Meeting documents

To be presented by Dr J O’Grady, Director of Public Health, Buckinghamshire County Council.

Dr J O’Grady, Director of Public Health, provided a presentation on the Director of Public Health Annual Report (DPHAR) 2019 entitled ‘Alcohol and Us’, appended to the minutes, and highlighted the following points:

• Two reports were available on the Public Health web page; Dr O’Grady urged the members of the board to read the full report which contained key Bucks facts along with personal stories from residents, front line staff, doctors and consultants impacted by the use of alcohol.
• One in four people drank more than the limit recommended by the Chief Medical Officer. 
• The guideline for safe drinking of alcohol was 14 units for women and 14 units for men per week.
• Most people in England were unable to correctly identify 14 units of alcohol. 
• Alcohol contributed to a wide range of long term conditions such as cancer and heart disease; it also contributed to mental health conditions such as self- harm, suicide and dementia.

·       Alcohol use affected people’s families and the wider community; it contributed to domestic violence, child abuse and neglect, violent crime and road traffic accidents, loss of employment and homelessness.

• People who abused alcohol died much younger; the average age was 54.
• 1 in 4 people in receipt of treatment were living in a house with a child and the report contained a section on how alcohol impacted on children's wellbeing.
• Approximately 118,000 people in Buckinghamshire were drinking more than the safe limit which was significantly higher than the national average.
• 24% of people attending NHS health checks were identified as drinking too much and did not realise they were harming their health or recognised that they had a problem with alcohol.
• There were 9,000 alcohol related hospital admissions in Buckinghamshire last year.
• Dr O’Grady listed what was known to work at a national and local level and the benefits of alcohol treatment.
• It was known that identifying people early who were drinking too much and giving them brief advice on how to reduce their drinking was effective and could reduce the amount people drank by 12%.
• It was estimated that for every £1.00 spent treating alcohol users, £2.80 of benefits was realised across crime, the NHS, local authorities and to the individual.  For users with more complex needs the return was £3.40 for every pound invested in the treatment.
• 85% of dependent drinkers were not in a structured treatment programme.
• There had been 399 new referrals to specialist services in 2018/19; 77% of the referrals were self-referrals or from family and friends.  It was not known how many of those had had discussions with health or social care staff but the number of direct referrals from other partners was low.
• The Oxford Health NHS Foundation Trust and Buckinghamshire Healthcare NHS Trust had signed up to the NHS CQUIN which was a quality improvement initiative to screen those admitted to an inpatient ward for at least one night for alcohol use, given brief advice or offered specialist referral.
• Dr O’Grady read out the recommendations contained in the DPHAR and highlighted the next steps.

The following points were noted in discussion and in answer to members’ questions:

• A member of the board commented that there was emerging evidence that eight units of alcohol a day damaged the brain and could lead to dementia.  Alcohol use affected many areas and it was agreed that a decision should be made on whether the DPHAR should be circulated to the other statutory boards.  .

ACTION:  Dr O’Grady 

• In response to a comment on the sources of help and whether the information could be consolidated with Bucks Mind Directory and Live Well Stay Well; Dr O’Grady confirmed that the website would be refreshed under the new Buckinghamshire Council and there would be different ways the information could be accessed.  The Chairman added that this would more than likely be discussed at the partner workshop on 17 October 2019.

• L Hazell, Cabinet Member for Health and Wellbeing, welcomed the report and agreed it needed to be promoted as widely as possible and suggested the damage caused to unborn babies be highlighted prominently.  Dr O’Grady explained that she expected the key messages on alcohol mis-use to feature in every prevention work stream and that it was important to ensure that people were directed to the correct places and were followed up when identified. A holistic approach was required.
• A member of the board asked what the drinks industry was doing to promote safe drinking.  Dr O’Grady agreed to contact Public Health England for the information.

ACTION:  Dr O’Grady

• In response to a comment on how to approach those who did not recognise that they were drinking too much, Dr O’Grady agreed it would be a challenge for all frontline staff to be trained.  She went on to say that the ‘Making Every Contact Count’ and IBA training worked. Dr O’Grady stressed that parents needed to be educated; 70% of children first obtained alcohol from their parents and there was evidence to show that if parents let their children start drinking early it caused alcohol related problems later on in life.
• The Substance Misuse Strategy Group would have a focussed task and finish group to refresh the Substance Misuse Strategy and Action Plan.
• A member of the board commented on the responsibility for employers to promote the key messages and provide information on how to access the services available.  It was suggested that the BCC poster campaign be circulated to other organisations.

ACTION:  Dr O’Grady

• A member of the board suggested a notice regarding safe drinking levels be provided on recycling bins as a reminder.  Dr O’Grady agreed to pass this suggestion on to the alcohol lead and added that this was the type of idea the Substance Misuse Group wanted to capture at the partnership workshop on 17 October 2019.

ACTION: Dr O’Grady

RESOLVED:  The Health and Wellbeing Board NOTED the Director of Public Health Annual Report and ENDORSED the recommendations set out in the report.