularly drink more than 2–3 units of alcohol a day
 Men should not regularly drink more than 3–4 units of alcohol a day
 Women who are pregnant or trying to conceive should avoid drinking alcohol
 Both men and women should have two alcohol free days per week
Remember, one drink isn’t always one unit.
11
Types of drinking (these terms are used throughout this strategy).
Low-risk drinking is defined as drinking within Government guidelines and making a
personal assessment of particular risks and responsibilities at the time.
Increasing risk drinking is defined as drinking more than the sensible drinking guidelines
but without having experienced any alcohol-related harms.
Higher risk drinking is defined as drinking more than the low risk drinking guidelines and
already experiencing some alcohol-related harms (but no dependence).
Dependent drinking is defined as (normally) drinking more than the low risk drinking
guidelines, experiencing alcohol-related harms and signs of psychological and/or physical
dependence.
Binge drinking generally refers to drinking large amounts of alcohol in a limited time period.
It is usually defined as more than six units for women and more than eight units for men in
one occasion, however binge drinkers may sit in any of the drinking risk groups.
The diagram below demonstrates how alcohol drinking behaviour is classified. The more
units regularly consumed per day increases the risk factor whilst binge drinkers could drink
at any level normally with an occasional binge. Dependent drinkers are predominantly a
subset of either increasing risk or high risk drinkers, however recovering drinkers could be
abstinent but remain dependent.
12
In addition to the consequences of violence and accidents, alcohol has been associated with
over 50 conditions and diseases. Some of which are demonstrated in the diagram below.
Epilepsy
Haemorrhagic
stroke
Intentional
Self Harm
Lip/Oral
Cancer
Poor Skin
Complexion
Cancer of
the Larynx
Breast Cancer
Alcoholic
Liver
Disease
Cardiac
Arrhythmias
Cancer of
the Colon
Spontaneous
Abortion
Impotence
Inflammation of
Intestines
Bone
Degeneration
Poor Blood
Circulation
Tremors
and
Instability
13
Alcohol
Harm in
Blackpool
14
Alcohol Harm in Blackpool
Despite significant effective investment in reducing alcohol harm, the alcohol harm in
Blackpool is amongst the highest in the country, with the highest alcohol and liver related
mortality, the highest number of months of life lost due to alcohol and amongst the highest
level of alcohol related hospital admissions.
The diagram below demonstrates where Blackpool stands in relation to other authority areas
in England on a range of key alcohol indicators.
15
Links to other strategies
Alcohol misuse cuts across national, regional and local strategies. Addressing alcohol
misuse will not only be dependent on this strategy but also the delivery of other strategies
and plans. Addressing alcohol misuse will help to achieve targets in these strategies and
plans through a range of groups and committees and project managed through the Alcohol
Policy Steering Group.
BSafe Crime &
Disorder Strategy
National Alcohol
Strategy
Blackpool Clinical
Commissioning
Group Priorities
Substance Misuse
Treatment Plan
Health &
Wellbeing
National Drugs
Recovery Strategy
Blackpool
Alcohol
Strategy
Children & Young
People’s Plan
Dual Diagnosis &
Suicide Strategy
Sexual Health
Strategy
Blackpool Vision
and Core Strategy
Mental Health
Strategy
Foetal Alcohol
Spectrum
Disorder Strategy
16
How will we
make the
strategy
happen?
17
How will we make the strategy happen?
The responsibility for the performance management and delivery of the strategy lies with the
Blackpool Health & Wellbeing Board, which links with the BSafe Crime and Disorder
Reduction Partnership. The Alcohol Policy Steering Group is a strategic partnership
responsible for implementing the strategy at a local level, while the Health and Wellbeing
Board is a strategic partnership for ensuring improvements in health and wellbeing, and the
Crime and Disorder Reduction Partnership has a parallel brief in relation to crime in
Blackpool.
The Alcohol Policy Steering group will be responsible for co-ordinating and ensuring that the
actions in the Blackpool Alcohol Strategy are delivered. Reports will be taken to the Alcohol
Policy Steering Group and the associated partnerships every three months to monitor
progress, and a full review will take place at the end of each year. The action plans will be
updated to reflect new or changing priorities.
A number of ad hoc alcohol working groups will also meet to ensure the operational delivery
of the strategy as required.
