The Greater Manchester
Alcohol Strategy
2014–2017
Foreword
Stronger Together
Greater Manchester’s vision is to be financially
self-sustaining by 2020, as set out in the
Greater Manchester strategy, Stronger Together
– created by the GMCA in 2011. Realising this
ambition requires change, and our Growth
and Reform Plan is how we will achieve this.
The alcohol strategy is one part of this plan,
alongside many other initiatives – in areas
such as transport, health, business, support,
skills, public service and education – which
are working across Greater Manchester to
deliver this vision.
Alcohol strategy programme
The development of an alcohol strategy
at the Greater Manchester level represents an
important step for all partners. The strategy
reflects both the complexity of the challenges
we face, and our collective resolve to meet
these challenges with a considered, resolute
and integrated response.
Alcohol is everybody’s business. It is a crosscutting issue that concerns the health and
wellbeing of our residents, the safety of our
communities, and the future success of our
town centres and their night-time economies.
The current level of alcohol consumption
across Greater Manchester poses a range of
significant challenges to individuals and to
society as a whole.
—— Alcohol has a disproportionate effect
upon Greater Manchester residents’ life
expectancy and mortality rates. Demand
upon NHS services linked to alcohol is
significant and a large number of workingage residents are dependent upon state
benefits as a result of alcohol-related health
conditions. The co-existence of alcohol,
drug and mental health problems remains
a vital and complex challenge.
—— Problem drinking is a significant
contributory factor in violent crime and
public disorder every weekend across
Greater Manchester, and a key driver of
wider nuisance and disruption within our
communities. Domestic abuse remains
a significant and complex challenge,
with a traumatic impact on victims and
families that often remains hidden due
to under-reporting of the issue.
—— Our town centres lie at the heart of our
local communities but continue to face
a series of fundamental challenges. Many
Greater Manchester residents perceive
problems with binge drinking in an
—2—
environment that can only be enjoyed by
a particular demographic and age group.
This can stunt the emergence of a stronger
food- and entertainment-based early
evening economy, resulting in lack
of footfall and unoccupied premises.
that exist at borough level; rather, it highlights
the added value that can be achieved through
us working together. We are proud to have
been designated as one of 20 Local Alcohol
Action Areas for 2014/15, and are already
working closely with the Home Office and
Public Health England in taking forward our
programme of work, a key element of which
focuses on the implementation of this strategy.
Much excellent and effective work has been
undertaken by partners in every district
across Greater Manchester to address these
challenges. However, as is the case across
the whole of the public sector, it is vital that
we continue to increase the pace at which
effective practices are spread and embedded
locally, and that we reform the way we tackle
alcohol-related harm.
The importance of a joined-up approach on
alcohol has never been clearer. One of the
most telling statistics we have is that crime,
health, worklessness and social care costs to
Greater Manchester arising from alcohol are
estimated at £1.2billion per year – around
£436 per resident. This represents significant
demand on our increasingly pressurised and
shrinking public services. Our overarching
Greater Manchester strategy, Stronger Together,
is built upon a clear understanding between
all partners that creating jobs and growth
without reforming services or transforming
places will not reduce the costs of dependency.
Only through a combined focus on both
growth and reform will we close the £4billion
gap between the tax we generate and the cost
of public services across Greater Manchester.
We wholeheartedly recommend this strategy
to the public of Greater Manchester, elected
members, all public sector agencies, our
voluntary and community sector partners,
and our private sector partners in the alcohol
industry. We are confident that the strategy
can provide a supportive and flexible
framework for collaboration within and
between the ten Greater Manchester districts,
and enhance all our efforts in this area over
the next three years.
Signatories:
Councillor Mike Connolly
Councillor Clifford Morris
Police and Crime Commissioner Tony Lloyd
Hamish Stedman, Chairman,
Association of Greater Manchester CCGs
This shared Greater Manchester Alcohol
Strategy is therefore a key means through
which we can enhance our well-established
partnership approach, and ensure that we
continue to challenge ourselves to do the very
best for the people of Greater Manchester. The
purpose of our Greater Manchester approach
is not to replace the many excellent strategies
—3—
1. Introduction
1.1 The overarching purpose of this Greater
Manchester Alcohol Strategy is to reduce
demand on public services and address
complex dependency issues through
early intervention and prevention activity.
