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Clearly the current health focus is strongly centred on Covid- 19 and related issues, as it has been for the past few weeks. It is a demanding situation for politicians, officials, and indeed all of us, especially those working in our healthcare system. One of the major challenges we face is increasing understanding and encouraging changes in behaviour, while also avoiding panic and overreaction. Trusted and accurate information is clearly essential, both for those who have a key role and for the general public. We are certainly seeing more of England’s Chief Medical Officer and Chief Scientific Adviser in the media than usual. In the current situation, politicians are not only keen to hear from experts, but also happy to let them step into the spotlight. While we still see sensationalist headlines, there are also visible benefits of this approach, with more measured and informed elements within the media coverage- though this is less evident on the outer reaches of the online universe. Before I move on to other topics, let us reflect on the significant additional pressures being placed on our frontline health providers. They deserve our gratitude and, in many instances, much improved terms and conditions. Let’s hope that when this coronavirus issue passes the staff that so many rely on are not overlooked.

Of course, the benefits of trusted information in supporting effective responses is not limited to the sphere of infectious disease. Anywhere you need to bring together a range of agencies to respond to a challenge, it is valuable to have agreed common ground on which to begin discussion and guide action. So, I am delighted that after a considerable amount of blood, sweat and some tears- not all mine by any means- we have managed to release a new updated version of Safer Nightlife in February. This guidance seeks to help venue managers, local authority staff, security staff, medical and welfare teams, the police, and others agree to approaches to reduce harm from drugs at a range of events.

This latest, digital, version builds on its predecessors. The first was produced back in 1996, which predates my involvement in the drugs and alcohol field. I was involved with the next iteration, Safer Clubbing, in 2002 but mainly in terms of its finalisation and launch. This was notable for being largely funded by the government, complete with a joint foreword by a Home Office minister. In 2008, a range of partners contributed to an update, Safer Nightlife, where again financial support from central government was crucial - even if there was now a degree of political distancing. One of the new features in this version was a guide for when to seek emergency medical help. 2010 saw Drugs at the Door, which- while very much part of the Safer Nightlife family- focussed on door security and the safe management of drugs found at venues. This emerged from the work we had undertaken into the use of drugs boxes in clubs and finding that at that time there was almost no advice on this subject and we conjured up the funds locally.

Regardless of the funding and level of political support, this strand of work has always benefitted from tremendous support across the range of organisations with an interest in the Night Time Economy and festivals. Medical experts, local authority officers, venue managers, festival gurus, police officers, lawyers, and door security experts have given generously of their time, without charge, to help produce a document that we hope helps to save lives. We are working on ensuring that it is a dynamic product, which can be updated regularly, reflect changes in policy and drug use, and reflecting the realities of working in this environment. Safer Nightlife seeks to act as a practical tool and, we hope, provides a meeting point for sensible, pragmatic, discussion on how we keep people safe. I must also thank Russell Webster for all the hard work in writing Safer Nightlife and helping with its transition to the digital world. No easy task! The wonderful design and functionality are due to Ideology. If you know of any colleagues who might find Safer Nightlife useful please do share – and let us have your feedback.

Another area of recent activity that seeks to provide basic knowledge for the uninitiated, and a refresher for those who may have some knowledge, has been around chem-sex. This is an area that is often misunderstood and attracts the most lurid of media interest. In practice, it’s an issue of relevance to many agencies and requires understanding and nuance. There is a complexity to understanding the behaviours and experiences of certain groups, while keeping sight of the crucial importance of consent and the reality that some individuals engage in predatory behaviour. I have to salute the Metropolitan Police Service for taking on this issue bringing together when they recently hosted a wide range of voluntary sector groups, police, probation and research experts. There were lively debates and clear disagreement on certain topics, but all attendees came away with a broader understanding of the issues and valuable contacts.