Accountability structure
Blackpool Clinical
Commissioning Group
Blackpool Council
BSafe Crime Reduction
Partnership
Health & Wellbeing Board
Blackpool Alcohol Steering
Group
Secondary Care
Licensing RA
Drugs & Alcohol Joint
Commissioning Group
Harm Reduction Forum
18
Reduce
alcohol
related ill
health
19
Successes from last strategy
The specialist treatment service provision was mapped and the impact of redesigns and
addition of new provisions was modelled and outcomes were calculated. The pathway was
completely redesigned and published with a further redesign to fully utilise existing services
within the drug treatment service resulting in the launch of the Horizon Treatment Service.
This service redesign has resulted in an increase in the capacity of the treatment service and
an increase in the numbers of people successfully completing treatment, rising to 71%
during 2012.
Two Alcohol Liaison Nurses were recruited to address alcohol harm in the hospital, the
demand for and the outcomes of their work has resulted in the team being expanded to 4
nurses covering seven days a week supported by two outreach workers who link patients
with community treatment services and follow up A&E patients who are discharged. This
provision has contributed to a slowdown in the rate of increasing hospital admissions from
an 18% year on year increase to a 2% year on year increase.
The Identification and Brief Advice (IBA) provision has been expanded extensively to include
training in the community, pharmacy and primary care IBA delivery, and IBA training and
delivery across Blackpool Victoria Hospital. This has resulted in over 5,000 people being
trained in IBA delivery since 2008 and over 20,000 IBAs have been recorded resulting in
reduced alcohol consumption and referral to treatment services.
National Policy & Drivers
The primary national steer for alcohol harm reduction is the 2012 Government Alcohol
Strategy which highlights the main areas of strategic direction, which needs to be
supplemented by local decision making processes. The key local strategic direction is
determined by the BSafe Crime and Disorder Partnership, Health & Wellbeing Board, and
the Clinical Commissioning Group. Our primary driver continues to be the intention to
reduce alcohol related hospital admissions and to decrease the incidence of alcohol related
crime. The National Drug Recovery Strategy is a key policy and driver of the specialist
alcohol treatment services ensuring a drive towards a full recovery from addiction.
Why we need action
As highlighted previously in this strategy document, Blackpool has a high level of alcohol
related premature deaths and a low life expectancy. The diagrams below demonstrate the
excess mortality for a specific age in Blackpool, and the 20% most deprived areas of
England compared with the national average for males and females. These highlight that
Blackpool residents are on average dying considerably younger than other areas of England;
these are predominantly caused by alcohol and deprivation.
20
Excess mortality compared to all spearhead areas
When the causes of premature mortality are examined further the evidence supports the
theory that the premature deaths are caused by alcohol. The diagrams below show the
causes of these excess deaths highlighting the high level of gastrological disease and
poisonings (drunk/alcohol poisoning).
21
Causes of early mortality on Blackpool
Blackpool is an extreme outlier from the national levels for mortality from chronic liver
disease. The town has held this position for many years, although some areas are moving
towards Blackpool, the town’s position continues to deteriorate. The chart below
demonstrates how Blackpool compares with other areas of England.
22
As a consequence of the poor health and society statistics, the various Blackpool authorities
have invested a lot of time and effort in addressing alcohol harm through a range of
interventions. These interventions may be responsible for a slow improvement in the trend
towards an increasing number of hospital admissions each year.
23
The charts below demonstrate the rapid increase in alcohol related hospital admissions over
recent years with a slowing down of the rate of increase over the last few years; a reduction
from an 18% increase during 2009 to just a 2% increase during 2012.
Number of Alcohol Related Hospital Admissions (NI39)
Blackpool Alcohol Related
Hospital Admissions
3,500
3,000
2,500
2,000
1,500
1,000
500
-
Year
The lower chart demonstrates the monthly alcohol related hospital admissions between
August 2010 and August 2012.
290
270
250
230
210
190
170
150
24
Action
Purpose
Target
Date
Responsible
Increase
awareness of
Foetal Alcohol
Spectrum Disorder
amongst health
professionals by
developing
identification tools
and care pathways
Develop an ‘Every
Contact Counts’
culture across all
agencies
Decrease incidence of
learning difficulties
amongst young people
and ensuring
appropriate care to
those with FASD
Education resource
established.
Pathways published.
