A guidance document has been released to support the delivery of clinical directed enhanced services, alcohol being one of the five key health and service priorities. The DES allows specific funding for GPs to deliver Screening and Brief Interventions (SBIs) to newly registered patients. The DESs began in April 2008 and are scheduled to run for 2 years backed by £50 million funding proposed earlier in the year, with an annual £8 million alcohol allocation.
According to the guidance, practices are required to screen newly registered patients using a shortened screening tool such as FAST. Those identified as positive will be given the full AUDIT test to determine if they are drinking at hazardous or harmful levels, and then offered the recommended intervention of 5 minutes brief advice in line with University of Newcastle's primary care guidance 'How Much is too much?'. Dependant drinkers should be referred to local treatment services.
Practices will be paid £2.33 for each newly registered patient aged 16 and over who have received screening by providing:
• the number of newly registered patients aged 16 and over within the financial year who have had the short standard case finding test (FAST or AUDIT-C)
• the number of newly registered patients aged 16 and over who have screened positive using a short case-finding test (as above) during the financial year, who then undergo a fuller assessment using a validated tool (AUDIT) to determine hazardous, harmful or likely dependent drinking
• the number of hazardous or harmful drinkers who have received a brief intervention to help them reduce their alcohol-related risk
• the number of patients scoring 20+ on AUDIT who have been referred for specialist
advice for dependent drinking
Earlier this year an alcohol primary care services framework was released by the NHS to support commissioners in setting up SBI programmes in primary care.
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