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Reducing towards Alcohol H arms and Health I nequalities. Julia Miller

Reducing towards Alcohol H arms and Health I nequalities. Julia Miller . What is the Healthy Places, Healthy Lives Programme ?. Funded by DH – originally three years, but reduced to one! Partnered by LGID, NST, Marmot Started Jan 2010 – end ?

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Reducing towards Alcohol H arms and Health I nequalities. Julia Miller

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  1. Reducing towards Alcohol Harms and Health Inequalities. Julia Miller

  2. What is the Healthy Places, Healthy Lives Programme? • Funded by DH – originally three years, but reduced to one! Partnered by LGID, NST, Marmot • Started Jan 2010 – end ? • Developing partnerships to reduce health inequalities • Implementing Marmot principles • 25 sites in England • Initiatives focus on teenage pregnancy, alcohol, obesity, community aspirations, CVD,diabetes, smoking, domestic abuse and more…

  3. Why Alcohol? Alcohol related hospital admissions (wholly and partially attributable to alcohol) Outpatients, A&E, Ambulance GP consultations, practice nurse consultations Specialist treatment services Dependency services Impact on families £2.9 Health Offenders under the influence Young people committing criminal damage Vehicle-related thefts Crime and Anti-Social Behaviour Domestic violence Fear of crime & impact on environment £8.0 Crime Employers Average employee absence (7.4 days per year) 11 million working days annually Sickness absence (17 million annually) Poor and underperforming £1.7 Not including estimated costs to the economy of alcohol-related deaths and unemployment

  4. Key Features of Healthy Places Healthy Lives

  5. Lincoln

  6. Work on supporting infrastructure

  7. Infrastructure Development • Cementing partnerships • Think Tanks • Mapping alcohol services • Links to commissioning • Links into other local • strategies and Boards e.g. • Child Poverty, Community Safety • Local leadership & cementing • partnerships • Understanding the wider • determinants Alcohol Strategy: Isle of Wight, Wolverhampton, Brighton, Gt Yarmouth

  8. City-wide Intelligence, Wolverhampton • Terms of Reference • Multiple stakeholder engagement • Linking data • Analyst expertise • Gaining buy-in across the City • Model to support other strategic work Benefits realisation, Gt Yarmouth & Waverney, Wolves • Economic modelling • Benefits realisation • Links to commissioning • Amenable mortality • Convincing commissioners

  9. Cost Effective Interventions

  10. Summary of the evidence of the effectiveness of alcohol interventions Source: WHO, Evidence for the effectiveness and cost-effectiveness of interventions to reduce alcohol-related harm, 2009

  11. Night Time Economy, ROI example: Keep It Safe, Wolverhampton Outline: • Increased police presence. • Voluntary ‘Street Pastors’ – street patrol and guidance. • ‘Safe Havens’ – alcohol free drinks, somewhere to wait, free call to taxi company. • Temporary medical centre (on the spot first aid) and triage ambulance to relieve A&E pressure. • Taxi enforcement officers to monitor unlicensed ‘plying for hire’ activities. • Multi-agency visits to licensed premises to ensure compliance with licensing and safety conditions. Impact (compared to same period, 2007/08): • 29% reduction in violent crime • 14% reduction in alcohol-related ambulance call-outs (28% reduction on New Year’s Eve) • 8% reduction in A&E attendances • 125 visits to licensed premises by enforcement officers (leading to 1 prosecution and 3 license reviews) • 12 taxi drivers were stopped for ‘plying for hire’, of which, 10 were prosecuted, enforcing the ‘get home safely’ message. • Fire Officers conducted 38 inspections across 24 premises. 23 required further action, relating to means of escape and insufficient fire risk assessments. Return on Investment: Total budget was £218,786. Cost analysis indicated total savings to the emergency services alone of £235,000. This shows strong ROI before Wider social determinates are factored in.

  12. Service Focused Interventions

  13. Brief Interventions

  14. Cardiff Model Continual improvement and feedback

  15. Scratch card scores • 3438 Scratch cards have been given out • 3322 Over the counter by pharmacies • 110 NHS Health checks (Chamber Health) • 3 Emergency Contraception • 3 Other • Details from Arrest Referral not yet available Scores above 5 could indicate that drinking levels are harmful or hazardous to health

  16. Community Focus

  17. Focussing on the wider social determinants

  18. Bilston East, Wolverhampton

  19. Addressing Marmot Policy Areas

  20. Lessons Learned • Partnerships take a while to mature and bed in with regular meetings between stakeholders • The financial climate and the changing shift in staff has been problematic in some places • Some issues need to be solved at a national level egincentivisingthe delivery of IBAs

  21. HPHL into 2011 • New sites joining • New Issues to discuss • Transforming Communities • Social return on investment • Raising Aspirations • NHS Institute is moving to Social Enterprise Model • We would welcome discussions with potential new sites!

  22. More information • Website - www.institute.nhs.uk/commissioning/general/healthy_places_healthy_lives.html • Flyer - www.institute.nhs.uk/images/documents/Healthy%20Places%20Healthy%20Lives/62934%20NHS%20Healthy%20Places%20A5%20flyer.pdf • juliamiller@nhs.net HPHL Alcohol Lead 07903 218321

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