September
2016
Children and
Young
People’s
Services
Increase the number of
staff enabled to ask
people about their
drinking, listen, and
refer to the appropriate
service
Reduce incidence of
Foetal Alcohol
Spectrum Disorder and
reduce demand on
social care and support
services for associated
learning difficulties
Reduce primary
accidental fires
12 Awareness courses
per year
March 2015
Public Health
12 Awareness courses
per year
September
2014
Public Health
Blackpool
Teaching
Hospitals
100 contacts per year
March 2014
Lancashire
Fire & Rescue
Increase number of
people able to deliver
IBA in Blackpool
900 trained every year
March 2014
Public Health
Reduce the number of
people drinking at
increasing risk levels.
1000 IBA in community
95% of BVH patients
screened for alcohol use
March 2015
Public Health
Reduce incidence of
Foetal Alcohol
Spectrum Disorder and
reduce demand on
social care and support
services for associated
learning difficulties
95% of patients receive
AUDIT and IBA at first
appointment
March 2016
Blackpool
Teaching
Hospitals
Maintain and build
upon high quality
community treatment
services and improve
Treatment service with
capacity for 1400 clients
per year
April 2014
Public Health
Train health care
professionals in
the effects of
alcohol during
pregnancy on the
unborn child
Carry out fire
safety visits to
alcohol specialist
treatment clients
and install
equipment where
required
Commission
effective IBA
training courses
Commission
services to deliver
IBA as a routine
element of care in
the community and
hospital
Screen all
pregnant women
for last 12 months
alcohol
consumption
behaviour at first
midwife
appointment and
maintain through
pregnancy
Evaluate Horizon
treatment service
and re-commission
service on a
25
Payment by
Results basis
Identify and utilise
a range of
community
locations for
specialist alcohol
services
particularly in
primary care
settings
Review
assessment
processes used by
treatment services
and develop new
assessment if
required, and
include in new
electronic patient
records system
Expand Alcohol
Liaison Nurse
Service at BVH to
be available 24/7
Increase Mental
Health service
awareness and
specialists
working across the
hospital and
community to
support alcohol
services
Continue to
commission
inpatient detox
through the
Lancashire
framework and
review during
15/16
Review inpatient
and community
rehabilitation and
commission the
most effective
interventions
Train Social Care
staff to provide
IBA and refer older
people to
outcomes
Increase accessibility
to treatment in the
locality and decrease
fear of stigma
associated with
seeking alcohol harm
reduction support
10 locations across
Blackpool in addition to
existing clinic sites
April 2014
Public Health
Improve referrals to
most appropriate
service and associated
services such as
Mental Health.
Improved information
recording and sharing
to improve patient
treatment
Implement new
assessment tool
March 2014
Public Health
To provide appropriate
treatment to patients
with alcohol related
health issues and
reduce repeat
admissions
Increase the quality of
life and opportunities to
recovery for those with
a Dual Diagnosis of
alcohol dependence
and poor mental health
Service to include two
staff available 08:0019:00 Mon-Fri and one
available at all other
times
March 2015
Clinical
Commissioning
Group
Increased joint care
coordination to 200
patients per year
March 2015
Clinical
Commissioning
Group
Increase number of
people successfully
stopping drinking
alcohol at high risk
levels through
dependency
120-140 referrals per
year
March 2014
Public Health
Improved long term
abstinence and
improved long term
health outcomes
60 clients per year
March 2015
Adult Services
Reduce Alcohol related
harm, complications
with other medication,
and alcohol related
30% Staff trained
April 2014
Adult services
26
specialist services
accidents
Enable and
support a network
of Peer support
and mutual aid
groups across
Blackpool
Reduce the risk of
dependant drinkers
relapsing
60 sessions per month
March 2016
Public Health
Provide a Night
Safe Haven for
vulnerable people
in the night time
economy to seek
help, report crime,
and recover from
the consequences
of alcohol
Provide a recovery
centre for people
under the
influence of
alcohol to recover
before receiving
medical treatment
Increase home
detox to Blackpool
residents in
preference to
inpatient detox
Establish a facility
to detox in a dry
house when
clients are
unsuitable for
hospital admission
but do not have
suitable support at
home
Provide immediate
appropriate help,
avoiding unnecessary
journeys to BVH and
the police station,
reducing the long term
harm of alcohol
1000 contacts per year
December
2013
Public Health
NWAS
Reduce pressures on
A&E and reduce
assaults at BVH
Service opening at
weekends
January
2014
Blackpool
Teaching
Hospitals
Blackpool CCG
Improved outcomes at
a reduced cost
100 patients per year
March 2016
Public Health
Reduce alcohol related
hospital admissions,
and reduce demand for
inpatient detox,
reducing financial
implications and
improving long term
outcomes
First dry house
established.
