Introduction: Public Health England (PHE) works to support local public health teams in their role as a responsible authority, providing guidance, workshops and training. In 2016, with the support of the Home Office and Department of Health (DH), PHE developed and piloted an analytical support package (ASP) to help public health teams in their existing role as a responsible authority as defined in the Licensing Act, and to explore the data and processes that would support a theoretical public health licensing objective.

A team based in Sunderland and Bristol universities was commissioned to lead the evaluation of the pilot. This report, based on their findings, explores the experience of pilot areas using the ASP tool. It describes how they accessed relevant health information and how that information was presented in fulfilling their role as a responsible authority. The pilot areas also explored how ASP-generated data and evidence could be of use in the context of a theoretical fifth licensing objective addressing the protection of public health. This report presents the findings from the project and how the areas engaged with the package in attempting to improve public health’s engagement with alcohol licensing.

Method: Eight pilot sites were selected across England. The pilot areas were supplied with a guidance document setting out time scales, reporting and evaluation methods. The ASP itself consisted of a data library, a local health tool to map health data at a local level and guidance on how to collate relevant information from primary data via surveys. A series of baseline interviews and focus groups were conducted with responsible authority representatives from the participating areas. These included the police, fire service, health and safety, trading standards, planning, environmental health, child protection and senior public health representation (either Director of Public Health (DPH) or the local authority lead for alcohol).

Findings: The ASP was seen as a useful resource that should, with further development, be made available nationally. Local public health teams need access to analytical capacity in order to maximise the most of the ASP.  

The level of access to health data varied, as did the granularity of the available data. In particular, a number of areas had difficulties in accessing Hospital Episode Statistics (HES) data. Despite barriers to data access, there was a recognition of the importance and potential for a wider range of health information and data to be explored and used. Where health data is used it should be part of a wider ‘story’ about meeting the licensing objectives. The participants’ experience was that an over-reliance on data limited their effectiveness in contributing to licensing decisions. Training and support for public health teams on using the tool and how to present information could help improve effectiveness. Public health teams need to be clear on the objectives of engaging with alcohol licensing and what success looks like. Strong partnership structures and working relationships with other responsible authorities to demonstrate the impact on health harms were seen to be important.

Some pilot areas identified more scope within the current objectives and provided examples of the positive role public health can play in providing effective engagement within the current licensing framework. Responses highlighted a mixed view on public health’s role and there wasn’t a clear consensus on the reach of public health within the current Licensing Act. This had an impact on the openness to engagement, acceptability of data within licensing and influenced the responses that came out of the work. The absence of a public health licensing objective was seen to be a barrier to public health being effective.

The conclusions: Overall, the ASP was seen as a useful addition to the resources that public health can call on in carrying out the role of a responsible authority. The ability for areas to adapt and enhance the supplied datasets, with locally collected data and/or bespoke local mapping information, helped areas think creatively and practically about how to access and utilise a range of available health information in ways applicable to local licensing practices. The work highlights ongoing challenges and areas of improvement which can be framed under 3 domains. 

Operational - The capacity of public health teams to engage in alcohol licensing work and the analytical capacity to work with and access data. 

Skills - The ability of public health teams to present health data in a format and context that licensing committees can assimilate in their decision-making process. The ability of those in licensing to understand and make the best use of public health’s contribution to promoting the licensing objectives.

Custom and practice - The existing custom and practice (relationships between responsible authorities, definitions of roles and interpretation of guidance and information) in a local area was an important factor in the level of engagement and effectiveness of public health in engaging with alcohol licensing. The areas that experimented with the mock hearing or who presented their evidence to workshops provided examples of how local areas could establish evidence relevant to decisions based on a public health licensing objective but also highlighted challenges in doing so. This project suggests that if a public health licensing objective is to be considered the wording of the objective and supporting guidance around it will be critical. Alternatively, consideration could be given to strengthen guidance around the current objectives and recommended local practices to enhance and reinforce the role that public health plays.