The National Audit Office has published a new report Reducing Alcohol Harm: Health services in England for alcohol misuse. The document reviews the existing state of alcohol health provision and makes recommendations on how services should be improved. The report highlights key gaps in the work of PCTs in efficiently reducing alcohol related harm through inconsistent use of tools, data, commissioning and partnership working across the country.
Main findings on the current state of services include:
- A quarter of PCTs had not accurately assessed the alcohol problems in their area
- Many PCTs do not have a strategy for alcohol harm, or a clear picture of their spending on services to address it
- PCTs are often relying on Drug and Alcohol Action Teams (DAATs) to address hazardous and harmful drinking, despite DAATs primarily being focused on providing specialist treatment
- Local provision of specialist services is not based on a good understanding of communities’ needs and there are wide variations between localities
- The new PSA performance indicator on alcohol-related hospital admissions gives PCTs an incentive to address alcohol harm, but it has limitations and carries risks.
- While the majority of PCTs have chosen to include the new alcohol-related performance indicator in their operating plans, or in a Local Area Agreement, more than a third have not
- Regional oversight of the NHS’s response to alcohol misuse has to date been limited. The creation of a new network of Regional Alcohol Offices in autumn 2008 aims to strengthen the influencing role of Strategic Health Authorities and Regional Directors of Public Health and to provide opportunities for sharing best practice between PCTs
Recommendations in the report are based on the following key issues:
- PCTs’ planning and commissioning of health services to reduce alcohol harm have not been tailored to local needs.
- While national systems collect detailed data on local patterns of alcohol misuse, some PCTs do not use these sources, and few PCTs collect information from their local partners
- The new PSA indicator on alcohol needs to act as an incentive for PCTs to address effectively the alcohol misuse problems in their local area.
- Historically, primary care data have not given a clear picture of alcohol misuse due to confusing ‘codes’ for recording diagnoses and interventions resulting in inconsistent recording of activity in primary care.
- Currently there is no consistency in how the level and cost of alcohol services is recorded locally
- Currently there is no systematic means of promoting good evidence-based practice on alcohol harm across PCTs
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