September
2014
Public Health
50 temporary residents
of dry house in first year
Evidence Base for Actions
NICE Guidance Public Health
NICE Guidance Clinical Governance
Models of Care for Alcohol Misuse
Local Routes: Guidance for developing alcohol treatment pathways
SIPS alcohol screening and brief intervention (ASBI) research programme
ALSPAC Foetal Alcohol Exposure: Evidence from a Population-Based Birth-Cohort Study
27
Reduce
alcohol
related
anti-social
behaviour
and crime
28
Successes from last strategy
The implementation of Cumulative Impact Policies (Saturation policies) has contributed
towards an overall decrease in violent crime. Other actions since the previous strategy
which have contributed to the reduction in crime include the increased early identification of
domestic abuse, increased use of polycarbonates and the implementation of Public Place
Orders. There has been an increase in visible enforcement activity which has raised
standards of behaviour and contributed towards a decrease in crime and anti-social
behaviour.
National Policy & Drivers
The policy drivers for reducing alcohol related crime and disorder are primarily laid out in
statute and Home Office crime reduction strategies. The constabulary steer has changed
from the Police Authority to the recently elected Police & Crime Commissioner who works in
conjunction with the BSafe Strategy Group.
Why we need action
Alcohol misuse is a major factor in crime, particularly violent crime. It costs Blackpool’s
economy £100.1mn a year, 38mn of which is spent on crime and licensing.
Violence is the most visible form of crime due to alcohol misuse. In the last three years a
minimum of 37% of violent crime has involved alcohol including 48% of rapes, 47% of
domestic violence and 41% of assaults. In the night time economy area alcohol influenced
violent crime increases to 53% and then to 68% between 02:00 and 06:00 hrs.
There has been a numerical but insignificant decrease in alcohol related crime as a whole,
though without a corresponding decrease in alcohol related violence since 2009.
Unfortunately it is the volume that is the issue not the trend. Blackpool is still the worst in
Lancashire for alcohol related crime and nationally for alcohol related issues overall.
The table below shows a breakdown of all crime in Blackpool and what proportion is alcohol
related.
BLACKPOOL (2010-2012)
CRIME
All Crime
Violent Crime
Violence against the person
Sexual Offences
Assaults
Rape
Damage
All Domestic marked
Violence Domestic marked
TOTAL
49406
13473
11092
718
9101
186
8407
5030
4133
Alcohol
7527
5034
4416
204
3725
89
862
2212
1951
% Alcohol
15%
37%
40%
28%
41%
48%
10%
44%
47%
29
The night time economy area in the town centre (14 streets) is responsible for a significant
amount of violent crime which can have a large impact on the feeling of security and can
cost Blackpool significantly. The table below breaks down the 2012 crime in the night time
economy and attributes a cost to this based on Home Office modelled crime costs, the total
cost was £3,403,053.
Blackpool NTE within 14 key streets
Violence against the person
Wounding
Serious wounding
Common Assault
Indecent Assault
Robbery
Number of crimes Home Office Cost
Total
284
£11,782 £2,792,381
13
£10,021
£130,273
12
£24,252
£291,024
64
£11,630
£104,320
1
£35,591
£35,591
6
£8,244
£49,464
£3,403,053
This information is supported by ambulance data. Frequently victims of violent crime phone
for an ambulance or present at A&E instead of the police and recording a crime. The chart
below demonstrates that the North West Ambulance Service responses to the night time
economy peak at the same time as the police responses.
30
Action
Purpose
Target
Date
Responsible
Carry out multi agency
enforcement activity
including test
purchasing for; under
age sales; proxy sales;
and serving to drunks
Maintain a thorough
and robust licensing
policy leading to
revocation and
suspension of licenses
if required
Reduce illegal
sales of alcohol
25 operations per
year
Less than 5%
failure rate
April 2015
Licensing
Responsible
Authorities
Reduce the
number of
irresponsible
alcohol retailers
and protect the
population from
alcohol harm
Reduce the
numbers injured
and killed by road
traffic accidents
caused by alcohol
consumption
Reduce the
numbers injured
and killed by road
traffic accidents
caused by alcohol
consumption
Reduce number
of repeat
complaints
regarding
premises
March 2014
Licensing
Responsible
Authorities
2 Campaigns per
year
December
2014
Police
2 Campaigns per
year
December
2014
Police
Reduce alcohol
related crime
70% successfully
complete
treatment
April 2014
Public Health
Police
Increase selfawareness and
implications of
actions.
