24-hour drinking linked to shift in hospital attendance patterns

Since the UK's move to 24-hour drinking, a large city centre hospital in Birmingham has seen an increase in drink-related attendances between the hours of 3am and 6am.

A new study, published in the open access journal BMC Public Health, shows no significant decrease in alcohol-related attendances after 24-hour drinking was introduced but a significant shift in the time of attendances.

Andrew Durnford and Tommy Perkins co-led a team of researchers from the University of Birmingham who investigated the effects of the Licensing Act 2003 on Emergency Department admissions to an inner city hospital. Durnford said, "Interestingly, since 24-hour drinking, significantly more alcohol-related attendances were observed in the early hours of the morning and a significantly smaller proportion in the earlier evening. This trend was seen for weekdays and weekends".

He added, "Our findings suggest that although the Act has not affected the number of alcohol-related attendances at the Emergency Department or the day of presentation; it is associated with a shift in the time of attendances into the early hours of the morning. This may reflect a change in drinking patterns".

The research suggests that 24-hour drinking has not reduced the burden of alcohol attendances to emergency departments and has simply shifted the problem later into the night. According to the authors, "For the NHS, this suggests 24-hour drinking has not lessened the workload. Furthermore, this shift to increased attendances in the early hours will have implications for night-time service provision in the NHS and the Police".

The Licensing Act 2003 allowed longer and more flexible opening hours for pubs, clubs and other licensed premises. Durnford and his colleagues investigated the alcohol-related attendances to the Emergency Department over a week in January 2005 (before the Act was implemented) and during the same week in January 2006 (after licensing hours were changed). In the period between the Act's implementation and the start of the study, 37% of licensed premises in Birmingham had successfully applied to extend their opening hours. However, the authors do point out that "Some venues may not have changed their opening hours immediately and attitudes towards alcohol may take more time to adapt to the new environment".

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