Better support for people struggling with alcohol problems

Close work between the A&E and alcohol teams at Royal Bolton Hospital is getting faster help to those with alcohol problems.

Alcohol remains one of the biggest causes of ill health and early death in the country, which means patients having the right support, can save lives.

Nationally, more people are being admitted to hospital with alcohol-related problems. The estimated cost of that to the NHS in England is £3.5 billion every year.

The team introduced a validated simple assessment tool for clinical staff in A&E (AUDIT-C: alcohol use disorders identification test). It is something that has been used for a long time but the first time in Bolton’s A&E department. The tool, which is a checklist of sorts, allows them to quickly screen for alcohol issues and refer into the hospital alcohol team when necessary.

Specialist nurse and Alcohol Team Leader Sam Osbourne explained why Audit C works well in the emergency department. She said: “We have people attend A&E with arm fractures, head injuries, social and mental health problems but really that’s the tip of the iceberg and alcohol is the issue. Historically, we weren’t tackling that and if the underlying issue is not met, people can go on to become frequent attenders.
“Audit C helps identify patients, so we can put care plans in place, get the right people involved to hopefully reduce alcoholism.”

Once a referral has been made into the alcohol team, they can bring their expertise to that patient in a number of areas, including; withdrawal, alcohol-related brain injury, alcohol-related mental health issues, malnutrition and more. The team then work with services in the community to avoid future hospital admissions, where possible.

Since completing the project, the team has increased the number of patients discharged from A&E, reduced the time they spend in the department and increased the number of patients discharged in under four hours.

This work has been praised as best practice in the NHS Long Term Plan. The plan, published earlier this year, outlines how the NHS will spend the £20.5bn funding outlined the national budget, including plans to roll out alcohol care teams to reduce alcohol-related admissions nationally.


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