Like many I have spent the last two weeks demonstrating a casual disregard for the advice provided by health organisations in terms of food and alcohol consumption. My levels of physical activity have not been all they should have been either, although I am full of good intentions for the coming year and have started to make my overfed body walk more.

On the upside I have greatly enjoyed spending time with colleagues, friends and family. Its been an opportunity to talk and to think in a more relaxed manner than working life normally allows. Inevitably, as we leave one year and look forward to 2019, I have been reflecting on what has gone on and considering what we face in the rapidly approaching future. Considering the UK’s political situation, ongoing reductions in public expenditure, the huge challenges we all face to improve the health and lives of our populations I have come to an odd realisation. Despite all apparent indications to the opposite I am feeling a sense of optimism. Those that know me will realise this is not necessarily my normal outlook. I can also confirm this is not fuelled by an excess of liquid Christmas cheer, nor even a glass of eggnog. Possibly the recent run of decent form by my football team might have had some impact but given their defeat today I think we can also discount that. So, what is behind this positive sentiment?

Fundamentally I think it’s down to changes in attitude, a growing understanding that we need to work differently and more collaboratively if we are going to sustain, let alone improve, the lives and health of our communities. While in many cases this is being driven by necessity, we should acknowledge that sometimes well-resourced funding silos are also a barrier to effective delivery. Politically there is also a greater understanding of the potential and importance of improving health and its associate, happiness. The growing recognition of the importance of tackling isolation and loneliness should help to increase understanding of the value of community assets such as lunch clubs and day centres. The potential of harm reduction, across a range of issues, also seems to be enjoying a renaissance. Again, I think this is probably, at least partly, driven by financial considerations, but the focus on the quality of individual and community life is one to be welcomed. Bringing people with us, helping them improve their own lives, beyond condemnation and lecturing, is something we should embrace and promote.

This line of thought takes me back to City Health 2018 in Odesa. I have previously mentioned the lecture delivered by David Wilson in the closing session. If you have not previously looked it up, I strongly recommend you do so. I guarantee its twenty minutes you will not regret investing. While on the City Health website also look up some of the other presentations, Geoff Gallop, Jon Sigfusson (essential for anyone with an interest in substance misuse prevention in young people) and David Vlahov stood out for me, but there really is something there for everyone. Other sessions at the conference and contacts made came in useful to me recently.

At a recent conference on Hepatitis C in London we were looking at lessons in community communication we can learn from others, including the HIV world. The work being advanced in the Ukraine, in demanding circumstances, stood out. Australia can also provide some impressive examples of reaching out to communities, in this case Aboriginal groups, demonstrating that the concept of “hard to reach” is often as much a conceptual barrier as an objective reality. At long last in London you can see the wheels are, slowly, turning to really improve our response to Hepatitis C and the potential to eradicate a virus by treatment is gaining ground in the minds of politicians and policy makers.

I am also feeling positive about the conference the London Drug and Alcohol Policy Forum is hosting with London South Bank University on 18 January, Addressing Complexity: Homelessness and Addiction. This is a new collaboration for us both and aims to bring research and practice closer together. London is experiencing high levels of rough sleeping and homelessness, but I have been delighted by the response to this event with people from local authorities, the police, charities and other agencies all wanting to come together and discuss how we can do better in helping some of our most vulnerable citizens. We have spent the grand total of £0, nothing, on marketing for this event so it also demonstrates that despite years of cuts and the loss of many excellent staff, our networks – as well as interest and enthusiasm – do endure.

The problems we all work to overcome in our work can often seem overwhelming but let’s remind ourselves that we have thousands of existing and potential allies and partners to work with. There are great networks, of which KAC is one (do get booked for City Health in Liverpool, 22 March) which provide further opportunities. If we continue to explore how we can work together and explore new approaches who knows what we might achieve in the year ahead and beyond?

So, on that unrelenting upbeat note let me wish health and happiness to you all for 2019.

D.Mackintosh photoDavid MacKintosh is the Head of Community Safety for the City of London, and has also been the Policy Adviser/Director to the London Drug and Alcohol Policy Forum (LDAPF) since 2001.  The LDAPF works to support policy delivery and promote good practice across the drugs, alcohol and community safety agendas.  He has been involved in a number of innovative campaigns around issues including drug driving, substance misuse in the workplace and improving awareness around drug safety in clubs and pubs. The LDAPF is funded by the City of London as part of its commitment to improving the life of all those who live and work in London.  For the last eight years he has also been seconded to the Greater London Authority to provide advice around substance use issues and health inequalities. 

Prior to this post David worked for the United Kingdom Anti-Drug Co-ordination Unit (part of the Cabinet Office) for two years, primarily on young people and treatment policy issues.  This followed on from some 8 years in the Department for Education and Skills where he worked in a number of areas including international relations and higher education policy. He spent ten years as chair of an East London based service provider and is currently a trustee of Adfam (families, drugs and alcohol) and the New Nicotine Alliance (which aims to improve public health by raising awareness of risk-reduced products).