Alcohol Policy UK

Alcohol field station for Camden

A special patrol of paramedics will treat drunken revellers in the streets of Camden Town in a bid to relieve pressure on hospitals. The pilot scheme to station a specific ambulance team in the area comes amid concerns there are too many alcohol-related admissions to Accident and Emergency from the area on Friday and Saturday nights.

Under the plans being developed by Camden’s Primary Care Trust and the London Ambulance Service, a team of paramedics in an ambulance will be based in the streets around Camden Town Tube station. They will be looking for drinkers who “appear to be intoxicated by alcohol”.

The aim is to treat them before they have to be taken to hospital accident and emergency departments, easing the pressure on the Royal Free and University College hospitals at peak times. The scheme is due to be operating by August, although the specific hours of cover are still being worked out.  Camden New Journal

See also previous posts about alcohol field stations

New direction towards alcohol for Cumbria DAAT

A plan to tackle substance abuse in Cumbria is now focusing more clearly on alcohol, with police admitting drink is linked to a large amount of violent crime. The Cumbria Drug and Alcohol Action Team (DAAT) is placing a higher priority on problems with alcohol after previously concentrating on drugs.

Assistant Chief Constable Neil Rhodes spoke about the DAAT plan at a meeting of Cumbria Police Authority, the body overseeing the county’s police force. He said:

“Generally, it is becoming far more focussed on the perils of alcohol. In the past it has been focussed almost exclusively on drugs. There is a new direction.

We recognise that alcohol underpins a lot of the problems we have in relation to violent crime. Domestic abuse and violence always has strong themes of alcohol running through it. If we are going to address offenders by any other means than enforcement, we need partner agencies (to be involved). Treatment is something DAAT is very good at.”  News & Star

Cumbria DAAT's Pooled Treatment Budget allocation was £2.8M this year (all PTB allocations here) but - as is the case for all English DATs - it is all ring-fenced for primary drug users and not for alcohol treatment, so it will be interesting to see how the new plan is funded.

Funding opportunities for GP alcohol inteventions?

Ministers have put forward plans for  £50 million of clinical funding that would be partly used to pay for Screening and Brief Interventions (SBIs) by GPs. The funding would see the development of a number of Locally Enhanced Services for GPs, a framework by which GPs are paid to screen and offer appropriate interventions to patients.

The clinical funding, if approved, would also pay for enhanced services for GPs to address osteoporosis, heart failure, improved collection of ethnicity data and annual health checks for those with learning disabilities.

However a number of obstacles are likely to affect the implementation of any such clinical programmes within the development of GP services. These include the pay dispute involving the British Medical Association (BMA) and concerns over the position of such proposals in relation to the development of the Quality Outcomes Framework (QOF). Dr Ahmat Fuat, a GP in Darlington and deputy chairman of Primary Care cardio-vascular society, candidly rasied his concerns relating to alcohol treatment in primary care, stating: "You’d probably need £50m to tackle alcohol alone."

The Health Secretary Alan Johnson nonetheless highlighted the opportunities being made available within the new agendas, saying:

"‘This is about developing high-quality services with a strong focus on prevention. It’s a great opportunity for entrepreneurial GPs as well as social enterprises, voluntary organisations and the independent sector to develop innovative services."

Increasing numbers of PCTs are already commissioning alcohol enhanced services either through Choosing Health or other local funding streams such as in Lewisham.

For more information follow the Pulse medical journal for GPs.

Alcohol Primary Care Service Framework released

The NHS have released Primary Care Service Framework: Alcohol Services in Primary Care, designed to support commissioners, practitioners and providers in setting up alcohol interventions in primary care.

The document is likely to be welcomed across the country as increasing numbers of PCTs and local authorities are setting up Screening and Brief Intervention programmes within primary care settings, particularly with General Practitioners and in cases other settings such as pharmacies.

Previously there had been no specific frameworks to help local commissioners and practitioners set up such programmes, despite national guidance such as Models of Care for Alcohol Misusers (MoCAM) and Alcohol Misuse Interventions: Guidance on developing a local programme of improvement. The Alcohol Services in Primary Care Framework may be particularly useful in helping commissioners and practitioners:

• Scope and define suitable services
• Identify key agendas and frameworks
• Identify suitable evidence bases and local need
• Identify service objectives and intended health outcomes
• Set up suitable governance, monitoring and evaluation arrangements
• Identify suitable contract management
• Identify suitable review, variation and recommissioning process
• Find supporting documents, guidance, definitions and Read codes

Where commissioners may still be stuck is around pricing of services with no recommended or nationally agreed prices.

The new framework comes as part of 6 new Primary Care Service Frameworks falling within objectives of providing enhanced, localised service provision within the Practice Based Commissioning agenda.

Alcohol Liaison Seminar, Wednesday 11th June

An Alcohol Liaison Seminar will take place on Wednesday 11th June 2008 in Leicestershire, following the success of forums in 2006 and 2007. The event is expected to be attended mainly by nurses and alcohol/drug workers in hospital or healthcare settings, although commissioners or service managers may wish to enquire about availability.

Further details on the event and how to book your place here

We reported on the previous event, with audio and presentations here.