In order to achieve this, it will seek to
deliver three interlinked outcomes:
I. reducing alcohol-related crime,
antisocial behaviour and domestic
abuse
II. reducing alcohol-related health harms
III. establishing diverse, vibrant and
safe night-time economies.
1.2 The strategy and its outcomes have been
developed collaboratively by Greater
Manchester partners, with all-party
support from the ten Greater Manchester
local authorities, Greater Manchester
Directors of Public Health, the Office
of the Police and Crime Commissioner
(OPCC), Greater Manchester Police,
the Association of Greater Manchester
Clinical Commissioning Groups, and New
Economy. The process of developing
the strategy has also been supported
by inputs from the Greater Manchester
Public Service Reform Team, Public
Health England (PHE), Drink Wise,
the Greater Manchester Public Health
Network, Greater Manchester Fire and
Rescue Service (GMFRS), and Pennine
Acute Hospital Foundation Trust.
1.3 Public consultation on the development
of the strategy was undertaken in
February and March 2014 to seek support
for the overall approach and headline
outcomes proposed. Elected members
were engaged in the development
process, as were representatives from the
alcohol industry, to canvass viewpoints
on key opportunities through a Greater
Manchester strategy. Feedback endorsed
the intended Greater Manchester approach
and the three suggested outcomes.
1.4 Partners followed a set of guiding
principles in considering how a Greater
Manchester strategy can best support a
collective response to the challenge of
tackling alcohol-related harms:
—4—
—— First, all partners agree that this
strategy must be properly aligned with
our overarching Greater Manchester
strategy focus on growth and
public service reform. The strategy
supports our shared vision to achieve
sustainable economic growth, and
ensure all residents can contribute
to and benefit from that growth. The
majority of the key activities to deliver
the strategy can be sensibly grouped
around these strategic priorities.
—— Second, partners have identified
that the Greater Manchester strategy
should support local delivery,
particularly where this facilitates
consistent application of best practice.
The strategy can act as a flexible
framework within which local areas
can share their experiences of
what works and identify innovative
approaches through collaboration.
—— Third, partners have resolved that
the Greater Manchester strategy
should take advantage of Greater
Manchester’s scale, particularly where
there are opportunities to challenge
the status quo and to position Greater
Manchester as a leader and innovator
in the field. To this end, some
elements of the strategy are focused
on lobbying and advocacy activities.
1.6 The remainder of this strategy sets
out further contextual background on
the nature and scale of the Greater
Manchester alcohol challenge, along with
details of the strategy priorities and plans
for implementation.
Section 2 provides a summary overview
of the Greater Manchester evidence base.
Section 3 outlines how we have built
an implementation plan for the strategy
that supports growth, reform, consistent
approaches, innovation and integration.
Sections 4, 5 and 6 specify the priorities
framing the activities that will drive
implementation of the strategy.
Separate annexe documents provide
further detail on the strategy, and plans
for implementation in 2014/15 (year 1).
1.5 Oversight and implementation of the
strategy will be driven by the Greater
Manchester Police and Crime Steering
Group and the related Leads Group,
which will oversee and drive strategy
implementation. Links will be made
as necessary to establish lines of
communication and accountability to
wider delivery structures (eg. across
crime and policing, public health, clinical
commissioning and economic strategy).
—5—
2. The scale and
nature of the Greater
Manchester challenge
2.1 The scale of the Greater Manchester
alcohol challenge is significant. In
summarising the evidence base set out
below, the case for change is clear and
the need for a transformational and
ambitious strategy reinforced.
estimates that the rate of all alcoholrelated crime in Greater Manchester is
second only to London: 8% above the
north west regional figure, and 11%
higher than the national figure.
Reducing alcohol-related crime,
antisocial behaviour and
domestic abuse
46–58% of adult offenders in Greater
Manchester have alcohol misuse risks/needs
38% of Greater Manchester violence
involving injury is alcohol related
32% of Greater Manchester domestic
incidents are alcohol-related
7% of Greater Manchester residents report
problems in their local area with alcoholrelated anti-social behaviour
—— Though reducing over recent years, a
greater number of violent offences are
recorded in Greater Manchester than
in any other police force area except
the Metropolitan Police area and the
West Midlands. Public Health England
—6—
—— It is estimated that less than 40% of
domestic violence crime is reported
to the police; repeat victimisation is
common, and the traumatic impact
on victims is often accompanied by
significant wider, long-term damage
to children. Home Office research on
domestic violence offenders showed
that 73% had drunk alcohol prior to
the offence, with 48% of perpetrators
assessed as being alcohol-dependent.
