Suffolk’s public health and communities team are using a data-driven approach to review local premises licence applications, focusing their influence on areas with the worst alcohol-related health harms and health inequalities. This work has been welcomed by local partners, including licensing officers and the police, for helping to reduce alcohol-related harm.
Background
Alcohol consumption is a significant cause of preventable ill-health in the UK. It contributes to more than 200 health conditions including some cancers, cardiovascular disease, liver disease and depression, according to the Office for Health Improvement and Disparities (see ‘further reading’ below).
In England, more than 10 million people consume alcohol at levels above the UK Chief Medical Officer’s low-risk drinking guidelines. The impact of alcohol use is greater for those experiencing the highest levels of deprivation – known as the ‘alcohol harm paradox’.
Policies to reduce alcohol harm take a range of approaches, from supporting individual behavioural change to reducing availability and affordability at population level. The minimum price per unit in Scotland is an example of taxation to reduce affordability and has been shown to both improve health and tackle health inequalities (see ‘further reading’).
Control over premises licensing presents an opportunity for councils to consider and potentially restrict alcohol availability.
Objectives
Local directors of public health are among the ‘responsible authorities’ that can comment on alcohol licence applications and can therefore object to those which may breach a licensing objective. There are four objectives within the Licensing Act 2003:
- preventing crime and disorder
- public safety
- preventing public nuisance
- protecting children from harm.
The public health and communities team at Suffolk County Council reviewed nearly 800 applications for premises licences over a five-year period to December 2023. They recognised the need for a system to target those applications with the worst potential health impacts.
The solution
The Suffolk team developed a triage system for reviewing licensing applications, recognising the importance of engaging and supporting partners, while meeting the obligations of a responsible authority within the constraints of managing other public health duties.
The triage system uses local small area data on hospital admissions and A&E attendances attributed to alcohol, along with relevant datasets such as the Index of Multiple Deprivation, to systematically identify high-risk applications in deprived areas with the worst alcohol-related health outcomes. Appropriate representations can then be made.
The impact
Suffolk’s triage system has been developed and in use since 2019. Over this time, the public health and communities team have objected to 33 licensing applications (16 new applications and 17 for a change in conditions). In 32 of those cases, the representations (or objections) were successful – with either conditions placed on the licence, the application withdrawn or the licence refused.
A recent review of the triage system found that these representations were focused on the most deprived urban areas in Suffolk, and that the approach made a proportionate, evidence-based contribution to a population-wide strategy to limit alcohol misuse.
Through this work the team has strengthened its partnerships with the police and with council licensing officers, who report that the public health input in this way has been “extremely useful”.
Moving forward
The team recently began using the ‘population health management’ system to access local-level and more timely health outcome data and to build a data-based Power BI dashboard. This has enabled them to tackle data relevance and quality issues, and to automate some of the processes to support representations.
On input of a building’s postcode, they can generate data graphics and text which enables them to compare health outcomes in that location to the rest of the district/borough, and to Suffolk as a whole.
Lessons learned
Dr Molly Thomas-Meyer, Public Health Consultant at Suffolk County Council, said this work has contributed to raising the profile of public health with police and licensing officers across Suffolk. “With the lack of specific public health objectives in the Licensing Act in England, it is crucial that we support our partners. Public health concerns alone are insufficient evidence to reject an application.
“We have adopted a proportionate, data-driven strategy to assist in reducing alcohol availability within our communities, thereby mitigating risks to health and wellbeing. Although it is challenging to fully demonstrate the impact on health or crime outcomes, which extend beyond licensing issues, our initiatives do contribute to a local approach to minimising alcohol-related harm.”
Contact
For more information contact Suffolk’s public health and communities team: [email protected]