Evaluation of the Public Health Alcohol Licencing (PHAL) Tool

Public health practitioners have opportunities within local authorities to shape decisions about how licences to sell alcohol are granted. This role has potential for shaping the availability of alcohol in local areas and for reducing some health and social harms resulting from alcohol use. However, we have limited knowledge about how much influence public health has in this role, and the challenges they face in trying to shape licensing decisions, particularly when licensing legislation in England does not acknowledge protecting health as a priority.

This study aimed to understand more about how public health practitioners in London undertake alcohol licensing work and the factors that shape how they can influence licensing decisions.

Researchers conducted research with practitioners across 24 out of the 33 local authorities in Greater London. Researchers used a range of methods including observations of public health practitioners’ licensing work, a survey, focus group discussions and interviews with different practitioners involved in licensing, and an analysis of data collected by public health teams on the outcomes of licence applications.

The study identified great variety across public health teams in London in terms of capacity to undertake alcohol licensing work, the approaches taken by public health practitioners, and perceptions of the influence public health has on licensing processes.

In some local authorities there was very little or no licensing work being undertaken by public health. In other areas, public health practitioners regularly took action to negotiate with licence applicants and to make recommendations for how and when alcohol can be sold.

A range of factors shaped how much public health practitioners can influence licensing decisions. These included the perceived status of public health in the licensing process; the amount of engagement between public health and other licensing practitioners; different interpretations of what counts as valuable evidence to support public health licensing recommendations; and resources and capacity within teams, particularly in the face of austerity.

This study makes several recommendations for strengthening public health contributions to alcohol licensing processes, and helping to reduce alcohol-related harms. These include:

1. Support regular engagement between public health and other licensing practitioners, for coordinated responses to alcohol licence applications and to licensing policy.
2. Public health practitioners should try to use a wide range of types of data and evidence to support their recommendations, from very local data on alcohol incidents to more general research evidence on alcohol-related harms.
3. Public health practitioners should be supported to learn from each other, to help share learning about effective ways to present recommendations against alcohol licence applications, and for alcohol licensing policy.

The research was funded by the NIHR School for Public Health Research (SPHR) Public Health Practice Evaluation Scheme (PHPES) in collaboration with Public Health England.

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