Reduce number
of rapes
12 courses per
year
March 2014
Public Health
Police
Reduction year
on year
March 2015
Police
Public Health
Provide
immediate
appropriate help,
avoiding
unnecessary
journeys to BVH
and the police
station, reducing
the long term
harm of alcohol
1000 contacts per December
year
2013
Carry out regular drink
drive campaigns
through marketing and
enforcement
Carry out regular
alcohol and road use
campaigns for
pedestrians and
cyclists through
marketing and
enforcement
Maintain an ‘ondemand’ Criminal
Justice Alcohol
Treatment Service
Introduce alcohol
awareness courses as
alternative to fixed
penalty notice
Raise awareness and
increase resilience
amongst women in
relation to alcohol and
sexual intercourse
without consent
Provide a Night Safe
Haven for vulnerable
people in the night time
economy to seek help,
report crime, and
recover from the
consequences of
alcohol
Reduction in
alcohol RTAs
Public Health
NWAS
31
Carry out consultation
and introduce Early
Morning Restriction
Orders (EMROs) in the
central
district
Continuously review
and consider new
Cumulative Impact and
Saturation policies for
on and off premises
licenses
Provide training
courses to magistrates
to promote Alcohol
Treatment Requirement
awareness
Evaluate the
effectiveness of Public
Place Orders and areas
of potential use across
Blackpool
Increase use of
Dispersal Orders,
Penalty Notices,
Inspector’s Caution,
and Conditional
Cautions
Establish Responsible
Authorities Group
meetings
Joint police, trading
standards, and HMRC
operations to seize
illicit alcohol supplies
Increase public
involvement in
licensing decisions by
making it easier for the
public to read
Reduce the
availability of
alcohol late at
night, reducing
alcohol harm and
anti-social
behaviour and
crime
Reduce alcohol
related crime and
(subject to
legislation alcohol
related health
harm) through the
reduction in
number of outlets
in target areas
Increase the
number of ATR
orders issued by
magistrates and
reduce alcohol
related crime
Reduce street
drinking
Introduction of
one EMRO in first
instance
December
2013
Police
Council
Annual review
December
2014
Licensing
Responsible
Authorities
2 training courses
per year
December
2014
Probation
Complete
evaluation
September
2014
Police
Council
Reduce antisocial behaviour
and crime
Reduce
reoffending
December
2013
Police
Council
Coordinate
responsible
authority activity
and provide
training
opportunities and
share good
practice to ensure
all authorities
operating at best
practice levels
Reduce
availability of
harmful and illegal
alcohol
Establish group
to meet 6 times a
year
April 2014
Licensing
Record and
publish quantity
seized
March 2015
Police
Trading
Standards
Increased quality
of life for
residents in local
communities
50 public
involvements per
year
March 2015
Licensing
32
applications and to
object and to raise
requests for license
reviews
Evidence Base for Actions
Local Routes: Guidance for developing alcohol treatment pathways
Government Alcohol Strategy 2012
Home Office Guidance
National Treatment Agency: Drug Intervention Programme
Alcohol controlled purchase operations performance report
World Health Organization – Road Safety (Alcohol)
Safe Haven Bus – Alcohol Learning Centre
33
Improve
Blackpool’s
cultural attitude to
alcohol, providing
a safe, enjoyable
and sustainable
environment for
visitors and
residents to
improve the town’s
economy
34
Successes from last strategy
Since the publication of the previous strategy the pubwatch scheme has expanded its
geographical area and increased its activity to reduce alcohol related disorder, increased
sharing of information of good practice and worked with police, council and the NHS to
deliver information campaigns. The altn8 project has been expanded across the night time
economy and a new modr8 home drinking units awareness campaign has been launched
with the support of retail and workplaces.
National Policy & Drivers
The 2012 Government Alcohol Strategy clearly lays out an intent to change the culture of our
attitudes towards alcohol through a range of measures. This is supported by a drive for an
increased responsibility by all in the community in which we live. A Lancashire wide Scrutiny
Committee during 2010 highlighted key areas for improvement which have contributed
heavily to this strategy’s priorities, these include:




the introduction of a Minimum Unit Price
a ban on multi-buy deals
an increase in education and
a restriction on advertising.
