Local Authorities' Strategies Against Alcohol Abuse Does Not Address Whole Spectrum of Harm

A review of local authorities’ strategies to improve health and wellbeing in their local population has been found to be inadequate to fully address the impact of alcohol abuse in their community.

The review follows the transfer of public health responsibility from primary care trusts to local authorities. Researchers looked at the Joint Strategic Needs Assessments (JSNAs), the Joint Health and Wellbeing Strategies (JHWSs) and Clinical Commissioning Group (CCG) strategies of 25 local authorities. Fifteen were from the top 25 authorities in the country for alcohol-related harm along with five each from the middle and lowest ranked authorities.

The survey sought to uncover whether the impact of alcohol was being recognized and prioritized by newly empowered local authorities and whether action plans reflected need. It found that while all of the JSNAs, JHWSs and many of the CCG plans did address alcohol, the attention to alcohol as a pressing health issue with far reaching implications varied greatly. Many of these suites of documents appeared unlikely to meet the Public Health England (PHE) recommendation that JSNAs have a “comprehensive section on alcohol-related harm.”

There is also reliance on hospital admissions data as the predominant indictor of local need. While this is clearly a key area of concern and a useful way of understanding the impact of alcohol-related harms, it’s important to recognize that there is a much wider impact from alcohol misuse. This needs to be recognized if all of the issues are to be fully addressed.

Eric Appleby, Chief Executive of Alcohol Concern said, “It’s really encouraging to see that all the local authorities we looked at address alcohol in some form but it’s worrying that for many alcohol harm received only a brief mention rather than a comprehensive section. Alcohol misuse has a huge impact on local communities not just at the hospital or doctors. It ranges from health to crime and disorder, affects older people as well as young people, it impacts on families and social services as well as the look and feel of the high street.”

He went on to say, “It’s vital that local authorities recognize all of these impacts in order to create joined-up strategies to address them. We need to see clear prioritization for both treatment and prevention services, responsibility must not be allowed to fall between the gaps of local bodies remits”

There are eleven recommendations from the review, including the four below:

1)    Directors of Public Health should ensure that JSNAs contain a “comprehensive section on alcohol related harm.”

2)    JSNAs should consider the impact of alcohol on sub-groups within the local community, for example different wards, ethnic and language communities, people with mental health problems, unemployed people, offenders, women who have been the victims of abuse.

3)    Directors of Public Health and CCG Chairs should ensure that, in considering alcohol treatment, the strategic process considers the client’s care pathway through treatment and states clearly responsibility for each step.

4)    In areas with lower comparative harms JSNAs, strategies and plans should reflect the actual impact that alcohol is having. In England even the lowest risk areas will have considerable harm from alcohol.

It’s hoped the review will help other local authorities develop suitable strategies for dealing with alcohol harm within their own population.

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The program, which uses a dual approach of medication and one-on-one life coaching, is now being used in many alcohol and drug addiction clinics in the U.S. The life coaching portion of the program is tailored to the specific needs of the alcoholic to help him or her plan for an alcohol-free life. It differs from the usual “rehab” approach, as it is conducted in a series of private sessions that involve only the patient, the life coach and in some cases, an accompanying recovery partner such as a friend or family member.

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