One fundamental issue raised was about the role of the law in protecting individuals, and whether illegality increased harm by making it less likely for individuals to seek help in an emergency. These are important debates and they will continue, but we have previously undertaken extensive work with opiate users to reassure them to call for an ambulance if they witness an overdose, making the point that the preservation of life is a police priority. There is some evidence that these approaches did help, alongside peer training and user engagement. Not all problems are resolvable by changes in the law. But places where we can share our perspectives, understanding, and have informed dialogue can help us make meaningful, life-saving progress.

Wednesday, April 01, 2020
Everything is changed. COVID-19 and responses to it have seen dramatic and fundamental changes to how life is lived around the globe. International travel has come to a near complete halt, much of the world is under some form of lock down with businesses, schools, shops, pubs and cafes shut. Our economic and social reality is now unrecognisable from that of only weeks ago.
Tuesday, March 10, 2020
Clearly the current health focus is strongly centred on Covid- 19 and related issues, as it has been for the past few weeks. It is a demanding situation for politicians, officials, and indeed all of us, especially those working in our healthcare system. One of the major challenges we face is increasing understanding and encouraging changes in behaviour, while also avoiding panic and overreaction. Trusted and accurate information is clearly essential, both for those who have a key role and for the general public. We are certainly seeing more of England’s Chief Medical Officer and Chief Scientific Adviser in the media than usual. In the current situation, politicians are not only keen to hear from experts, but also happy to let them step into the spotlight. While we still see sensationalist headlines, there are also visible benefits of this approach, with more measured and informed elements within the media coverage- though this is less evident on the outer reaches of the online universe. Before I move on to other topics, let us reflect on the significant additional pressures being placed on our frontline health providers. They deserve our gratitude and, in many instances, much improved terms and conditions. Let’s hope that when this coronavirus issue passes the staff that so many rely on are not overlooked.
Monday, February 10, 2020
Public health is front and centre of the media currently, with concerns about the coronavirus outbreak, which was first identified in the Chinese city of Wuhan, splashed across almost every front page. With confirmed cases now reported in numerous countries across the world, we face the possibility of a pandemic. As several experts and commentators have pointed out, in our modern, highly interconnected world no epidemic remains a local concern. This, of course, makes for frightening headlines- which, in turn, calls for calm and informed responses.
Wednesday, January 15, 2020
So here we are: 2020. Let me start by wishing all of you the very best for the year ahead. I have, occasionally, been accused of an inclination toward cynicism and a failure to look on the bright side of things. So, for my first blog of the year, at least, I am going to be determinedly upbeat. You can judge for yourself how long it lasts. This sense of optimism is influenced by the fact that the end of 2019 saw some positive signs in the world of substance misuse. While it was something of a mad scramble against time, we managed to pull together a high quality and well-supported pan-London Christmas alcohol campaign. I am very grateful to colleagues who delivered the key elements of this work and to everyone who supported it. Some, in fact, went well beyond the call of duty to engage with our colleagues in the blue light services. Although we will not have any data in terms of its reach and impact for some months (I will update you), what I can confidently say is that many individuals and organisations liked the messaging and tone. I like to think it is helping contribute to Londoners having a more considered and healthier relationship with alcohol, though there is a way to go yet!

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CITY HEALTH INTERNATIONAL EVENTS

CHI Melbourne 2019

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CHI Liverpool 2019

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CHI Odessa 2018

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CHI Basel 2017

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CHI London 2016

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CHI Barcelona 2015

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CHI Amsterdam 2014

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CHI Glasgow 2013

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CHI London 2012

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City Health International
Founded in 2012 City Health International is a network of individuals and organisations engaged in the study of and response to structural health issues and health behaviours in the urban environment. For the first time in history the majority of the world’s population now live in urban environments and the proportion continues to grow. As national governments struggle to deal with the pressures and demands of growing urban populations against a backdrop of financial deficits and uncertainty, it is increasingly left to those working at a city level to provide the leadership and support needed to tackle key health issues.