An evaluation report of a novel rapid access alcohol detox service identifies significant cost savings as a result of reductions in drinking and subsequent use of health services.
The RADAR (Rapid Access to Alcohol Detox Acute Referral) service was established in Greater Manchester as a direct pathway from A&E departments into specialist detox facilities. RADAR accepts referrals from eleven different acute hospitals in the area, combining a range of psychosocial interventions with physical health management and aftercare planning. Stays typically take between 5 and 7 days before discharge and referral to community alcohol services.
Evaluation outcomes
The Centre for Public Health conducted an evaluation of RADAR to explore experiences of stakeholders and cost-effectiveness. The RADAR service has four main aims: reducing the burden on acute trusts, improving clinical outcomes for service users, providing improved experience for service users in a therapeutic setting and demonstrating cost-effectiveness.
The report outlines overwhelming positive perceptions of the service, particularly from patients. Six months after discharge, just over half of those who could be contacted reported either being abstinent or being controlled drinkers. This resulted in fewer contacts with Acute Hospitals, with reductions in both the number of A&E attendances and nights in hospital being reported. The cost-effectiveness analysis of RADAR suggests a projected saving of £1,320,921 over a 12 month period.
Although the evaluation identifies that patient outcomes rely on self-reported data, it found the average visits to A&E before entering RADAR were around three visits per patient, while visits after were found to be around one visit per patient. A statistically significant reduction in overnight hospital stays resulting from hospital visit was also found, reducing from an average of two to less than one post-RADAR. A reduction in GP visits was also found, although not statistically significant.
Over half of the patients did not attend and alcohol service before RADAR (53%), in comparison to 69% attending after RADAR. However use of self-help groups did not increase following engagement in the service.
Read the report here or see a summary presentation of the award-winning service.
A new model for Hospital pathways?
Over recent years the presence of alcohol liaison roles or teams in hospitals has been rising, in line with NICE and PHE guidance. However RADAR may be considered novel despite a wide range of models existing. Last year PHE released a report reviewing the provision of alcohol services in England's hospitals which identified integration with community services as a key issue.
PHE also recently released guidance to improve support for young people in A&E with alcohol related problems.
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