1. SCREENING POLICIES

2. GATHERING INFORMATION AND INTELLIGENCE

3. ASSESSING THE IMPACT

EQUALITIES IMPACT ASSESSMENT

Service Area: Community Safety Lead Officer: Alison Williams
1. SCREENING POLICIES
1.1 What policy area or strategy are you assessing? Why?
This assessment concerns the Newham Alcohol Harm Reduction Strategy 2008-11. There is a statutory duty on Crime and Disorder Reduction Partnerships to produce a strategy that addresses alcohol-related crime and disorder. In line with government guidance, Newham’s strategy also addresses alcohol-related health harms and the impact of alcohol misuse on children and families.
The overarching aim of the strategy is to minimise the health and social harms, violence and anti-social behaviour associated with alcohol, while ensuring that people are able to enjoy alcohol safely and responsibly.
Objectives of the strategy are:
·  to reduce alcohol-related crime and anti-social behaviour
·  to reduce the levels of chronic and acute ill-health caused by alcohol, resulting in fewer alcohol-related accidents and hospital admissions
·  to prevent alcohol-related harm to children and young people
·  to raise awareness of sensible drinking
·  to improve our understanding of alcohol-related harm
The strategy will contribute to the Corporate Plan and Mayor’s priorities (in particular: feeling better and safer; and better health and well-being). It is linked to a number of Local Area Agreement and Crime and Disorder Reduction Partnership targets (see section 5 below). In addition, the strategy will contribute to the development and regeneration associated with the Olympics by addressing the links between Planning and alcohol Licensing.
1.2 Specify which aspects of equalities will be addressed ( eg race, gender, disability, sexual orientation, religion, equality, pay …)
The relevant aspects of equality that are addressed here are race, gender, disability, sexual orientation, age and faith.
1.3 Which group/s will be affected differently?
The alcohol strategy covers alcohol-related enforcement, regulation, education, support and treatment for all Newham’s population. It recognises that alcohol misuse can have an impact on individual drinkers as well as families and the wider community. Due to its breadth and coverage, efforts have been made through the implementation plan of the strategy to ensure that no-one is disadvantaged by the strategy or excluded from the planning, implementation and evaluation of services.
Home office research and performance data indicates that the impact of harms associated with alcohol and drugs is affected by equalities factors. A summary of key findings is set out below:
·  For young people aged 18-25,there are significant gender differences in terms of drinking. A greater proportion of males in this age group drink alcohol regularly than do females in the same age group. Among young people aged 10-17 who drink at least once a week, boys report committing significantly more offences as a result of drinking than do girls.
·  Young people from BME groups are less likely to drink alcohol: one in twenty young people aged 1217 report drinking alcohol frequently, compared with one in four white young people. ·
·  Men are more likely to binge drink (48%) than women (31%). Of those, 25% of men reported committing violent crime in the previous twelve months, compared to 3% of women.
·  Those living in a deprived area are more likely to be victims of crime, and to have higher levels of worry about crime perception and of antisocial behaviour.
·  Perceived increases in the rate of crime over the past two years is more prevalent among women and older age groups. · Worry about violent crime, which is to a large extent driven by alcohol misuse, is higher among women.
·  Women are more likely to be victims of domestic violence, to suffer 4 or more attacks, to suffer greater injury and to be classed as chronic victims of domestic violence than men. ·
·  Disabled people have a heightened fear of crime. ·
·  Fewer women than men are cautioned or found guilty for drug offences.
·  Young people in vulnerable groups are significantly more likely to use illegal drugs. · Of people aged 16-59 from a mixed race background, 26% reported using an illegal drug in the year before the 2001/02 British Crime Survey and 7% reported using a Class A drug. This is much higher than white people, which is the group demonstrating the second highest use, at 12% and 3% respectively.
·  Data from the 2005/06 BCS show that unemployed respondents reported cocaine use within the last year at more than twice the rate as those in employment.
·  BME offenders are overrepresented among offenders and account for a significantly greater proportion of the prison population (23%) than their proportion of the general population (9%).
The implementation plan details actions that are set against target indicators so that performance can be identified and monitored and remedial action taken if necessary. There is an acknowledged lack of data on many aspects of alcohol misuse in the borough, including information about equalities and alcohol. The strategy makes improving data a priority, and funds have been made available though the Alcohol Improvement Grant to the PCT to employ an analyst to specialise in alcohol data collection.
2. GATHERING INFORMATION AND INTELLIGENCE
2.1 What current info/data do you have about these group/s or communities?

Race

In 2004 the Health Survey for England found that people from many ethnic minority groups in England (Indian, Pakistani, Bangladeshi, Black Caribbean and Black African) were on average more likely to be non-drinkers and less likely to drink above recommended levels or to binge drink than the general population. This is reflected in Newham, where White people are most likely to be admitted to hospital for alcohol-related illness, accounting for 53% of admissions (Figure 1) compared to Asian (15%) and Black (11%) people. Since 34% of Newham’s population is White, this group clearly suffers disproportionate levels of alcohol-related morbidity.
Figure 1

White British clients accounted for nearly half (49%) of all clients attending DASL (Drug and Alcohol Service for London), the main specialist alcohol treatment service in the borough, in 2007 (Figure 2). DASL’s client profile appears roughly to reflect the relative levels of alcohol-related morbidity in Newham.
Figure 2

Gender

Men at all ages are more likely to drink above the recommended limits than women. 82% of Newham’s alcohol-related hospital admissions in 2007/08 were male. From DASL’s data, 446 men (75% of all clients) and 151 women (25%) were assessed for specialist alcohol treatment in 2007/08, a ratio of 3:1. Nationally, the ratio of men to women accessing drug and alcohol services is about 2:1. Whilst this may suggest women clients are under-represented at DASL’s, the relatively high hospital admission rates for men in Newham indicates that this is not so.

