Innovation and diversity in public health team engagement in local alcohol premises licensing: qualitative interview findings from the ExILEnS study

Abstract

Background: Evidence suggests that controls on the physical and temporal availability of alcohol can reduce alcohol-related harms. Public health teams (PHTs) in England and Scotland have in recent years been given a statutory role in licensing systems through which premises are granted permits to sell alcohol. The ExILEnS (Exploring the Impact of alcohol Licensing in England and Scotland) study examined PHT efforts to engage in alcohol licensing from 2012-2019. Objective: We aimed to describe the range of PHT practice in engaging with alcohol licensing across England and Scotland, with a particular focus on unusual or innovative practices. Methods: Two sets of interviews were conducted with 20 PHTs in England and Scotland who were actively engaged in alcohol premises licensing. Firstly, representatives of each PHT with experience of licensing activity took part in structured face-to-face or telephone interviews (n=41) and provided documentation to identify how and when their team engaged with alcohol premises licensing. Secondly, members of PHTs, took part in in-depth one-to-one interviews (n=28) focused on individual roles and responsibilities. Relevant PHT activity was analysed quantitatively within nineteen activities in six categories using the ‘Public Health engagement in Alcohol Licensing’ (PHIAL) Measure, as well as qualitatively using NVivo. Innovative practices were identified using the highest PHIAL scores for specific activity types across single or multiple six-month periods. Findings: Within each of the six activity categories, a range of practices were observed. More unusual practices included: having a dedicated post to work full-time on alcohol licensing; developing a standardised reviewer tool allowing the team to respond to applications and provide the most relevant evidence in a consistent and systematic way; committing to additional scrutiny of occasional licenses or temporary event notices; maintaining a detailed database recording applications made, whether the PHT decided to object and the outcome of the licensing board’s decision; engaging with applicants prior to them submitting an application; visiting proposed/current licensed premises to gather bespoke data; leading the writing of local licensing policy; and working closely with licensing standards officers. Conclusions: Across six categories of PHT activity relating to the local alcohol premises licensing system, PHT practices varied and some PHTs stood out as engaging in more innovative or intensive activities. The identified examples will be of value in informing PHT practice in what remains a relatively new area of work for many, despite limitations in the system. The inclusion of examples from both England and Scotland and from many PHTs will facilitate cross-fertilisation of ideas and practice across PHTs.