Domestic homicide reviews undertaken
across Greater Manchester have
identified long-term alcohol misuse as
an important factor in several of the
most serious cases of domestic abuse.
—— Greater Manchester has one of
the highest incidences of reported
antisocial behaviour in England and
Wales (50 incidents per thousand
residents). At least one in every ten
calls to Greater Manchester Police
relating to antisocial behaviour
references the consumption and
effect of alcohol.
Reducing alcohol-related
health harms
Mortality – Greater Manchester mortality
rates are among the highest in the
country in relation to alcohol-specific
conditions, alcohol-related conditions,
and chronic liver disease.
Hospital admissions – Rates of admission
to hospital for both alcohol-specific, and
alcohol-related conditions in Greater
Manchester are among the highest in
the country, looking both at numbers
of individuals presenting and overall
numbers of episodes.
Worklessness – A far greater proportion
of the working-age population in Greater
Manchester are economically inactive due
to alcoholism than is the case nationally.
All Greater Manchester districts feature in
the 30% most challenging local authority
areas in England.
—— Alcohol is the biggest lifestyle health
risk factor for illness and death after
tobacco and high blood pressure, and
nationally is estimated to cost the
NHS about £3.5billion per year.
—— Various statistics concerning alcoholrelated mortality and life expectancy
show that health harms are consistently
higher in Greater Manchester than any
other area covered by Public Health
England. On most measures, at least
six of the ten Greater Manchester local
authorities are ranked within the 20%
most challenging boroughs nationwide
(and on several measures the picture
is even more concerning). Nationally,
liver disease has now been identified
as the only major killer on the increase.
—— The demands placed on the NHS as
a result of alcohol, both in terms of
attendance at accident and emergency
departments at busy times and in
terms of the impact on availability
of beds, are significant. The rate
of admissions for alcohol-related
conditions has doubled nationally in
a decade and is continuing to rise.
The Greater Manchester rate is higher
than all other PHE areas. Hospital
admission figures within the Public
Health Outcomes Framework also
demonstrate higher-than-average levels
of demand within Greater Manchester.
—— The official statistics also
demonstrate the negative impact on
the Greater Manchester economy:
a disproportionate number of
people in Greater Manchester are
not economically active and are
dependent on medical-related benefits
as a result of economic inactivity
linked to alcoholism. Most recent
data shows there are 175 claimants of
incapacity benefit or severe disability
allowance for every 100,000 workingage people in Greater Manchester.
Eight of the ten Greater Manchester
—— Alcohol consumption, wider
substance misuse and mental ill
health are intimately linked. There
are significant connections between
reported alcohol use and depressive
symptoms. National research into
substance misuse and mental illness
found that 85% of users of alcohol
services were experiencing mental
health problems. As many as 65%
of suicides have been linked to
excessive drinking.
—7—
districts feature in the 20% most
challenging local authority areas
nationally on this particular measure.
Establishing diverse, vibrant and
safe night-time economies
Cost – The combination of crime, health,
worklessness and social care costs to
Greater Manchester arising from alcohol
are estimated at £1.2billion per year –
around £436 per resident.
Binge drinking – is disproportionately
high across Greater Manchester. Latest
figures estimate that 8/10 Greater
Manchester districts are among the top
20% nationally with particular challenge
in this area.
Town centres – and local night-time
economies are often unbalanced and
narrow, with the consequences of
excessive alcohol consumption placing
significant and costly demands on
emergency services.
—— Addressing alcohol within the nighttime economy cuts across a range
of interlinked wider challenges and
risks: poly-drug use, transport and
road safety, emergency healthcare,
sexual health and abuse, violence,
public nuisance, and neighbourhood
disturbance.
—— Concerns around alcohol-related
disorder in some of our town centres
and the regional centre can have
a negative impact on the economy,
contributing to a lack of footfall
in town centres, a prevalence of
unoccupied units, and the absence
—8—
of a family-focused/inclusive food and
entertainment-based early-evening
economy. The north west Big Drink
Debate survey revealed that nearly
half of respondents said they avoid
their local town and city centres at
night because of drunken behaviour.
