Alcohol in the West Midlands

Alcohol

Since 1970 alcohol consumption has risen by 40% in England. We now know that the average adult drinks the equivalent of 120 bottles of wine every year. Whilst most people drink sensibly, for many others excessive consumption of alcohol by themselves or others can and does have devastating consequences including harm to the unborn foetus, hypertension, cause various cancers not to mention the hundreds of thousands of acts of vandalism and assault that take place every year in the UK.

The burden left by the harms that alcohol causes are felt not just by the individual but by society as a whole. Alcohol related crime and anti-social behaviour costs England an estimated £7.3 billion and the NHS an estimated £2.7 billion per year.

In this region alone 1798 people died in 2007 of alcohol related conditions; since 2003 the annual number of hospital admissions related to alcohol has risen from 46,000 to 104,000; and in the last year over 46,000 crimes related to alcohol were recorded in the West Midlands, 33,000 of which were violent crimes.

Sensible Drinking

The NHS recommends that:  

• Men should not regularly drink more than three to four units of alcohol per day.
• Women should not regularly drink more than two to three units of alcohol per day.
• Pregnant women or women trying to conceive should avoid drinking alcohol. If they do choose to drink, to protect the baby, they should not drink more than one to two units of alcohol once or twice a week and should not get drunk.

How to measure how many units you are drinking. 

NHS Mid-Life Checks

NHS Mid-life LifeCheck has been developed for people aged between 45 and 60 years to enable them to know what they are doing well, flags up possible problems for the future and gives advice accordingly. Alcohol use is one of the topics that the LifeCheck addresses along with:  

• Stopping smoking
• Healthy eating
• Physical activity, and
• Emotional wellbeing.

Department of Health Alcohol Harm Reduction Programme

In 2008 the DH launched their alcohol harm reduction programme for the English regions. The overall objective of the programme is to reduce alcohol related harm with a specific focus on the reduction of alcohol-related hospital admissions across local areas in England.

The key objectives of the programme include:  

• Encourage more people to drink less through Identification and Brief Advice
• Work in Partnership
• Appoint Alcohol Health Workers in acute care
• Influence change through advocacy and use of champions
• Improve effectiveness and capacity of specialist treatment
• Develop activities to control alcohol misuse in the community
• Amplify social marketing strategies at a local level

Alcohol in the West Midlands

The West Midlands has a significant relationship with alcohol and currently has some of the highest rates in England for alcohol related conditions including:

(For more information visit the North West PHO Local Alcohol Profiles for England  

Reducing Alcohol Related Hospital Admissions

The reducing alcohol related hospital admissions indicator (expressed as an age standardised rate per 100,000 population) is the main indicator that drives the programme. The West Midlands as a region currently has the third highest rated of alcohol related hospital admissions in England behind the North West and North East.

The indicator is calculated by applying attributable fractions (AF) to each admission based on the disease diagnosis. The attributable fractions for each diagnosis are drawn from epidemiological research. Thus, the diagnosis of alcoholic cirrhosis has an AF of 1, and so every admission with a diagnosis of alcoholic cirrhosis counts as an alcohol-related admission. The diagnosis of road accidents has an AF of 0.4, and so 40% of admissions due to road accidents count as alcohol-related.

The trend in ArHA rate over the last few years has been inexorably upward. In 2006/7, the latest year for which we have data, there were in the West Midlands Region, an estimated 88,916 such admissions. The rate of 1449 per 100,000 was a jump of 16% over the previous year’s rate – a steeper rise than in any other Region.

The indicator is currently being used to measure alcohol harm reduction in a number of contexts including Local Area Agreements (NI39), 7 of the 14 Local Authorities in the Region included this indicator (NI 39) in their list of designated indicators.

Regional Structures

Regional Alcohol Group
The Department of Health West Midlands chairs the West Midlands Regional Alcohol Group (WMRAG) The group brings together senior officials from other Government departments (Home Office, Ministry of Justice) and other partner organisations including the NHS, National Treatment Agency (NTA), National Drug Treatment Monitoring Service (NTDMS), National Offender Management Service (NOMS), Care Services Improvement Partnership (CSIP), the Probation service, Police and the voluntary sector. The Group provides leadership and strategic direction and is responsible for developing regional plans to implement national strategy, considering emerging issues to do with alcohol and responding accordingly.

The group feeds into the Government Office quarterly Regional Operating Review Board which has oversight of PSA 25 – Reducing the harm caused by alcohol and drugs.

Regional Alcohol Manager (RAM)
In 2009 following recommendation from the Department of Health, a Regional Alcohol Manager was appointed to build capacity to help PCTs and their partners deliver the planned reductions in alcohol-related hospital admissions, coordinate regional activity, support SHA and GO performance management of the alcohol indicator, and report on regional activity.

NI 39 Network
A network of local alcohol leads from local PCT or local authorities / Drugs and Alcohol Action Teams has been set up. The purpose of the network is to support PCTs to deliver on their target to reduce alcohol-related hospital admission by sharing good practice, agreeing information and data requirements so that any analysis that is necessary is done once, disseminating evidence of what works, and agreeing a process of on -going evaluation and performance monitoring.

Big Drink Debate

In 2008 the Regional Alcohol Group ran a region-wide survey on alcohol – the West Midlands Big Drink Debate. The purpose was to raise awareness of the harms from alcohol misuse and to gauge the public appetite for various policy options that may be necessary to tackle a culture of excessive drinking. A campaign report is now available. Headline results from the BDD included:

• 65% of people surveyed thought that their local area had a drink problem  
• 89% of people thought that anti-social behaviour was one of the main problems associated with alcohol
• 72% of people thought that drink driving was one of the main problems associated with alcohol  
• 70% of people thought that negative health problems was one of the main problems associated with alcohol
• 64% of people thought that crime rates was one of the main problems associated with alcohol
• 63% of people thought that cost to the NHS was one of the main problems associated with alcohol  
• 53% of people thought that adverts for alcoholic products should only be shown on television after 9pm and during 18 films in cinemas.  
• 58% of people wanted to see special offers such as promotional shots and happy hours banned
• 50% of people thought that alcoholic products should carry large health warning labels like cigarettes.
• 67% of people supported the idea of alcohol free zones in towns  
• 65% of people wanted to see the blood alcohol limit for drivers halved

In December 2009 the Big Drink Debate received a gold and silver award at the Chartered Institute of Public Relations (CIPR) regional awards.

For more information contact wmphg_enquiries@dh.gsi.gov.uk