A set of resources relating to the delivery of hospital-based Alcohol Care Teams (ACTs) has been released.
The guidance, co-produced with Public Health England (PHE), follows a commitment in the NHS Long Term Plan (LTP) earlier this year to establish ACTs in hospitals with the highest rate of alcohol dependence-related admissions.
A summary document [pdf] sets out the role of ACTs as part of an effective local area alcohol treatment system, also supported by a core service descriptor [pdf], a case study example [pdf], and a checklist for commissioners [XLS].
The guidance states admission to hospital is 'often the first time alcohol dependence is identified and diagnosed as an underlying or primary condition, so hospital admission provides an ideal opportunity for early intervention and access to more comprehensive alcohol treatment.'
Baseline data for the preventing ill health CQUIN indicates that around 5% of inpatients are alcohol dependent versus 1.4% in the general population, although a meta-analysis released earlier this indicated as many as 1 in 10 hospital attendees (including A&E visits) were alcohol dependent, with 1 in 5 harmful drinkers.
ACTs should also facilitate identification of alcohol misusers in hospitals, such as through supporting IBA delivery, and contribute to packages of care provided by multi-disciplinary teams. Currently, a national CQUIN is in place across hospitals to incentivise the delivery of brief advice to at-risk drinkers and smokers. Eighty per cent of patients admitted for one night or more are expected to be screened using the three AUDIT-C questions, whereby a score of 5 or more indicates an alcohol use disorder for which brief advice or referral is required.
A 2014 PHE report identified that many hospitals had at least some form of specialist alcohol provision, whilst models such as assertive outreach or targeting frequent attenders are also being championed. The LTP pledge though stated funding for the ACTs would come from local clinical commissioning groups (CCGs) health inequalities funding supplement, thus the commitment appeared to amount to support to establish them, rather than any new or specific funding.
Meanwhile, the Alcohol Health Alliance (AHA) have called for the next Government to implement ACTs in every district hospital alongside improvements to community alcohol treatment and a number of wider alcohol policy measures.
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