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. 2018 Dec 18;18(1):1385.
doi: 10.1186/s12889-018-6306-8.

Processes, practices and influence: a mixed methods study of public health contributions to alcohol licensing in local government

Joanna Reynolds  1 , Michael McGrath  2 , Jessica Engen  2 , Ghazaleh Pashmi  3 , Matthew Andrews  3 , Jin Lim  4   5 , Karen Lock  2
Affiliations

Processes, practices and influence: a mixed methods study of public health contributions to alcohol licensing in local government

Joanna Reynolds et al. BMC Public Health. .

Abstract

Background: Public health in England has opportunities to reduce alcohol-related harms via shaping the availability and accessibility of alcohol through the licensing function in local government. While the constraints of licensing legislation have been recognised, what is currently little understood are the day-to-day realities of how public health practitioners enact the licensing role, and how they can influence the local alcohol environment.

Methods: To address this, a mixed-methods study was conducted across 24 local authorities in Greater London between 2016 and 17. Data collection involved ethnographic observation of public health practitioners' alcohol licensing work (in eight local authorities); a survey of public health practitioners (n = 18); interviews with licensing stakeholders (n = 10); and analysis of public health licensing data from five local authorities. Fieldnotes and interview transcripts were analysed thematically, and quantitative data were analysed using descriptive statistics.

Results: Results indicated that some public health teams struggle to justify the resources required to engage with licensing processes when they perceive little capacity to influence licensing decisions. Other public health teams consider the licensing role as important for shaping the local alcohol environment, and also as a strategic approach for positioning public health within the council. Practitioners use different processes to assess the potential risks of licence applications but also the potential strengths of their objections, to determine when and how actions should be taken. Identifying the direct influence of public health on individual licences is challenging, but the study revealed how practitioners did achieve some level of impact, for example through negotiation with applicants.

Conclusions: This study shows public health impact following alcohol licensing work is difficult to measure in terms of reducing alcohol-related harms, which poses challenges for justifying this work amid resource constraints. However, there is potential added value of the licensing role in strategic positioning of public health in local government to influence broader determinants of health.

Keywords: Alcohol; England; Ethnography; Licensing; Local government; Mixed methods; Process; Public health.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the ethics committee at LSHTM (reference 11770). Permission to conduct ethnographic observation was negotiated first with the Director of Public Health (or equivalent) in each LA, followed by individual written consent taken from each PHP observed. For observation of non-public meetings (such as responsible authority meetings), consent to observe and take notes was requested from each participant at the outset of the meeting. Licensing sub-committee meetings are open to the public so explicit consent was not needed for observation of these, although where appropriate the chair of the sub-committee was informed in advance of the researcher’s presence. For the interviews, participants were sent an information sheet in advance and written consent was taken before the interview started. For the survey, participants were sent an information sheet, and were asked to confirm their consent on the first page of the questionnaire. Written consent to use the routine data was gained from the relevant public health lead in each LA.

Consent for publication

Participants gave consent for direct quotations to be used in research outputs, including this manuscript.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Bar chart illustrating the frequency of different types of actions taken on licence applications reported by survey respondents (n = 18)
See this image and copyright information in PMC

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