Agenda item

Report ES 16069

 

The report was written by Dr Agnes Marossy (Consultant in Public Health) to provide information about alcohol abuse in Bromley. Members of the Committee were asked to consider and comment on issues outlined in the report.

 

The Committee heard that alcohol related harm was determined by:

 

·  The volume of alcohol consumed

·  The pattern of drinking

·  The quality of the alcohol consumed

 

The ‘mechanisms of harm’ were explained as:

 

·  Toxic effects on organs and tissues

·  Intoxication

·  Dependence

 

The Committee was informed that the factors affecting alcohol consumption and alcohol related harm were age, gender and familial risk factors. Drinking behaviours were classified in three ways—lower, increasing and higher risk. Classification could also be undertaken by virtue of the degree of dependence.

 

Dr Marossy explained that recent data collected from GPs indicated that only 42.2% of individuals had been asked about alcohol consumption over the last three years, so it was not really possible to draw definite conclusions about alcohol consumption in Bromley. Members looked at statistical data that showed that the number of people consuming alcohol over the recommended weekly limit was least in Darwin Ward, and greatest in the Hayes and Coney Hall Ward. There was no local data for Bromley on binge drinking. It was the case that young people aged 16-24 were more likely to consume more than the recommended weekly limit of alcohol in one day. 

 

The Committee were concerned to hear of the conditions for which alcohol was a causal factor:

 

·  Various cancers—mouth, throat, stomach, liver and breast cancer.

·  Cirrhosis of the liver

·  Heart Disease

·  Depression

·  Stroke

·  Pancreatitis

 

Alcohol abuse was also linked to mental health issues and suicide.

 

The Committee was concerned to learn that excessive alcohol consumption was a major cause of premature death. Liver disease was one of the leading causes of death in England, and people were dying from it at younger ages. The rate of alcohol related hospital admissions was increasing at national, regional and local levels, but the rate remained lower in Bromley, than for London and the rest of England. The Committee noted that excessive alcohol consumption had socio-economic impacts which included harm to individuals, and harm to society at large. Members were also briefed on the treatment and management of alcohol misuse.

 

The Committee was informed that in Bromley, many of those requiring structured treatment for alcohol misuse were in regular employment (37%). This compared favourably with the national figure which was 29%. It was also noted that in Bromley, more individuals were commencing treatment with housing problems than in other parts of the country. 

 

The Committee was dismayed to learn of the financial burden imposed upon the UK as a result of alcohol abuse which was £21bn. Some positive news was that the number of alcohol specific admissions involving the under 18s was reducing. Dr Marossy explained that there were three different types of prevention which were:

 

·  Primary—consisting of Education and Licensing

·  Secondary—consisting of early detection and screening

·  Tertiary—consisting of treatment services

 

It was generally a good thing if individuals received treatment for a period of six months, as three months was generally considered too short to successfully complete the course of treatment.

 

With regard to individuals accessing the service for harm reduction only (not dependent drinkers):

 

•  Between July 2015 and June 2016, there were 74 individuals drinking at higher risk levels who received support from the service.

•  Of these 64.9% were male and two thirds were between 35 and 54 years of age.

•  Many of this group had stable backgrounds, i.e. stable housing (75.7%), a stable employment situation (44.6%), and no identified safeguarding issues (51.4%).

•  Referrals were mainly from the GP (37.8%) or self-referrals (31.1%).

 

Dr Marossy explained that a strategic review of alcohol services in Bromley was being undertaken. This review would use the ‘CLeaR’ Framework. ‘C’ referred to the process of Challenging local services that delivered interventions to prevent or reduce alcohol-related harm.

 

‘L’ referred to ‘Leadership’ – this domain considered the extent to which strategic leadership was supporting comprehensive action to reduce alcohol harm. It looked at local structures and arrangements to assess whether commissioning decisions were informed by a robust understanding of local need and to evaluate the strength of partnership working, and the governance structures underpinning this. R referred to ‘Results’– this domain looked at the data used locally to evidence the outcomes delivered by the partnership against national and local priorities and would reflect on emerging local trends.

 

The Committee heard that the key to successfully dealing with alcohol abuse in LBB was to actively involve all relevant partners which were identified as:

 

·  Elected Members

·  Local Authorities

·  Public Health

·  Health and Wellbeing Boards

·  CCGs

·  Primary Care

·  Hospitals

·  Treatment Services

·  Mental Health

·  Police

·  Courts, Prison and Probation Services

·  Children and Family Services

·  Housing Support

·  Job Centre Plus

·  Voluntary Sector

 

Any member of the Committee that would like to visit Bromley Drug and Alcohol Service (BDAS) were advised to contact Jonathan Williams, Service Manager.

 

Jonathan.Williams@cgl.org.uk

 

The Chairman asked Dr Marossy what she thought about the changes in the law that permitted 24 hour consumption of alcohol in the UK. Dr Marossy responded that this was a difficult issue to contain if the police were not objecting to Licensing applications, and noted that there was no Public Health element in the legislation. It was difficult to assess the impact of 24 hour drinking as there was a different drinking culture in the UK compared with the rest of Europe.

 

A Member enquired if there was a plan or strategy that was being developed in relation to Town Centre drinking.  Dr Marossy responded that this was the remit of Licensing and not Public Health. Drinking was not illegal, and it did create jobs and stimulate the night time economy, so a balance was required. The police could look at how to deal with crime and physical violence. 

 

The Chairman considered that Planning was an important issue to consider, and that planning permission should not be given for too many vertical drinking establishments; she felt that a café type culture should be encouraged. A member expressed the view that many publicans were now going out of business. Dr Marossy mentioned that people were making their own choices—alcohol was cheap to buy and many people were now choosing to drink at home.

 

A member referred to the Alcohol Reduction Programme and asked what sort of follow up was undertaken, as it was crucial to see if the interventions undertaken were successful or not. Dr Marossy agreed that the outcomes were important, but this data was not available on the night. 

 

A member asked how accurate the data was as many people underestimated the amount of alcohol that they consumed. Dr Marossy noted the point and stated that there was an issue around data collection, as many people did not understand what was meant by units of alcohol.

 

The Chairman asked if the School Alcohol Education Programme was effective. Dr Marossy answered that this was difficult to assess, but it was the case that fewer hospital admissions were being reported. The Chairman was concerned to note that there was an issue concerning the consumption of alcohol by pregnant women, and enquired if there was any sort of education in place to help with this. Dr Marossy advised the Committee that some help and advice was offered at the time of ante-natal screening.

 

The Vice Chairman asked if reduction in alcohol strengths was beneficial. Dr Marossy felt that this could have the effect of slight reductions in risk, and would support continued reductions.

 

It was suggested that Bromley Youth Council may like to consider the topic of alcohol abuse for a future campaign.

 

 

RESOLVED that the report on Alcohol Abuse in Bromley be noted.