The more things change the more they stay the same: Assessing the immediate impact of the licensing act (2004) on attendances to accident & emergency departments

This paper reports on a survey of 39 Accident and Emergency departments (AED) in England regarding presentations over a three month time period before and after the changes in the Licensing Act (2003) which came into force in November 2005. The time periods reported are January – March 2005 (the PRE period) and January – March 2006 (the POST period). Our data indicated NO significant change in the number of attendances that could be related to alcohol consumption (hereafter referred to as ‘attendances’) in the first two months following increased availability. In the third month there was a significant decrease in ‘attendances’. There was considerable variation in the changes in ‘attendances’ between participating AEDs. The pattern of ‘attendances’ on weekdays (Monday – Thursday) was unchanged. Following increased availability ‘attendances’ on Saturday fell, but increased on Fridays and Sundays. There were no changes in the pattern of ‘attendances’ across the 24 hour period, with most patients presenting at around Midday. Rates of ‘attendances’ for Assault and Head Injury fell significantly following the change in availability. The number of ‘attendances’ where alcohol was specifically mentioned increased significantly during the POST period. Prior to the increase in availability, the number of ‘attendances’ where alcohol was specifically mentioned peaked sharply around Midnight. Following the change in the law, there was a general increase in such ‘attendances’ from 11PM through to 3AM. Although there was a general increase in alcohol specified ‘attendances’ across the week, there was a significant increase in such ‘attendances’ on a Sunday. Data from one Northern and one Southern Local Ambulance Service was provided to complement the data obtained from individual AEDs. The number of alcohol related ambulance call outs for the LAS and NEAS increased following the change in the law