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.
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