This element of the strategy is a key component for the successful delivery of the Blackpool
Core Strategy.
Why we need action
The financial burden of alcohol in Blackpool has been assessed and published in ‘The Cost
of Alcohol to the North West Economy’ report which estimates that alcohol abuse costs
Blackpool £100.1m a year. This amounts to £715 per resident, and is the highest in England,
with Manchester having the second highest cost at £536; considerably lower. The chart
below demonstrates how Blackpool’s financial burden of alcohol compares with other areas.
800
Expenditure per head (£)
700
600
500
400
300
200
100
0
35
The quality of health is determined by a range of factors, not just infectious diseases and
toxic substances such as alcohol, it is also affected by wider determinants such as
education, housing, employment and many other factors. Many of these determinants in
Blackpool are below the national average. There are few subject areas which are affected
more by these wider determinants than alcohol related poor health. The diagram below was
developed by Dahlgren and Whitehead to demonstrate how wider determinants have an
impact on health and behaviour.
Diagrammatic representation of the wider determinants of health, Dahlgren and Whitehead
Action
Purpose
Target
Date
Responsible
Develop training
courses and
professional status for
staff selling alcohol
Reduce illegal and
irresponsible sales, and
develop safe
environments for
people to socialise
3 courses per
year
March 2016
Licensing
Responsible
Authorities
Change in licensing and
planning policy to
promote development of
non-alcoholic alternative
entertainment
Increased family
attractions and a
change away from
alcohol as the main
financial income
March 2016
Built
Environment
Council wide
recognition
scheme
established
Change in
policy
Increase
proportion of
non-alcohol
venues
Responsible
Licensing
Authorities
36
Support national alcohol
harm reduction
campaigns with local
intelligence led altn8,
modr8 and other
campaigns via a range
of media including print,
broadcast, web, social
media and alternative
marketing
Establish an Alcohol
Policy Steering Group
through a public sector
partnership and employ
a manager to coordinate
the work of the group
Increased awareness
of alcohol harm, where
to go for help and to
decrease numbers
seeking alcohol
treatment.
4 major
campaigns per
year
March 2014
Public Health
BSafe
To provide a clear, high
level joined up strategic
lead in relation to
alcohol policy
Establish a
steering group
to meet
quarterly
December
2013
Public Health
Council CEO
Office
Employ an Alcohol
Officer to carry out
community engagement
To provide education
and support to
communities and raise
their awareness of
alcohol harm whilst
listening to their
concerns and helping
form policy
Decrease alcohol harm
and increase
awareness of services
available to reduce
consumption
2000 contacts
with members
of the public
and
employees per
year
April 2013
Public Health
Publish policy
75% staff
awareness
50% patient
awareness
1 campaign
per year
April 2015
Blackpool
Teaching
Hospitals
Increase alcohol harm
awareness and help
address the culture of
alcohol normalisation
10 new
champions per
year
March 2014
Public Health
Increase community
involvement in
addressing alcohol
harm
Improve quality of staff
serving/selling alcohol,
and reduce harm
through inappropriate
sales
4 partnerships
March 2016
Public Health
4 courses per
year
September
2015
Licensing
Public Health
Develop and implement
a trust wide
communication plan for
staff, patients, and
visitors at the hospital
and community,
including campaigns
and health mentors
Identify a senior level
champion to maintain
alcohol harm reduction
on the agenda of all
public sector
organisations and
promote their adoption
in the private sector
Develop Community
Alcohol Partnerships
Deliver training to
licensees who breach
licensing conditions
prior to reinstatement of
license or staff are
permitted to serve
alcohol again
Fully implement
Selective Licensing
across target areas to
Improve living
conditions of individuals
and improve health,
37
include support
(including IBA) to
individuals in HMOs
reconnect families and
friends.
Ensure soft drinks are
available cheaper than
alcohol in licensed
premises
Provide consumers
with a reasonable and
fair choice to choose an
alternative to alcohol,
helping individuals
reduce their alcohol
consumption if they
choose.
