So, a few days ago I wrote about how minimum unit pricing was not the most effective way of dealing with the problems of binge drinking and alcoholism. But, that doesn’t mean that I’m blind to the problems that they cause.
And it’s a problem that is just as prevalent in Wales. Nearly 40% of adults in Wales admit to consuming more than the recommended daily limits for drinking and 20% admit to binge drinking. Even this statistic seems quite low to me and I suspect that there are many more who are simply not admitting it. Most people I know admit that they aren’t entirely truthful with their doctor if asked how much they drinking and downplay it slightly.
According to the Welsh Assembly Government, 15% of all hospital admissions in Wales are due to ‘alcohol intoxication’ and 300,000 hospital bed days are lost as a result. The resulting cost to the Welsh NHS is estimated at between £70 million and £85 million each year. This is a small chunk of the estimated £20 billion alcohol costs the UK economy each year.
But what can be done about it?
The Royal College of Nursing have produced research that makes for interesting reading. Trials have been conducted at a number of A&E departments within the UK (Edinburgh, London, Liverpool, Belfast and Cardiff) to see how effective an ‘Alcohol Liaison Nurse’ can be. The role of these specialist nurses was to identify those with alcohol problems while they were already within the healthcare system to increase the chances of them attending follow-up sessions, but while also decreasing the chance of them returning to A&E for alcohol related problems and injuries.
The inclusion of Alcohol Liaison Nurses within Welsh A&E units, particularly those within larger cities such as Cardiff, Wrexham and Swansea, could see a decrease in the number of patients who return to A&E with further problems stemming from their drinking. This would not just be beneficial for patients, but also to the NHS itself due to them money that can potentially be saved by cutting repeat A&E attendances.
And there is a significant business case for them. The alcohol liaison project in St Mary’s Hospital in London saved an estimated £1,500 for each patient screened in A&E savings. In Belfast, the introduction of one Nurse resulted in an estimated monthly saving of £19,740 by saving 84 bed days a month. The salary of the nurse would have been between £26,000 and £35,000. This means that the introduction of one nurse saved around £200,000. In terms of NHS budgets, this is a relatively small figure, but if such a saving could be replicated across hospitals in Wales, the savings would soon mount up.
But of course this isn’t just about cash. Appointments of this kind would need to show some form of medical benefits too. In Cardiff, there were a total of 400 referrals in the first 12 months of the project, with referrals increasing monthly. 25% of these were referred to specialist addiction services, including counselling, other health organisations and residential rehabilitation. Mental health services, homelessness services and criminal justice organisations were also engaged with. Other referrals received health advice and GP support from their brief interventions.
Across the five trials there were many other benefits shown, such as reduced A+E re-attendance, decreases in the physical manifestations of hazardous alcohol use and reduced necessity for attendance and admission to hospital. 96% of patients in Liverpool said they had benefited and 99% said they would prefer to speak to a nurse than a Doctor.
So, we have an idea that helps patients and saves the NHS money? Seems like a bit of a no-brainer really doesn’t it? Surely creating trial appointments, with an aim to extending the scheme should be one of the key parts of the Welsh Assembly Government’s Substance Misuse Strategy? But it doesn’t even get mentioned. In fact, a quick search of this document contains only two mentions of the word ‘Nurse’, both in terms of prescribing (which is however important).
The Government are missing an opportunity to help those suffering from alcohol problems, help those whose alcohol use is could potentially become a problem and save the Welsh NHS money. My own view is that there should be a wider trial based in several Welsh hospitals to see if the results gained in the original trial can be replicated. Should this be the case then it could be rolled out across Wales.
Sorting out the nations drinking habits will take more than just attempting to stop people drinking. There has to be more support for addicts in Wales as well. This is one cost effective way of helping some people, plenty more people will still fall through the net, but if some can be helped while saving money, that has to be an option worth pursuing.
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Good post. You have highlighted the problems of alcoholism. It’s cost to society . Actually men do admit to being drinkers. Women perhaps are more likely to not admit to binge drinking. Female drinking is still underplayed. Nurse! Nurse! when they get tipsy can be lippy mairs!
More seriouslly these Alcohol liaison nurses may save money. But ultimately it’s money being thrown at deviance. There are more deserving cases such as the elderly or disabled to have public money spent upon them.
Ignoring the issue of whether it is right or wrong to spend money on ‘deviance’, surely it would make more sense to spend £30,000 on drinkers and save £200,000 that can then be spent on the elderly than spending just £30,000 on the elderly?
i would not spend a penny on drunkards or Alcy’s Matt. I say no more drunken, unruly behaviour, swearing, spiitng, breaking glass, making people feel scared….they always listen to me…lets all have an apple juice instead!
Good tolerant behaviour then, rather than reactionary bollocks.
If alcoholism is, as most people agree, a medical condition then it would be both counterproductive and immoral to deny them medical treatment. It is both a productive approach and also one that admits that people make mistakes.
Or would you rather leave people to die?
ach shut up you senn sible..dont take it too seriously these comments. I would not want them to die. If it is a medical condition it is SELF INDUCED ……..I have pleasant, peaceable times with friends without the need for intoxication.