Case study

Embedding public health in Coventry’s Licensing Policy statement

A review of Coventry City Council's Statement of Licensing Policy (SLP) benefits from considering public health and health equality issues.

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Background

Coventry is a growing city situated in the West Midlands with a population of 323,000 inhabitants. It is mainly urban but includes significant areas that are semi-rural. Alcohol is widely available, with outlets selling alcohol in most neighbourhoods in addition to increasing availability via supermarket home delivery services.

Around 500 shops, pubs, clubs, off-licences and garages sell alcohol in Coventry. Outlets selling alcohol are not equally dispersed across the city. Instead they are concentrated in the more deprived neighbourhoods in the north and east of the city.

Alcohol is identified as a priority within Coventry’s Health and Wellbeing Strategy. Drinking too much can cause physical and mental harm. Coventry City Council’s Alcohol Strategy also contains a vision to reduce the harms caused by alcohol misuse and make Coventry a safer and healthier place where less alcohol is consumed.

This vision can be supported through opportunities within the licensing process. Public health related licence conditions will be used where practicable to reduce the impact of alcohol on public safety and other licensing objectives.

Case in brief

Coventry City Council has a duty under the Licensing Act 2003 to carry out its functions with a view to promoting the licensing objectives and operate in line with the Council’s SLP. Under the terms of the Act, the Council’s SLP has to be renewed every 5 years. The current SLP came into effect in 2011, so a review must be completed, and a revised statement published, by January 2016.

The general principles of the Licensing Policy are centred on the Licensing Act’s 4 licensing objectives:

  • the prevention of crime and disorder
  • ensuring public safety
  • the prevention of public nuisance
  • the protection of children from harm

The approach used

The Licensing Act 2003 allows the scrutiny of licence applications by people working or living in the vicinity of licensed premises, interested parties and a number of public bodies. Directors of Public Health (DPH) are the most recent addition to the list of responsible authorities and in Coventry, a public health practitioner represents the DPH to act as the public health representative for all licensing matters. All responsible authorities, including public health, meet regularly to review applications and share intelligence, which is used, for example to trigger operations to seize illegal alcohol or identify premises selling alcohol to under 18s.

The resulting collaboration provides an opportunity for health and wellbeing to be considered during the refresh of Coventry’s SLP. Consequently public health and health inequalities are now embedded throughout the policy.

The data

The scale of alcohol misuse is extensive and over 50,000 adults in Coventry regularly drink to excess.

Category No of adult residents % of Coventry’s adult population % of West Midlands adult population
Non-drinkers 53,058 20.8% 17.9%
Lower-risk 149,703 74.1%* 73.9%*
Increasing Risk 38,789 19.2%* 19.6%*
Higher risk 13,738 6.8%* 6.5%*
Total 16+ population 255,086 - -

*% of drinking population

The harms caused by alcohol in Coventry are considerable. We estimate that each year alcohol:

  • causes 38,000 A&E attendances
  • leads, or is a factor in, 3,100 crimes
  • is an issue in one in five child protection cases

Health-related harms in Coventry are worse than the England and regional average, and worse than many comparable areas. Alcohol related hospital admissions for adults is rising and the city is among the poorest 25% of areas for alcohol related hospital admissions for young people. While there is evidence that alcohol consumption levels are falling, there is a lagged effect in terms of the harms caused by higher risk drinking.

Outcome

A number of new paragraphs have been added to Coventry’s SLP acknowledging that Public Health is now a Responsible Authority.

The policy recognises that Coventry’s DPH will:

  • explore the impact of alcohol related incidents on emergency services such as West Midlands Ambulance Service
  • consider the proximity of licensed premises to schools, youth centres, play groups and family centres
  • share anonymised A&E data with other responsible authorities relating to young people and alcohol related incidents
  • analyse data on attendance at emergency departments and the use of ambulance services following alcohol related incidents
  • collate anonymised data on incidents relating to specific premises and present to licensing sub-committees when representations are made
  • support the police by facilitating access to health information such as anonymised A&E data for alcohol related admissions, for example, as part of a licence review application
  • provide Trading Standards with evidence of the health impact of illicit or counterfeit alcohol
  • support the sharing of health information such as anonymised A&E data with other responsible authorities where it links to public safety
  • provide evidence on the impact of the health and wellbeing of vulnerable groups such as street drinkers, and the effect this has on antisocial behaviour
  • engage with Coventry Safeguarding Children Board to share relevant information such as data on young people accessing substance misuse services
  • investigate links between ambulance callouts and attendance to irresponsible practices at specific licensed premises

Other important principles considered

There is a social gradient in the harms from alcohol consumption, but not in alcohol consumption itself. Quantities and patterns of drinking differ across socio-economic groups, as do harmful outcomes. According to the Marmot Review, ‘Fair Society, Healthy Lives’ people from more deprived areas who consume alcohol are more likely to have problematic drinking patterns and dependence than those from more affluent areas. Binge drinking in under-18s is associated with deprivation and unemployment is associated with alcohol consumption.

In line with the principles of the Marmot Review, Coventry City Council has agreed to develop common policies to reduce the scale and impact of health inequalities across the city. This includes focussing interventions such as alcohol reduction on reducing the social gradient in health.

Coventry’s Statement of Licensing Policy came into effect January 2016.

Published 8 March 2017