The annual Greater Manchester-wide
survey of 2,500 businesses showed
one in three is dissatisfied with levels
of crime and antisocial behaviour, and
flagged the importance of the town
centre environment being one where
businesses want to locate and invest.
—— Greater Manchester Police deals
with disorder by intoxicated visitors
to Greater Manchester’s town
centres and the regional centre
from midnight to 6am and even
7am, placing a significant burden
on already stretched resources.
Transferring people to hospital places
a costly demand on the North West
Ambulance Service and accident and
emergency departments.
3. Strategy priorities
Headline outcomes
3.1 The Greater Manchester Alcohol Strategy
has an overarching purpose to reduce
demand on public services and address
complex dependency issues through
early intervention and prevention activity.
In order to achieve this, it will seek to
deliver three interlinked outcomes:
1.reducing alcohol-related crime,
antisocial behaviour and domestic
abuse
2.reducing alcohol-related health harms
3.establishing diverse, vibrant and safe
night-time economies.
3.2 All elements of the strategy are designed
to have a positive impact on achieving
these outcomes. Our approach recognises
the interrelationship between each of the
three outcomes (ie. many of the activities
taken forward in the strategy will
contribute to more than one outcome).
The structure of the Greater
Manchester strategy
3.3 All partners have agreed that there is
a strong rationale to structure activity
in a manner that promotes integrated
working across the conventional themes
of community safety, public health
and economic strategy. The Greater
Manchester Alcohol Strategy 2014–2017
will take forward a programme of activity
that, in total, covers 11 strategic priorities.
In line with the guiding principles
underpinning the strategy, these are
grouped together and structured to
retain a focus on growth and reform, to
promote effective practice within Greater
Manchester, and to challenge the status
quo on key national issues.
3.4 Sections 4, 5 and 6 specify the priorities
that form the focus of the Greater
Manchester Alcohol Strategy, to be
addressed and implemented over the
period 2014–17.
—9—
4. A platform for
growth and reform
Large-scale change and Greater
Manchester consistency of best practice
can maximise their influence through
combined efforts and wider regional
collaboration. We will consider how
Greater Manchester can influence and
support continued debate on alcohol
pricing and advertising, ensuring a link
between the Greater Manchester strategy
and the national policy landscape.
4.1 This strategy has a key role to encourage
local excellence. In order to deliver on the
strategy’s growth and reform elements,
where appropriate it will encourage
consistency and best practice in different
areas, while maintaining local flexibility.
4.2 Several elements within this Greater
Manchester strategy are focused on
promoting the effective, appropriate and
consistent use of our existing tools and
powers (eg. in relation to licensing and
wider regulatory services, and in relation
to our consideration of legal and civil
powers to address antisocial behaviour).
Partners will review promising approaches
to licensing and regulation from other
parts of the country, with a focus on
working collaboratively with the industry
to promote responsible retailing. This
will review, for example, opportunities
to use voluntary agreements to control
the availability of high-strength alcohol
products in partnership with the industry,
and district-based pilot work will test
these approaches as one facet of a
rounded local response.
4.3 The strategy will also focus on advocacy
and lobbying activities, recognising
that partners across Greater Manchester
4.4 Implementation of this part of the Greater
Manchester Alcohol Strategy will help
achieve our shared outcomes through:
Priority 1: Promoting the effective and
consistent use of licensing/regulatory
tools and powers to reduce demand,
including through enforcement-based
activities and wider voluntary agreements
with the alcohol trade.
Priority 2: Promoting consistent,
appropriate and effective use of tools
to address alcohol-related antisocial
behaviour, including new measures
within the Anti-Social Behaviour, Crime
and Policing Act 2014.
Priority 3: Ensuring that Greater
Manchester leads the way on best
practice alcohol marketing.
Priority 4: Continuing to lobby
government for national implementation
of a minimum unit price.
— 10 —
5. Supporting Greater
Manchester’s growth
Diverse, vibrant and safe regional and
town centres
5.1 This strategy has an important part to
play in delivering economic growth. Our
alcohol strategy can support wider work
to raise the productivity of businesses
and residents, and focuses attention on
the issue of how to diversify the evening
and night-time economy across Greater
Manchester’s principal town centres and
the regional centre itself.