NHS statitics on alcohol report prompts further calls for action

The NHS this week released the report Statistics on alcohol: England 2008, compiled from a range of previously published alcohol related information and data. Whilst the report may not contain new data, it has re-emphasised the growing cost of alcohol misuse and prompted a range of news and media reports.

A Guardian article quoted a number of leading figures speaking in response, including the Public Health minister, Dawn Primarolo, who referred to the new £6 million campaign launched this week to raise alcohol unit awareness. Spokespersons for the British Liver Trust and drugs charity Turning Point raised concerns over the growing level of harm from alcohol and long waits some face to receive treatment. Professor Ian Gilmore of the Royal College of Physicians continued to call for  further controls on the extent of cheap and readily available alcohol. A report from the Department of Health is expected in July that will inform the government on the impact of price and harm to society, following earlier reports that such moves would be considered if supermarkets and retailers continued to act irresponsibly.

An article in the Times highlighted the growing concern over alcohol misuse by young people, citing the Office for National Statistics data that showed more 13 year olds had drank alcohol than not, whilst also drawing attention to a Home Office audit that had found extensive abuse of voluntary codes of practise by retailers.

BBC Radio 4's alcohol series 2008

BBC Radio 4's PM programme has released Alcohol series 2008 with a number of short broadcasts examining stories investigating the impact of alcohol misuse. The series so far contains 4 reports including:

• Monday's report - speaking to three people who have been affected by the misuse of alcohol
• Tuesday's report - speaking to a former high flying city executive rebuilding her life after alcohol dependency
• Wednesday's report - examines whether more can be done to detect and treat alcohol misuse
• Thursday's report - looks at alcohol misuse in France compared to the UK

Radio 4 have also supported the series with an action line for anyone who would like help or information on alcoholism.

First prison alcohol treatment programme wins award

The Rehabilitation for Addicted Prisoners Trust (RAPt) has won accreditation for its alcohol dependency treatment programme, awarded by the Correctional Services Accreditation Panel. The National Offender Management Service (NOMS) funded RAPt in 2006 to develop a programme for alcohol-dependant offenders in HMP Bullingdon. Whilst there has been significant investment in drug treatment in prisons, the alcohol specific treatment programme is the first of its kind. A release on the Addiction Today site indicated significant  successes through preliminary findings  including:

• Most men accessing the programme are in custody for violent offences connected to their alcohol use
• The programme can substantially reduce offenders’ risk of re-offending
• Participants show increased awareness of the impact of their crimes on their victims
• After treatment, 77% of participants rated their risk of relapse as low or very low
• Participants completing the programme continue to access support to help them stay sober and avoid the risk of re-offending on release

Alcohol Concern report: The extent of local alcohol commissioning?

Alcohol Concern have released The Poor Relation - has the emphasis on 'localism' really improved alcohol commissioning, which sets out the findings from Freedom of Information requests asking PCTs for data on a number of key alcohol spend indicators including:

• Spend on alcohol treatment  for 07/08 (and whether the £15 million Choosing Health money was used locally or not)
• Data on waiting times for accessing alcohol treatment
• The percentage of dependant drinkers in treatment
• Whether trusts had any information about hazardous, harmful and dependant drinkers

Nearly 40% of the trusts were not able to return the questionnaire but the report provides a compelling analysis of the extent of investment into alcohol treatment and of the changes to commissioning structures and the devolving of decisions to local level.  The report points out that 'MoCAM and other Department of Health related guidance have not improved alcohol commissioning or treatment provision at the local level.'  There is still a 'postcode lottery' concerning alcohol treatment, with huge variations in spend and provision across the country.

  The report recommends that:

• the local Pooled Treatment Budgets (for drug treatment) should include the funding of alcohol treatment where required in addition to existing PCT or local authority alcohol spend
• the Department of Health should set an optimum level of access for alcohol treatment, reducing the current national average of 1 in 18 to around 1 in 7
• the Department of Health should consider requiring local commissioners to reduce alcohol treatment waiting times to those for drug treatment, since alcohol treatment data must now be submitted to the National Drug Treatment Monitoring System (NDTMS)
• PCTs should make better cases for investment in alcohol treatment
• Strategic Health Authorities should ensure their local PCTs are meeting local alcohol treatment needs through key agendas and commissioning structures including Standards for Better Health

Alcohol projects get a boost with new online portal

The The Hub of Commissioned Alcohol Projects and Policies (HubCAPP) has now been launched, offering an excellent new resource for commissioners and strategic project managers across England. The new online database provides key information on a comprehensive range of alcohol projects, policies and initiatives to help disseminate best practice and share key learnings. HubCAPP has been funded by the Department of Health and will be managed by Alcohol Concern.

Don Shenker, Acting Chief Executive of Alcohol Concern says:

Alcohol professionals already have a fairly well developed library of guidance documents available to them. HubCAPP has the potential to make the development of new strategies a more dynamic and collaborative process than it has been before. We invite local partnerships to view the time spent submitting their own strategies as an investment. Not only will it help build a valuable mass of information, but it also presents a good opportunity to put some critical distance between them and the decisions they’ve taken to date.

If you have a project you would like to submit or any further questions, please contact Sarah Ward, HubCAPP manager on 0207 264 0510 or info@hubcapp.org.uk