Abstract
BackgroundThe considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere. We adopted a case study approach to identify the major characteristics and drivers of differences in the patterns of local alcohol policies and services in two contrasting local authority (LA) areas in England.MethodsData were collected via thirteen semi-structured interviews with key informants (including public health, licensing and trading standards) and documentary analysis, including harm reduction strategies and statements of licensing policy. A two-stage thematic analysis was used to categorize all relevant statements into seven over-arching themes, by which document sources were then also analysed.ResultsThree of the seven over-arching themes (drink environment, treatment services and barriers and facilitators), provided for the most explanatory detail informing the contrasting policy responses of the two LAs: LA1 pursued a risk-informed strategy via a specialist police team working proactively with problem premises and screening systematically to identify riskier drinking. LA2 adopted a more upstream regulatory approach around restrictions on availability with less emphasis on co-ordinated screening and treatment measures.ConclusionNew powers over alcohol policy for LAs in England can produce markedly different policies for reducing alcohol-related harm. These difference are rooted in economic, opportunistic, organisational and personnel factors particular to the LAs themselves and may lead to closely tailored solutions in some policy areas and poorer co-ordination and attention in others.
Highlights
The considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere
Within the context of this new policy environment, this paper aims to identify and examine the most significant policy drivers that have led to different suites of alcohol policies being adopted in two local authority (LA) in Northern England
Based on previous ethnographic studies of local alcohol policy decision-making processes [8, 11], available guidance documents and supplementary informal advice from colleagues working in local government, we identified the three core key informants to interview as: (i) Public Health; (ii) Licensing/Trading standards; and (iii) Commissioning
Summary
The considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere. The often considerable political challenges inherent in pursuing national level public health policies to reduce alcohol harm has prompted policy makers in a number of countries to explore locally tailored approaches [1,2,3] Such measures have particular relevance in England following two recent policy shifts: Firstly, the transfer of public health teams from the National Health Service to 152 upper tier local authorities (LAs) and, secondly, the designation of local Directors of Public Health as responsible authorities able to challenge applications for Mooney et al BMC Public Health (2017) 17:825 alcohol retail licenses [4]. This includes how particular policies and combinations (or suites) of policies are chosen and how decisionmaking is variously informed by the identified or perceived needs of their local populations, the prioritisation of alcohol-related harm as well as resource constraints and competing priorities
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