Alcohol Policy UK

Alcohol Concern manifesto for local authority elections

Alcohol Concern calls for all candidates to sign up to 10 commitments to reduce alcohol related harm:

1. Identify the support needs of local populations, including vulnerable groups (for example homeless populations and those with mental ill health)  
2. Work with colleagues in Health and Criminal Justice to draw up a local alcohol strategy
3. Set stretching targets for reducing alcohol related harm suffered locally  
4. Review local alcohol services which are provided after the publication of Models of Care for Alcohol Misuse (a framework against which to commission effective, quality services)   
5. Provide a full and diverse range of services for those who need them  
6. Supply better information for problem drinkers so that those who need help know how and where to get it
7. Involve service users and their families in shaping services   
8. Use Health Scrutiny Powers to ensure that local Primary Care Trusts are giving sufficient priority to alcohol   
9. Crack down on unscrupulous traders to reduce underage sales   
10. Work with local licensees to develop agreements on good practice

More details here.

AUDIT efficient and cost effective compared to biochemical tests

Research published in BMJ this week, here, compares the alcohol use disorders identification test (AUDIT) and biochemical screening tools (gamma glutamyltransferase, aspartate aminotransferase, per cent carbohydrate deficient transferrin, and erythrocyte mean cell volume) in primary care.

The researchers found a significant correlation score on the AUDIT and measures of gamma-glutamyltransferase  and per cent carbohydrate deficient transferrin but not aspartate aminotransferase or erythrocyte mean cell volume .

AUDIT exhibited significantly higher sensitivity, specificity, and positive predictive value than all of the biochemical markers for hazardous consumption (69%, 98%, and 95%), weekly binge consumption (75%, 90%, and 71%), monthly binge consumption (66%, 97%, and 91%), and alcohol dependence (84%, 83%, and 41%). The questionnaire was also more cost efficient, with a lower cost per true positive for all consumption outcomes.

For more info on AUDIT, see the WHO Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care, here.

 

Funding scheme for young people's alcohol prevention

The Mentor Foundation has announced a new Awards Scheme to recognise and promote excellence in alcohol misuse prevention and alcohol education for primary school age children.  The scheme has £30k funding from Diageo Great Britain and £30k worth of mentoring.

Entries can come from a broad range of projects or activities - from adults or young people themselves. Awards will be made in three categories: Schools, Communities and Young People’s Involvement.

Details and applications forms here.

Strategy for the care of gastrointestinal disorders published

The British Society of Gastroenterology (BSG) published Care of Patients with Gastrointestinal Disorders in the United Kingdom: A Strategy for the Future last week.  The BSG has reviewed the evidence on gastrointestinal disorders and developed the strategy, which aims to provide "robust support for the development and commissioning of Gastroenterology and Hepatology services in the UK".

The document supports the recommendations laid down in the Royal College of Physicians’ document Alcohol related harm, the growing crisis – a time for action (2001) (see Alcohol: can the NHS afford it?, here):

• Screening strategy for early detection of harmful/co-incidental hazardous drinkers
• Early assessment of dependence severity by appropriate trained staff
• Widely available protocols for the pharmacotherapy of detoxification
• Readily available acute response from liaison or specialist alcohol psychiatry services for the management of patients undergoing complicated alcohol withdrawal
• Assessment of the need for referral to on-going support services by appropriately trained staff with knowledge of local services
• Provision of brief interventions for co-incidental hazardous drinkers
• Provision of general staff education
• Occupational policies for alcohol for all hospital health care workers, for example with respect to drinking at work
• Close liaison with General Practitioners on discharge

Each NHS Trust should have:

• A senior member of medical staff and a senior member of nursing staff to act as a focus for alcohol strategy and to support more junior members of staff
• Senior psychiatric colleagues with an interest in the management of alcohol problems to act as the primary link between the acute hospital trust and local mental health services. This individual may or may not be employed by the acute trust
• One or more dedicated alcohol health workers employed by and answerable to the acute Trust. The roles will include: a) Implementation of screening strategies. b) Detoxification of dependent drinkers. c) Brief interventions in hazardous drinkers. d) Referral of patients for on-going support – with access/knowledge about locally available non-statutory/voluntary agencies. e) To provide links with liaison/specialist alcohol psychiatry. f ) An education resource and support focus for other health care workers in the Trust.

Download the BSG strategy document here.
Also, listen to Professor Elwyn Elias talking about liver disease and the role of alcohol at the launch of the strategy.  Go to the webcast here, and select the introduction section, which is an hour and half long.  Prof Elwyn is at 27.09 for ten minutes.  Powerpoint slides from the launch are currently available from the BSG homepage, here.

Government's handling of Licensing Act criticised

The government was criticised for its management of implementing the Licensing Act 2003, as reported by the BBC (here) and many others.  The criticism came from the Office of the Deputy Prime Minister (ODPM) Select Committee, who said:

The ODPM failed local authorities: the department is there to support the workings of local authorities. We see little evidence that this was done during the transition period. Nor was action taken when direct appeals were made.

The Committee made a number of recommendations that may have a bearing on the revised guidance being prepared by Department of Culture and Sport (DCMS), such as:

• introduction of a mediation procedure into the application process, in order to foster better relations between licensees and residents, to reduce the burden on magistrates’ courts and to minimise the cost to applicants
• annual day for payment of fees
• allowing residents to object to Temporary Event Notice applications
• consideration of the disproportionate impact of fees on small businesses
• review DCMS guidance to residents
• clarification of the government's position towards the issue of zoning, and making the right of local authorities to create zones of cumulative impact explicit, so that local authorities and licensees alike can understand the aims of the Act in this respect

The report can be downloaded here.
The Elton review of licensing fees is due to report in Autumn 2006 (info here);  The review panel published Independent Licensing Fees Review- Interim Report in November 2005, which can be downloaded here.