Reduce alcohol related
road traffic accidents
Reduce the overall
volume of alcohol
consumed and reduce
alcohol harm
Reduce alcohol harm
amongst council staff,
reduce sickness and
provide support where
necessary
Increase employability,
improved health of staff
and improved local
economy
Increase alcohol harm
awareness amongst
Blackpool employees
and reduce alcohol
harm, increasing
productivity
Decrease alcohol
related crime and antisocial behaviour,
prohibiting known
trouble makers from
gaining access to
Blackpool licensed
premises
Improve and support
legislation compliance.
Decrease alcohol
related crime and antisocial behaviour,
improve academic
attainment, and reduce
harm to health.
Continue to advocate for
Minimum Unit Pricing
through legislation
Develop and implement
a council wide Healthy
Workplace Policy
Use council policy to
develop support and
materials for other
workplaces
Facilitate the adoption of
the Healthy Work Award
Support Pubwatch to
ensure safety of
customers and raise
professional standards
of industry
Establish Off-license
responsible traders
forum to ensure safety
of customers and raise
professional standards
of industry
Increase the number and
variety of
establishments in the
twilight time economy
Provide consumers
with an alternative to
alcohol consumption for
an early evening’s
75% of pubs
complying
March 2016
Licensing
Trading
Standards
Public Health
National
Legislation
September
2014
Public Health
Publication
March 2014
and
implementation
of policy
Public Health
Council CLT
Publication
March 2015
and
implementation
of resource
25 employers
March 2014
Public Health
Council
6 meetings per
year with over
75 attending.
Deliver one
harm reduction
campaign per
year
September
2014
BID
Public Health
Establish at
least one
forum with
regular
meetings, to
include
independent
and multiple
retailers.
10 new venues
March 2015
Responsible
Licensing
Authorities
March 2015
Council
Public Health
38
(entertainment venues,
shopping, restaurants,
coffee shops)
entertainment and
socialising.
Reduce alcohol harm
Evidence Base for Actions
Local Routes: Guidance for developing alcohol treatment pathways
Government Alcohol Strategy 2012
Home Office Guidance
Department of Health Alcohol Social Marketing Toolkit
Does minimum pricing reduce alcohol consumption? The experience of a Canadian
province.
Alcohol Pricing and Promotion: Modelling the Potential Impact of Pricing and Promotion
Policies for Alcohol in England: Results from the Sheffield Alcohol Policy Model
Review of Community Alcohol Partnerships: Alcohol Learning Centre
Alcohol and the workplace: Institute of Alcohol Studies
39
Provide a safe
alcohol-free
environment for
children and
empower young
people to make
informed
decisions in
relation to
alcohol.
40
Successes from last strategy
Test purchasing activity since the publication of the previous strategy has increased
dramatically, resulting in a 100% deny to serve rate during 2012. The standards of premises
have increased significantly despite challenging financial climate due to the multi agency
visits.
The Hub young people’s treatment service has expanded and continued to increase the
quality of outcomes and, during 2012 took responsibility for 18-25 year olds entering
treatment as their service model has proven more effective for their drug and alcohol use
patterns. PHSE tools and guidance have been developed alongside the use of programmes
to prevent young people drinking alcohol and to provide support to children who have people
drinking excess alcohol in their home. The Alcohol Officers have provided training and
support to young people in the community, schools and colleges.
National Policy & Drivers
Key drivers for this area of work are the Children’s Plan and the Blackpool Children & Young
People’s Plan. The 2012 Government Alcohol Strategy and the Blackpool Core Strategy are
also key drivers.
Why we need action
In the 2012 SHEU survey 2% of boys and 4% of girls in year 4 and 6 (aged 8 & 9 and 10 &
11) said they had drank an alcoholic drink in the last week. 82% of pupils in years 4 and 6
said they don’t drink alcohol and 4% reported that their parents never, or only sometimes,
know they drink alcohol.
13% of year 8 and 27% of year 10 pupils said they drank alcohol at least once in the week
before the survey. 8% of them said they were drunk at least once in that week. 2% had
bought alcohol at a supermarket and 4% from an off-license. When asked the main reason
for their drinking alcohol, 63% of drinkers said it was often or always to socialise and have
fun, and 36% said it was to get drunk.
In Blackpool 51% of adults in alcohol treatment services report to be parents. Of these 35%
live with children. 22% of the treatment population are parents but do not have children
living with them.