Disability

There is little national information on prevalence of people with disabilities with alcohol problems and the data is not collected by local services. This means there is a knowledge gap in this area.140 people in Newham claimed benefits for incapacity or Severe Disablement due to alcoholism as of November 2007. Alcohol is often used problematically by people with mental health problems, which can seriously affect the ability of services to assess, treat and care for patients safely and effectively. The use of alcohol can make symptoms worse and trigger acute illness relapse. Aside from mental health problems, there are no alcohol services currently targeted at people with specific disabilities.
Sexual orientation
With the exception of DASL (which has a focused service for LGBT clients), data on sexuality is not routinely collected by treatment services, GPs or hospitals – making it difficult to gauge both the extent of alcohol problems amongst LGBT and any possible impact of this strategy. However, anecdotal evidence from elsewhere suggests that gay men are particularly vulnerable to, and fearful of, homophobic violence outside gay pubs and clubs and there is some evidence that LGBT people are vulnerable to alcohol and drug misuse as a result of homophobia and as a coping mechanism for problems associated with sexual identity. There needs to be an awareness of this by all services working with/or coming into contact with LBGT from the police through to health care professionals. We also need to understand the extent to which alcohol related violent crime in the borough is targeted at LGBT and to ensure that commissioned alcohol services are sensitive to/ and accessible to LGBT.

Age

People under 45 are more likely to exceed the recommended daily limits for alcohol consumption than people who are older (Figure 3). The General Household Survey 2005 found that, for England, the 16-24 age group was most likely to drink at harmful levels.
Figure 3

The national picture for adults is reflected in DASL’s data (Figure 4). Younger clients attend another service (Create).
Figure 4

Analysis of alcohol-related hospital admissions in Newham shows that the average age of all patients was 39 in 2007/08, although the average age of both men and women fluctuated considerably for each month of the year.
Figure 5

Faith

The use of alcohol varies markedly across different faith groups. For some, it is prohibited whilst in others it is used as part of religious ceremony. There is insufficient data available at present to assess the impact of the strategy on different faith groups. However, there are good examples of positive steps being taken by treatment providers as follows: staff represent most faith groups, religious festivals are respected, flexible appointments are available, prayer and quiet spaces are available, and providers have policies on respecting other users' beliefs. There is a need to ensure all service providers collect data on faith.
2.2 Who has been consulted in carrying out this impact assessment?
Alcohol related harm cuts across a wide angel of services and organisations. The following were all consulted in the drafting of the strategy.
Newham Primary Care Trust (now Newham NHS)
Adults Services Including: Integrated Commissioning, Safeguarding Adults, the Substance Misuse Services including the Drug Intervention Project, and Supporting People.
LBN Community Participation Team
Community Safety Division (formerly crime and Anti-Social behaviour Service), including the Domestic Violence Team,
Children and Young People’s Services including: Lifelong Learning and Economic Wellbeing, Learning and Schools and Children Young People and families, the Youth Offending Team
Housing and Public Protection; including Licensing and Trading Standards
Regeneration, Business Development, including Town Centre Managers
Metropolitan Police
British Transport Police
London Fire Brigade
East London NHS Foundation Trust inc Healthy Options Team and SSMT and CAMHS
Newham PCT
London Ambulance Service,
Newham Homes
London & Quadrant Housing Trust
East Thames Group
DASL(Drug and Alcohol Services for London)
Involve
Anchor House
DASL
The Newham Community Renewal Programme
Turnaround
Dept of Health National Alcohol Improvement Lead,
Emmanuel Parish Church
Newham Chamber of Commerce
Newham Pub Watch
Stratford Town Centre Forum,
The following were also consulted in meetings
Crime and Disorder Reduction Partnership
Children and Young People’s Partnership Board
NEB
Robin Wales
Social Landlord ASB Forum
Substance Misuse Partnership Board
June Leitch (lead Executive Member for Crime and ASB)
3. ASSESSING THE IMPACT
3.1 What gaps have been identified?
There are gaps in our knowledge and understanding of the links to local alcohol-related harm and disability, faith and sexual orientation.
Servcies are currently provided to those seeking help from GPs identified from A&E in off peak hours, and by referral to DASL from a variety of sources for assessment and treatment. This service provides counselling and detox. This is supplemented by the structures day programme
3.2 Does this constitute an adverse impact?
The fact that particular groups such as the white Community and LGBT suggest that they are disproportionately affected however, there is no empirical data to support this
4. ACTION REQUIRED
4.1 What actions /policy decisions are needed to remedy the adverse impact if any?
In order to address the data gap and to assess the impact on these groups the following action is required:
i.  Operational policies to be reviewed to include a requirement to collect client data on disability, faith and sexual orientation by all alcohol treatment services
ii.  Develop systems to improve data collected on alcohol-related violence to establish if any groups are particularly affected.
4.2 How will this action be carried out and prioritised?
These actions are included in the strategy’s implementation plan, the delivery of which will be decided by Newham Partnership Board..
5. MONITORING
5.1 How will this be monitored?
A decision on governance for the delivery of the implementation plan will be made by Newham Partnership Board.The CDRP will receive regular updates and the plan will be reviewed yearly.
5.2 How will you monitor for potential adverse impact in the future?
The overall impact of the strategy will be reviewed by the Strategic Alcohol Board, and the review will include revisiting the equalities impact assessment.
Analysis of data / intelligence collected by treatment providers and other practitioners and through research
·  Alcohol related surveys
·  Casework audit