Alcohol in Blackpool Stephen Morton Alcohol Harm Reduction Policy Officer NHS Blackpool

The Social Impact Alcohol related crime Violent crime Street drinking Domestic abuse Hen/Stag Nights Litter Anti Social Behaviour Unemployment claimants Family breakdown Deters visitors returning

The Health Impact Highest number of months of life lost attributable to alcohol Highest number of alcohol specific mortality Highest rate of mortality from chronic liver disease 26 th highest number of alcohol attributable hospital admissions Sexual health impact

The Statistics

Targets Performance Completions for inpatient and domiciliary detoxifications Completions in alcohol counselling course and successful discharge Training in Brief Interventions Number of licensees, licensing and Magistrates trained in alcohol harm reduction Number of Underage sales (test purchase) Increasing the amount of licencing reviews submitted Number of off-licences (Revocations achieved)

Commitment Strong sense of commitment to the agenda by all key public sector organisations Evident commitment and engagement at senior officer and membership level of Blackpool Council, NHS Blackpool and Lancashire Constabulary with respect to alcohol harm reduction exemplified by the arrangements for BSafe Blackpool Lots of enthusiasm and passion in relation to reducing alcohol harm in Blackpool Alcohol Harm Reduction has been included as one of the top World Class Commissioning priorities by NHS Blackpool

Commitment NHS Blackpool has agreed investment of £1m in alcohol initiatives in , and the following year with an intention to increase investment from 2009/10. Created a small multi-agency team focused on Alcohol Harm based at NHS Blackpool There has been national recognition for the ALTN8 campaign for the partnership of NHS Blackpool, Blackpool Council, the Lancashire Constabulary and the Fire and Police Authority – with further plans being prepared.

Partnership Working There are Joint Commissioning arrangements for community services There are good examples of collaboration between BFW Hospitals NHS Foundation Trust and NHS Blackpool and NHS Blackpool’s Medical Director and DPH regularly attend BFW Hospital’s Clinical Directors meeting. At operational level there are examples of good nationally recognised partnerships, eg Multi Agency Risk Assessment Committee (MARAC) and NightSafe.

Progress Workforce Training This is the second year of a programme to train front line staff in brief interventions. 850 staff were trained last year. Secondary Care Resources have been committed and two alcohol liaison nurses appointed to work in the Gastroenterology Department within the BFW Hospitals NHS Foundation Trust There is an intention to appoint a Public Health facilitator who will have public health champions and link personnel across departments in the BFW Hospitals NHS Foundation Trust. The work of the facilitator will be informed by phase one of a training needs analysis across the Trust. A substance misuse mid-wife works across the BFW Hospitals NHS Foundation Trust and is focused on high need areas. There is a generic Paediatric link between A&E and the acute inpatient wards which provides opportunities for screening and brief interventions with respect to alcohol. There is routine data sharing between the A and E Department and BSafe Blackpool through the Trauma and Injury Intelligence Group (TIIG).

Progress Primary Care Investment in Tier 2 workers in primary care. Specific outreach services to recruit hard to reach groups into treatment services Three new Primary Care Centres are planned, to incorporate Alcohol Services, with plans for an Urgent Care Centre providing potential to integrate alcohol interventions Intensive support programme for homeless people ‘The Bridge Project’. This includes health professional clinics with the ability to pick up and provide interventions with respect to alcohol misuse. Children and Families Multi-agency Springboard team which focuses on 5% of the most complex families, with opportunities to pick up alcohol issues. Easy access to and clear pathways for young people with substance misuse issues with little waiting time. This service is offered up to the age 21 for existing service users. Children of substance misuse parents ‘Cosmic’ programme.

Overall Strengths Licensing and the Criminal Justice System There is a robust commitment to enforce legislation and adherence to the Licensing Act by the Police and Trading Standards. Blackpool has the highest number of prosecutions in the country for Licensing breaches, with a targeted and systematic approach by the Council in conjunction with the Police and other partners. This is complemented by a number of enabling schemes including training for Licensees and Door Staff, regular mail shots, Proof of Age Cards and Forums for both on and off–licence premises. An arrest referral function is in place to divert young people with alcohol problems into treatment from the Criminal Justice system Head cameras have been introduced for the Police, with the objective of increasing convictions and improving behaviour.

Overall Strengths Communications NHS Blackpool’s communication strategy includes alcohol. The Council, NHS Blackpool and the Police produce a regular joint newsletter “Your Blackpool” which is distributed to every house hold in Blackpool. There have been a number of awareness arising campaigns including ALTN8, MEASURE, Think B4 U Drink, Blackpool Life Rise to the Challenge. NHS Blackpool are developing a social marketing strategy including alcohol.

Good/Innovative Practice Programme to train front line staff in brief intervention with 850 staff trained Programme to train front line staff in brief intervention with 850 staff trained last year. last year. Specific outreach service delivery to recruit hard to reach groups into Specific outreach service delivery to recruit hard to reach groups into treatment services treatment services Three new Primary Care Centres incorporating Alcohol Services Three new Primary Care Centres incorporating Alcohol Services Above and beyond support programme for homeless people, ‘The Bridge Above and beyond support programme for homeless people, ‘The Bridge Project’. This includes health professional clinics with the ability to pick up Project’. This includes health professional clinics with the ability to pick up and provide interventions with respect to alcohol misuse. and provide interventions with respect to alcohol misuse. Multi-agency Springboard team which focuses on 5% of the most complex Multi-agency Springboard team which focuses on 5% of the most complex families with opportunities to pick up alcohol issues. families with opportunities to pick up alcohol issues. Easy access to and clear pathways for young people with substance misuse Easy access to and clear pathways for young people with substance misuse issues with little waiting time. This service is offered up to the age 21 for issues with little waiting time. This service is offered up to the age 21 for existing service users. existing service users. Training for Licensees and Door Staff, regular mail shots, Proof of Age Cards Training for Licensees and Door Staff, regular mail shots, Proof of Age Cards and Forums for both on and off–licence premises. and Forums for both on and off–licence premises. Modern Apprenticeship Scheme for non-clinical roles within the PCT Modern Apprenticeship Scheme for non-clinical roles within the PCT

Priority Actions Strategy The strategy should be underpinned by a delivery plan, to include delivery of a reduction in the rate of alcohol-related hospital admissions with a number of characteristics as outlined in the main body of the report. There needs to be explicit, quantified assumptions about the impact expected on alcohol-related hospital admissions and alcohol-related crime from the many developments and initiatives already implemented and planned.

Priority Actions Commissioning It is recommended that the development and commissioning of an integrated local treatment system through the tiered framework of provision: – The system should be navigated through the medium of clearly identified and published pathways describing entry points and the routes through, dependent on the needs of individuals. The components for this exist but we believe that further support could help to consolidate and clarify how the system operates. – The pathway should be evidenced based and desired outcomes

Priority Actions Communication Develop a bespoke MOSAIC map and analysis for Blackpool. This should be used as the basis of developing a Customer Access Strategy We believe there needs to be further analysis with respect to the population that make up the greatest proportion of alcohol related admissions. These are likely to be older rather than younger residents. Other The NST believes that efforts to increase alcohol free zones and reduce the number of trading licensed premises has the potential to contribute to the regeneration of Blackpool and the reduction of alcohol harm to Blackpool’s population, to both adults and children

Summary Good Progress on strategy targets Some targets need adapting Achieving LAA targets NHS Blackpool has set Alcohol as one of its priorities for the next 5 years A positive and useful National Support Team visit