5.2 Implementation of this part of the Greater
Manchester Alcohol Strategy will help
achieve our shared outcomes through:
Priority 5: Defining and supporting
implementation of best practice
approaches to reduce alcohol-related
harm in Greater Manchester’s night-time
economies (NTEs)
— 11 —
6. Supporting public
service reform and
reducing demand
Alcohol, complex dependency and
health and social care integration
6.1 Public service reform (PSR) in Greater
Manchester is how we will support
increasing numbers of our residents to
become independent and self-reliant.
This involves connecting more people
to job opportunities, and reducing the
demand for expensive, reactive public
services. Over the next two years we
will accelerate the pace and scale
of progress on reform, focusing on
two key issues: helping people with
issues of complex dependency to gain
employment, and integrating health and
social care services. Greater Manchester’s
complex dependency work will build
on our local implementation of the
Government’s programme to turn around
the lives of the most troubled families.
This will consider those factors that
generate the greatest demand and cost
to public services, including skills and
employment, offenders, domestic abuse,
mental health and substance misuse.
6.2 We need to better understand the degree
to which alcohol is a feature in complex
dependency, and therefore a priority
for commissioners. This strategy will
therefore strongly support existing work
streams on data sharing, risk stratification
and systems thinking. Our alcohol
strategy integrates efforts to alleviate and
better manage the demand placed on
emergency services in criminal justice
and healthcare. It will help to address the
identified and unmet needs of offenders
at all points in the criminal justice
system, as part of a broader approach
to ensuring services are in place and
rehabilitation pathways defined and
resourced. It will also align with and
enhance existing work to protect victims
of domestic abuse.
6.3 In respect of public health, the strategy
will promote collaborative public health
action where this supports local delivery
(eg. activity to create environments
that encourage lower-risk drinking; to
intervene earlier with those experiencing
alcohol-related harm and those at risk of
harm; and to reduce dependency and aid
recovery). This strategy supports a range
of strategic NHS and PSR programmes
focused on integrated care, whole-system
approaches to workforce development,
behaviour change and community-based
asset development. We recognise that the
strategy cannot tackle alcohol as a single
— 12 —
issue; it will align with a broader riskand-harm agenda linking to drug misuse,
mental health, complex presentations
and dual diagnosis. It will also support
prevention work in the broader health
inequalities context of ‘Making Every
Contact Count’.
6.4 Implementation of this part of the Greater
Manchester Alcohol Strategy will help
achieve our shared outcomes through:
Priority 6: Supporting the prioritisation of
domestic abuse victims, promoting data
sharing and new approaches as a part
of Greater Manchester’s programme to
address complex dependency.
Priority 7: Developing and evaluating
interventions to address alcohol and
wider substance misuse by offenders at
the point of arrest, sentence and release.
Priority 8: Prioritising activity that
supports attitude and behaviour change
among young people and their families,
and challenges social norms.
Priority 9: Ensuring consistency of best
practice in the delivery/uptake of alcohol
identification and brief advice.
Priority 10: Supporting the development
of local recovery organisations and
networks, creating the conditions to
maximise their role as community assets
for reducing alcohol harm.
Priority 11: Ensuring a collaborative
and evidence-based approach to
commissioning interventions that address
alcohol dependence effectively.
— 13 —
Conclusions
Through the priorities outlined, this strategy
has a strong focus and emphasis on delivering
the three key outcomes:
—— reducing alcohol-related crime, antisocial
behaviour and domestic abuse
—— reducing alcohol-related health harms
—— establishing diverse, vibrant and safe
night-time economies.
Work towards achieving the priorities is
detailed within the annexed implementation
plan. This plan specifies the different activities,
initiatives and projects that will be delivered
in the first year of the strategy, along with
timescales and information about lead and
support bodies and agencies. Progress with the
different elements of the plan will be overseen
by the Police and Crime Steering Group.
This alcohol strategy is one of the ways our
ten local authorities are working together
to create a truly Greater Manchester, where
everyone shares in this success. Please see the
Greater Manchester Strategy ‘Stronger Together’
for more information about our growth and
reform priorities.
— 14 —
Further information
Electronic copies of this strategy document
can be accessed online via the AGMA website,
www.agma.gov.uk
For media enquiries, please contact:
Chris Dunbar
Strategic PR Manager
Wigan Council
[email protected]
For logistical queries on the
development of the alcohol strategy:
Rachel Dodd
Communications Business Lead
GMCA
[email protected]
For statistical/background research
enquiries:
Mark Coleman
Communications Manager
Marketing Manchester
(on behalf of New Economy)
[email protected]
— 15 —