Agenda item

Report and Presentation of the Corporate Director of Adult and Health Services and the Director of Public Health, Durham County Council.

The Board received an update report on reducing alcohol harms within our local communities as part of one of the four Joint Local Health and Wellbeing Strategy priorities (for copy of report see file of minutes).  The report was accompanied by a presentation, given by Rachel Osbaldeston, Public Health Advanced Practitioner and Sue Taylor, Head of Alcohol Policy, Balance.

The Public Health Advanced Practitioner noted the key findings from Office for National Statistics (ONS), with the North East having the highest rate of alcohol-specific deaths of any English region in 2022, 21.8 deaths per 100,000, 32.8 percent greater than the last pre-pandemic rate in 2019 of 11.8 deaths per 100,000.  She noted that therefore it was important to look how we would tackle that increase and look at groups being disproportionally impacted, such as men, as well as how the alcohol industry was marketing their products, such as the rise of alcoholic drinks being aimed towards young women.  The Board noted that County Durham was not an outlier in terms of alcohol related mortality rates within the North East, however, it was noted that the county was more rural in nature when compared to other parts of the region.

The Public Health Advanced Practitioner explained that the new Combating Drugs and Alcohol Partnership (CDAP) was set up across County Durham and Darlington, chaired by the Police and Crime Commissioner, and had many partner organisations feeding information into this partnership.  She noted that one aspect was for each organisation to look at their internal culture and it was noted that phrases such as ‘it’s wine o’clock’ or ‘Friday night, drinks night’ reinforced alcohol consumption as a norm, and partner organisations needed to be ‘on the same page’.

The Public Health Advanced Practitioner explained as regards ‘making every contact count’ training and work with the Alcohol Care Teams within the NHS Trusts in County Durham and Darlington and Tees, Esk and Wear Valley. 

She added it was important to recognise that addiction was a condition, and not ‘a choice’ and to tackle that image, and other stereotypes such as ‘they can’t handle their drink’, those not capable being perceived ‘weak’.  She added that when people were admitted into hospital, this was often a good opportunity for intervention, with people often more receptive to the idea of change when they are feeling most effected by the issue.  It was noted that online drink coaches were working very well, with many people preferring that approach rather than face-to-face meetings, with some being reluctant to be seen attending services that also dealt with drug misuse.  The Public Health Advanced Practitioner added that with alcohol harm being such a large issue, it was placed front and centre, with progress having been made over the last 18 months.

The Public Health Advanced Practitioner noted that a recent World Health Organisation report had shown that young people were consuming less alcohol that previous generations, however, we still saw a lot of harm to children and young people from alcohol, with the impact in the UK being much greater than in the EU.  She added there was a focus on children and young people, noting the work of the Police in terms of alcohol seizures, and support offered to young people.  She noted that the impact of the pandemic on the economy had impacted disadvantaged communities more and explained that minimum unit pricing (MUP) could still be an option to help reduce alcohol harms.  She concluded by noting that the challenges for the Health and Wellbeing Board included: how do we support the wider system to engage in addressing health behaviours to help reduce alcohol harms; is MUP one of the solutions; and where do we go next to reduce alcohol harms.

The Head of Alcohol Policy, Balance noted that alcohol harms were at record levels not imaginable ten years ago.  She noted the work of Balance and reminded the Board that it was funded through the seven North East Local Authorities and the North East Combined Authority (NECA).  She added that alongside campaigns and interventions, Balance also lobbied Government, similar to how FRESH had lobbied in terms of tobacco harm.  She reminded the board that Minimum Unit Price (MUP) had been introduced in Scotland in 2018, with a number of evaluations of the impact in Scotland showing reduced consumption and reduced number of deaths.  She explained as regards the amount of prominent advertising in relation to alcohol, such as in the promotion of football, as well as within shops, bus stands and on television.

