Reducing Alcohol Harm & Violence: Sharing ED DataClare Charlton,

Project Manager, Violence and Alcohol Harm Reduction, Department of Health - London

The London Experience Basis for the Model:

• London Drink Debate

• Healthcare Led Models

• Policing Led Models

• CSP Led Models

• Joint working!

• Making it work for London

• “I live in Fulham and Friday and Saturday night you are dodging drunks and piles of vomit and it isn’t nice. I’d like to see more police on the beat at those times, alongside people who can help those who have a real problem with alcohol”

• LDD Attendee, December 2009

“There’s a lot of violence on the streets now, with drunk people coming out of pubs and clubs looking for aggro”LDD Attendee, December 2009

“I’d like to see the police and local authorities working much more closely together on things like licensing, so we don’t get the situation where there are too many pubs and clubs clustered in one place.”LDD Attendee, December 2009

ED Data Sharing and beyond:

• Responding to London People;

• Acting on needs;

• Reviewing what works for different parts of London;

• Local strategies based on Local Problems;

• Pan-London Data Sharing

• Problem solving locally with regional implication;

Alcohol Harm, Serious Youth Violence and

Violence against the Person

Local Councils

Local PCT’s

Acute NHS Trusts

LHO

BTP & City of London Police

ED Data Sharing: Implementation• Make Contact!• Establish what you want, what you need, and what

you can live without!• How often do you need the data?• How will you close the information loop?• Build a project team

– ED Staff Members– CSP Analysts – Police / Police Analysts – PCT Public Health – Alcohol Lead

Implementation: Best Practice?

• Clear Policy Agenda – Mixed messages don’t help• Be clear on what you want, don’t ask for too much,

just what you are going to use!• Funding: Can Help, Can Hinder;• Get support from local partners where needed;• Get Clinical support;• Offer feedback to the hospital / PCT (close the loop);• DON’T PANIC!

-Crime Reduction-Safer Communities-Improving Health

LSP- LAA Priority,

CDRP ensuresAction

ED and Health:•Routine enquiry re alcohol &violence: A&E, MH, 1° Care

•Record location & timeOf violent injuries

•Share Anonymous Information with CDRP

•DV support Nurse•Alcohol Brief Interventions:

A&E, GUM, PHC• Embed Protocols & Training

•Alcohol & ViolenceSupport/ info leaflets

•Police direct phone inA&E Waiting area

•Ambulance forensic blankets•Referral pathways to GUM/ SARC,

GP, Drug Services, MH & VCS

Local Authority:•Workplace violence &

Bullying policies•Housing & support for

Offenders & drug misuse•Improve Street Lighting

•Night time public transport•Disperse fast food venues

& Taxi ranks•Reduce litter & graffiti

•Night time litter collection•Increase Pedestrian Areas

•Alcohol Misuse EnforcementCampaigns

Police:•Increase Reporting of Crime

•Analyse police & A&E data to inform activity

• Inform location of CCTVs•Share data with CDRP

•Refer Child Protection & DV unit•Refer Victim Support

•Fixed Penalty Notices, ASBOs & Drink Banning Orders

Licensing Committee:•Licence & Opening hours

•Reduce happy hours, increaselager price

•Soft drinks & ‘cooling down’ period•Door Supervisors & staff training

•Alcohol Disorder Zones•Toughened bottles & glasses

•Public awareness posters

VCS SupportEnsure sufficient

Capacity, Resources

& Standards

Children & YP:•Parenting Skills

•Violence Prevention skills Schools & high risk groups

•School Bullying Policy•CAMHS: Conduct Disorder

•Child Protection- Health & SS

Drinks Industry:•Local sponsorship

•Policy & Staff training•Social Responsibility Standards

Shepherd J, Sheehan D & Nurse J, 2005

Attendances by Day of Week• As expected the highest attendances were on Fri night/Sat morning

& Sat night/ Sun morning. Attendances during this time almost doubled compared with the same time on any other day.

Ethnicity breakdown• English make up 17% of assault patients closely followed by Eastern

Europeans 14%.

Different Boroughs, Different Models A&E Data Sharing

Licensing Route Healthcare Route Youth Violence Route

Police Licensing Team

Council Licensing Team

Paramedics

PCT Lead Development

Acute Trust LeadDevelopment

Youth Workere.g. Kings Model Police Engagement

Commissioning powers

Alcohol Team

Clinical Knowledge

Alcohol Liaison Nurses

DV Liaison Nurses

Violence Nurse Specialist

e.g Whittington

Senior Clinicians Led

Industry

Alcohol Leads at DAAT

Regional PublicHealth Route

Public Health Leadership

Regional GovernmentLinks

Engages the kids!

Links into A&E

Enforcement andEvidence

And Finally...

• Clare Charlton• Project Manager, Violence and Alcohol• Regional Public Health Group - London• 5th Floor, Riverwalk House, • 157-161 Milbank• London, SW1P 4RR

• T: 0207 217 3040• M: 07766 298 014• E-Mail: Clare.Charlton@dh.gsi.gov.uk• www.londondrinkdebate.co.uk