Abstract
BackgroundPublic health in England has opportunities to reduce alcohol-related harms via shaping the availability and accessibility of alcohol through the licensing function in local government. While the constraints of licensing legislation have been recognised, what is currently little understood are the day-to-day realities of how public health practitioners enact the licensing role, and how they can influence the local alcohol environment.MethodsTo address this, a mixed-methods study was conducted across 24 local authorities in Greater London between 2016 and 17. Data collection involved ethnographic observation of public health practitioners’ alcohol licensing work (in eight local authorities); a survey of public health practitioners (n = 18); interviews with licensing stakeholders (n = 10); and analysis of public health licensing data from five local authorities. Fieldnotes and interview transcripts were analysed thematically, and quantitative data were analysed using descriptive statistics.ResultsResults indicated that some public health teams struggle to justify the resources required to engage with licensing processes when they perceive little capacity to influence licensing decisions. Other public health teams consider the licensing role as important for shaping the local alcohol environment, and also as a strategic approach for positioning public health within the council. Practitioners use different processes to assess the potential risks of licence applications but also the potential strengths of their objections, to determine when and how actions should be taken. Identifying the direct influence of public health on individual licences is challenging, but the study revealed how practitioners did achieve some level of impact, for example through negotiation with applicants.ConclusionsThis study shows public health impact following alcohol licensing work is difficult to measure in terms of reducing alcohol-related harms, which poses challenges for justifying this work amid resource constraints. However, there is potential added value of the licensing role in strategic positioning of public health in local government to influence broader determinants of health.
Highlights
Public health in England has opportunities to reduce alcohol-related harms via shaping the availability and accessibility of alcohol through the licensing function in local government
We focus on the opportunities for public health practitioners (PHPs) in England to shape the provision of alcohol in local areas through licensing functions within local government, highlighting the situated processes, influences and outcomes of this role for Public health practitioner (PHP)
Drawing from recent literature critically examining how evidence-based policy making is done in practice, this paper describes a mixed methods study which aimed to explore the public health alcohol licensing role and how it unfolds within the day-to-day context of Local authority (LA) in Greater London
Summary
Public health in England has opportunities to reduce alcohol-related harms via shaping the availability and accessibility of alcohol through the licensing function in local government. We focus on the opportunities for public health practitioners (PHPs) in England to shape the provision of alcohol in local areas through licensing functions within local government, highlighting the situated processes, influences and outcomes of this role for PHPs. The (re)positioning of public health into local government in England and Wales in 2013 was viewed as creating new opportunities for closer working between public health and other agencies, with focus on the broader social and environmental determinants of health [5, 6]. The (re)positioning of public health into local government in England and Wales in 2013 was viewed as creating new opportunities for closer working between public health and other agencies, with focus on the broader social and environmental determinants of health [5, 6] One example of this is the local alcohol environment which public health, alongside other agencies, can seek to influence via the local government function of licensing premises to sell alcohol.
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