Executive Summary

• The School of Health and Related Research (ScHARR) at the University of Sheffield were commissioned by NHS England & NHS Improvement to estimate the impacts of pandemic related changes in alcohol consumption on alcohol-related health and mortality.
• The work was conducted using Alcohol Toolkit Study (ATS) data to estimate the changes in drinking in 2020 and 2021, and scenario modelling using the Sheffield Alcohol Policy Model (SAPM).
• ATS data shows that lighter drinkers decreased their consumption during the pandemic but heavy drinkers increased consumption. This polarisation is greatest among men and people in the highest socioeconomic groups while 25-34 year-olds who were drinking at risky levels before the pandemic have seen the biggest increase in alcohol consumption in 2020/21.

• We developed five alternative scenarios for how alcohol consumption may develop from 2022 onwards. One main scenario was chosen for illustrative purposes, which assumed that lower risk drinkers (those drinking within the current UK low risk guidelines) return to their pre-pandemic levels of drinking from 2022, whilst heavier drinkers remain at their pandemic levels for a further 5 years before gradually returning to pre-pandemic levels over the following 5 years.

• Four other scenarios were chosen to reflect a range of more or less pessimistic outcomes. These included a best-case scenario where all drinkers return to their 2019 levels of drinking in 2022, and a worst-case scenario where alcohol consumption increases in 2022 as a result of relaxation of COVID restrictions and the opening up of pubs, bars, restaurants and nightclubs.

• In our main scenario, we estimate that over the next 20 years, there will be an additional 207,597 alcohol-attributable hospital admissions and 7,153 alcohol-attributable deaths, costing the NHS an additional £1.1bn compared to if alcohol consumption had remained at 2019 levels.

• These impacts are not evenly distributed across the population, with heavier drinkers and those in the most deprived areas, who already suffer the highest rates of alcoholattributable harm, expected to be disproportionately affected.

• In our best-case scenario, even if drinking behaviour returns to pre-pandemic levels in 2022, we estimate an additional 42,677 alcohol-attributable hospital admissions and 1,830 deaths over 20 years.

• In our worst-case scenario these figures rise to an additional 972,382 alcohol-attributable admissions and 25,192 deaths at a cost to the NHS of £5.2bn over 20 years.

• This analysis highlights that changes in alcohol consumption during the COVID pandemic are estimated to have a significant impact on alcohol-related harm in England for many years to come.

• Given that these impacts come at a time when there are significant pressures affecting the NHS as a result of the pandemic, the government should give due consideration to policies aimed at reducing alcohol consumption and the associated burden of harm.