The Head of Alcohol Policy, Balance explained that there were different approaches that could be taken by the Local Authority, an example being in terms of the Licensing Act and the County Durham Licensing Policy, in terms of looking at MUP in certain areas. 

She added that while it was guidance, it would not be enforceable, however, she felt it was something all North East Local Authorities should adopt.

In respect of campaigns, the Head of Alcohol Policy, Balance noted two main campaigns were undertaken each year, noting the last campaign having reached around six out of ten people, helping to sow the seeds of change.  In respect of MUP she reiterated as regards local MUP, however, acknowledged that the greatest benefits would be found from a national introduction of a MUP. 

J Pearce noted the differential impact upon disadvantaged communities and noted many young people within social care often had a poor quality of health, as noted in respect of oral health previously discussed.  He explained it was important to come together to work to overcome the overarching inequalities that compounded such issues, noting the figures relating to 15 years olds and experimentation with alcohol were particularly stark. 

The Chair asked if Assistant Chief Constable R Allen could speak as regards the impact of alcohol from a Police perspective.  Assistant Chief Constable R Allen noted that in 2023/24 there had been around 27,500 alcohol related incidents attended by Durham Constabulary.  He added incidents could vary in nature, from some incidents involving violent confrontations between young people in our parks to domestic violence.  It was noted that the Police saw a lot of combined drug and alcohol use and there was a lot of work picked up by the Police, working alongside partners in County Durham and Darlington.

F Jassat noted that a lot of the prevention work was very good, and akin to fluoridation, there was a cost/benefit analysis to look at the cost of such preventative work and the cost to Local Authorities, the Police, Fire Service and the NHS.  He noted it was important to see where we were saving, to help convince all partners of the benefits of that work.  J Pearce added that, as noted within the presentation, it was also about a shift in culture as regards the acceptability of alcohol at levels that caused harm.  He noted there had been a lot more work undertaken in terms of tobacco harms, with most people understanding the risks and harms, while people were less knowledgeable as regards similar harms from alcohol.  He added the question was how to get to the same position for alcohol that we had reached for tobacco.

Councillor R Bell noted the established link between alcohol harms and deprivation; however, he recalled information presented at the Adults, Wellbeing and Health Overview and Scrutiny Committee that levels of excess alcohol consumption were higher in Teesdale than Easington. 

He noted that while there was a need to focus upon areas of acute incidents, we should not lose sight of the wider impact of general excess consumption, for example of wine, throughout our communities. 

He noted the links between alcohol production and climate change, through CO₂ production, and the impact of cheap alcohol sales on offer within UK supermarkets.  The Chair noted the opportunity to link the issue through the green agenda.

The Head of Alcohol Policy, Balance noted national research had shown that around 1 million people drank more than the recommended levels, and therefore while there were targeted interventions in areas with the most harm, the wider issue of too much consumption would not be forgotten.  The Public Health Advanced Practitioner noted it was important for people to be mindful of their alcohol intake, with the ‘DrinkCoach’ app helping people to assess the impact upon their own health.

The Director of Public Health thanked the Officers for their report and presentation and noted that while MUP had been off the table for the time being, there was continued work with Sheffield University in terms of the data demonstrating the potential positive impact of MUP.

Resolved:

(a)     That the content of the report and presentation be noted;

(b)     That the reduction of alcohol harms within the community be maintained as a key priority of the Health and Wellbeing Board as an ongoing action;

(c)      That a system-wide, population health management approach to engage with those individuals who are alcohol dependent to access support be encouraged, starting with an effective conversation undertaken by health and social care professionals followed by a referral into the Drug and Alcohol Recovery Services (DARS);

(d)     That the impact of Dame Carol Black funding on the rates of Successful Completions for alcohol seen within the DARS be monitored and recognise the potential for implication if the funding is withdrawn after 2025/2026.

(e)     That the Health and Wellbeing Board continue to support lobbying in respect of Minimum Unit Pricing (MUP).