41
Action
Purpose
Target
Date
Responsible
Establish group to
develop a ‘Promotions
and Advertising’ code of
practice; and implement
code through planning,
licensing, marketing
media companies, and
by working with the
industry
Reduce and regulate
marketing for alcohol
products seen by
young people to delay
the ‘age of first
alcoholic drink’ and
allow more time for
alcohol harm
awareness knowledge
to be gained
Code of
Practice
published and
implemented
December
2014
Public Health
Council CEO
office
Put young people at the
centre of future
Licensing Policy
Statements
Increase public, health
workers, and education
workers awareness of
symptoms of Foetal
Alcohol Spectrum
Disorder
Reduce availability of
alcohol to young
people
Incorporate
April 2015
Young People
consideration in
policy statement
2 campaigns
March 2014
per year
Licensing
Promote a range of
activities for young
people to participate in
during times of rest and
free time
Develop an alcohol harm
awareness programme
for Key Stage 2 and Key
Stage 3 to be used in
schools and youth
groups to be used as a
framework for PSHE
Provide a structured
alternative to avoid
consuming alcohol
amongst young
people
Raise awareness of
alcohol harm to self,
the community, and
internationally with the
aim of young people
understanding all
implications of
drinking alcohol.
Publish web list
March 2014
Children’s
Services
Publish and
implement use
of programme.
September
2013
Public Health
Children’s
Services
School nurses
Material to be
used by 75% of
schools
July 2015
Introduce Foetal Alcohol
Spectrum Disorder
education to young
people at school
Increased awareness
to encourage
responsible
abstinence from
alcohol during
pregnancy later in life
Raise awareness of
alcohol harm to young
people and reduce the
numbers of young
people drinking
alcohol.
All Secondary
schools to
deliver
education
September
2015
Children’s
Services
School nurses
2 campaigns
per year
March 2015
Public Health
Children and
Young people
School nurses
Reduce availability of
alcohol to young
people
25 operations
per year
Less than 5%
failure rate
April 2015
Licensing
Responsible
Authorities
Develop targeted
dynamic social
marketing alcohol harm
awareness campaigns
aimed at young people
Carry out multi agency
enforcement activity
including test
purchasing for; under
age sales; proxy sales;
and serving to drunks
Early identification of
Foetal Alcohol
Spectrum Disorder
and improve
opportunities for the
children
Children and
Young People
42
Provide targeted alcohol
treatment to all families
in need
Reduce alcohol
related negative
impact upon families
and reduce family
breakdown
All families are
offered a
targeted service
and a 25%
increase in
uptake of
services
March 2015
Children and
Young People
Public Health
Employ two Hidden
Harm Workers working
with parents and
children
Reduce the number of
children harmed by
parental drinking and
improve children’s
achievements and
health.
Reduce premature
inappropriate
introductions to
alcohol amongst
young people, whilst
supporting those who
are drinking
themselves or are
effected by others
consumption of
alcohol
Provide early
intervention treatment
for young people
drinking alcohol or at
risk of drinking to
reduce alcohol harm
and dependence
Monitor drinking habits
of young people to
inform policy and
ensure demand is met
Secure
continued
funding
March 2014
Children and
Young People
Publish and
implement
policy with 95%
school
adoption
September
2014
Children’s
Services
200 Clients per
year
March 2014
Public Health
One research
project in 5
schools each
year
September
2014
Trading
Standards
Reduce the number of
children harmed by
parental drinking and
improve children’s
achievements and
health.
Admission to
scheme
September
2013
Children and
Young People
Develop a Schools and
Education
Establishment Alcohol
Policy to be adopted
across Blackpool,
addressing education,
consumption, behaviour,
culture, and
normalisation
Commission specialist
Young People’s alcohol
treatment services
Commission Trading
Standards North West’s
young people’s drinking
habits research
Seek to take part in the
Children’s Commission
‘Supporting Children of
Parent’s Drinking
Project’
43
Evidence Base for Actions
Local Routes: Guidance for developing alcohol treatment pathways
Government Alcohol Strategy 2012
Home Office Guidance
Department of Health Alcohol Social Marketing Toolkit
NICE Public Health Guidance
North West Trading Standards, Tobacco and Alcohol Use Annual Report
Nice Guidance Clinical Guidance
The normalisation of alcohol: Scottish Health Action on Alcohol Problems
Alcohol controlled purchase operations performance report
ALSPAC Foetal Alcohol Exposure: Evidence from a Population-Based Birth-Cohort Study
44