Statistics on Alcohol, England 2021

This document constitutes a background quality report for the Statistics on Alcohol publication. The statistics included in this release are the latest available annual figures from a range of data sources.

This annual compendium report presents newly published information on prescriptions items for drugs used to treat alcohol dependence and affordability of alcohol and expenditure on alcohol.

The report also provides commentary on hospital admissions for diseases, injuries and conditions that can be attributed to alcohol consumption. The data in this section comes from the Office for Health Improvement and Disparities (OHID) Local Alcohol Profiles for England, which use data from NHS Digital’s Hospital Episode Statistics.

Additionally, the report provides links to information relating to alcohol use and misuse drawn from a variety of sources including alcohol-specific deaths; drinking behaviours among adults and children and road casualties involving illegal alcohol levels.

The report is published on the NHS Digital website at: http://digital.nhs.uk/pubs/alcohol21.

This data quality statement aims to provide users with an evidence-based assessment of the quality of the statistical output included in this report.

It reports against those of the nine European Statistical System (ESS) quality dimensions and principles appropriate to this output. In doing so, this meets NHS Digital’s obligation to comply with the UK Statistics Authority (UKSA) Code of Practice for Statistics , and the following principles in particular:

• Trustworthiness pillar, principle 6 (Data governance) which states “Organisations should look after people’s information securely and manage data in ways that are consistent with relevant legislation and serve the public good.”
• Quality pillar, principle 3 (Assured Quality) which states “Producers of statistics and data should explain clearly how they assure themselves that statistics and data are accurate, reliable, coherent and timely.”
• Value pillar, principle 1 (Relevance to Users) which states “Users of statistics and data should be at the centre of statistical production; their needs should be understood, their views sought and acted upon, and their use of statistics supported.”
• Value pillar, principle 2 (Accessibility) which states “Statistics and data should be equally available to all, not given to some people before others. They should be published at a sufficient level of detail and remain publicly available.”

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

This publication is considered to be of particular interest to central and local government, the NHS and independent sector providers in England and to English NHS commissioning organisations. However, data and findings are likely also to be of interest to a much broader base of users.

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

This report is a National Statistic and is produced according to the Code of Practice for Official Statistics.

Most of the information in this report has been previously published. The sources of the information are trusted sources; the majority being either National or Official Statistics. Most sources referenced in this report include a Methodology section for further information.

Hospital admissions data

The data presented in this report are for inpatients only and therefore does not reflect all hospital activity. This should be considered when interpreting the data as recording and clinical practice may vary over time and between regions.

Further general information on HES data processing and data quality, including specific known issues can be found here:

The processing cycle and HES data quality

COVID-19 and the production of statistics:  Due to the coronavirus illness (COVID-19) disruption, it would seem that there is some effect on the quality and coverage of some of our statistics in relation to the 2020/21 period. It is known that many hospitals are reporting zero or significantly less activity across one or more datasets for March 2020 onwards. The HES data in this publication relates to 2019/20, therefore, the end of the reporting period for this publication includes some of the pandemic period but this is estimated to have a negligible impact on the data.

Prescription data

The number of prescriptions is not the same as the volume of drugs prescribed.  Each single item prescribed is counted as a prescription item and volume is not available within the prescribing data. There will be different practices locally on the duration of supply for a prescription.

The NIC is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, dispensing costs, prescription charges or fees.

Survey data

Some of the information signposted to in the report is taken from survey data. Sometimes the mode of data collection used in a survey can have an impact on how respondents answer the questionnaire. For example, surveys conducted via a face-to-face interview such as the Health Survey for England (HSE) provide an opportunity for an interviewer to use a computer to record the respondent’s answers which will improve the quality of the data by ensuring all the questions are completed and not allowing any invalid answers. By comparison data collected on paper forms such as the Smoking, Drinking and Drug Use amongst Young People (SDD) survey will have none of these inbuilt validations.

Face-to-face interviews also provide an opportunity to guide the respondent through any interpretation issues, which is more difficult in a non-face-to-face interview.

Both modes however may suffer from respondents being tempted to give answers which are considered to be more socially acceptable. This could occur either through the surveys being completed in the home when other family members are present, or through the interviewer being present at a face-to-face interview. This effect is reduced in surveys such as SDD which is conducted in schools in exam conditions.

Timeliness refers to the time gap between publication and the reference period. Punctuality refers to the gap between planned and actual publication dates.

This compendia report is published annually and presents or signposts the most up-to-date information available.

The publication of this report was delayed from October 2021 due to the coronavirus pandemic (COVID-19) requiring changes to NHS Digital’s statistical production schedule.

Accessibility is the ease with which users are able to access the data, also reflecting the format in which the data are available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

The report is accessible on the NHS Digital website in HTML format. All tables in the report are provided in Excel format and as csv files, as part of the government’s requirement to make public data public.

Coherence is the degree to which data, which have been derived from different sources or methods but refer to the same topic, are similar. Comparability is the degree to which data can be compared over time and domain.

Alcohol-related hospital admissions

Alcohol-related hospital admissions have been estimated by applying alcohol-attributable fractions (AAFs) to Hospital Episode Statistics (HES) data. AAFs are the proportion of disease cases that can be attributable to alcohol. In 2020 new AAFs were calculated based on updated alcohol consumption rates and the latest evidence linking alcohol consumption to disease outcomes. 

Alcohol-attributable fractions for England: an update

Alcohol-related hospital admissions in this report use the new set of AAFs, and so differ from previously published data. Time series comparisons are based on the new AAFs but data is only available from 2016/17.

The “broad” measure of alcohol-related hospital admissions is more dependent on the use of secondary diagnoses than the “narrow” measure. Consequently increases for the "broad” measure may be due to improvements in the recording of secondary diagnoses and the “narrow” measure is a better indicator of changes over time.

This dimension describes the extent to which different aspects of quality are balanced against each other.

The sources used in this report include provide information on methodology which will contain specific information about trade-offs. Further details are available in the Appendices.

This dimension covers the processes for finding out about users and uses and their views on the statistical products.

In 2015 a consultation was carried out to gain feedback on how to make the report more user-friendly and accessible while also producing it in the most cost-effective way.

Findings of the Consultation

In response to the feedback received, the format of the report was changed for the 2016 report.

Another consultation is planned for January 2022 to seek user views on proposed changes to the content and publication schedule of the Lifestyles compendia series. 

NHS Digital is keen to gain a better understanding of the users of this publication and of their needs; feedback is welcome and may be sent to [email protected] (please include ‘Alcohol’ in the subject line).

This dimension describes the effectiveness, efficiency and economy of the statistical output.

All data used within this report is either already published or is part of an existing dataset. Therefore, there are no data collected specifically for this report.

The procedures and policy used to ensure sound confidentiality, security and transparent practices.

The Code of Practice for Statistics sets the standards that producers of official statistics should commit to.

Code of Practice for Statistics

NHS Digital provide supporting documents for statistical publications including the statistical governance policy and disclosure control procedure.

Publications supporting user documents