Prevention work is carried out in schools, colleges and youth hubs by the local Young People’s Substance Misuse Service, which works in Hackney and with young people in the City of London. The service provides awareness sessions as part of PSHE A in schools along with targeted group work, and was recently expanded to include a greater focus on prevention and early intervention. There are plans to further strengthen links with health and education services, and with Hackney’s health outreach services for those aged 5-19. The service also works with young people experiencing ‘hidden harm’ as a result of substance misuse by a family member.

In both Hackney and the City of London, integrated substance misuse services are commissioned which, in addition to treatment services, also include the provision of preventative outreach activity. Screening is currently available in primary care, and is carried out as standard for new patient admissions, as part of the NHS Health Check for those aged 40-74 and in annual health checks for people with long-term conditions. Work is underway by City and Hackney Clinical Commissioning Group together with Homerton Hospital and substance misuse service providers to reduce hospital admissions related to alcohol, through the introduction of an ambulatory care alcohol detoxification pathway, based on successful models elsewhere. 1

The City of London launched Business Healthy in 2013 to unite business leadership in meeting the health and wellbeing needs of City workers. Business Healthy provides an up-to-date library of resources and holds expert-led events throughout the year for City businesses. These have included events on alcohol and wellbeing at work. Hackney Council has recently been awarded London Healthy Workplace Charter status (at ‘commitment’ level) and the City of London Corporation has already been awarded ‘achievement’ under the Charter.  This provides an excellent platform for the two local authorities to work with employers in the area to enable and encourage health behaviours around alcohol, making the most of the workplace as a health promoting setting.

In terms of the broader alcohol and policy environment, a range of work is underway to influence this locally. This includes the introduction in Hackney of a voluntary minimum unit price of 50p, as well as ensuring a role for public health in reviewing new licence applications and variations in existing licences for on and off sales.  For further details on local licensing interventions, please see the Society and environment JSNA chapter.

Box 3: Case study – ‘Nudging pubs’ in Hackney

‘Nudging pubs’ is the culmination of a year-long study into behaviour change and licensed venues based in Dalston, carried out by Club Soda (supported by Alcohol Concern). The project was funded by Hackney Council in 2015/16 through the Healthier Hackney Fund.

The work aims to promote sensible drinking by increasing the range of non-alcoholic drinks on offer in pubs and other licensed venues. Venues stand to gain by attracting customers who want to drink less, or not at all.  Increasing the social acceptability of soft drinks may also lead to more sensible drinking. Feedback from Club Soda members indicates that a major barrier to reducing alcohol consumption is the impact on people’s social life.

“I would like to be strong enough to refuse a drink while in a drinking environment. I find my designated ‘non-drinking’ days involve staying at home.”

“Need to drink more low alcohol alternatives, and to decide to ‘cap’ my drinking before I go out. Unplanned drinking is always the worst.”

“It’s rare for me not to be insulted or mocked by bar staff if I ask if they serve alcohol free beer, even if they do actually sell it.”

Training bar staff and empowering customers were seen as critical in effecting change, and the research concludes that it is possible to support bars and pubs to change their drinks offer. This, in turn, encourages positive behaviour change, as given better information about non-alcoholic options on offer by staff, customers are more likely to make healthier choices.

Continuing into 2016/17, as part of the Healthier Hackney Fund activities grants, Club Soda and their partners Blenheim are using this learning to work with venues, customers and licensing to develop new digital tools to support sensible drinking. This will include supporting venues to carry out self-assessments to rate how well they are doing at providing for their customers who want to drink less. The project will also share good practice and develop a local rewards scheme for innovation in promoting sensible drinking.

Notes

  1. Personal, social and health education

References

  1. V. Wong, R. Turner and J. Pleming, “Ambulatory Care Alcohol Detoxification (acad) At Whittington Health: A New Approach,” Gut , vol. 63, no. A28-A29, p. http://gut.bmj.com/content/63/Suppl_1/A28.2, 2014.