Appoint an Alcohol Health Worker

What does this mean?

Since their report in 2001, The Royal College of Physicians have advocated the appointment of a dedicated Alcohol Health Worker or an Alcohol Liaison Nurse in each major acute hospital, to work with a named Consultant/Senior Nurse Alcohol Lead, to provide a focus for:

• Medical management of patients with alcohol problems within the hospital
• Liaison with community alcohol and other specialist services
• Education and support for other healthcare workers in the hospital
• Implementation of case-fi nding strategy and delivery of brief advice within the hospital.

What is the evidence that this works?

Over an 18 month period, the intensive care management and discharge planning delivered by an Alcohol Liaison Nurse in the Royal Liverpool Hospital had been shown to prevent 258 admissions or re-admissions - about 15 admissions per month.

Economic analysis of such an appointment in a general hospital suggested that the post saved ten times more in reducing repeat admission than its cost.

References

Alcohol - can the NHS afford it? London: Royal College of Physicians, (2001)

London: Royal College of Physicians, (2001)

Case Examples

Nottingham Alcohol Liaison Team

This team has been operational since March 2002. Based principally at the Queen's Medical Centre this patient-centred project works closely with local statutory and non-statutory healthcare, alcohol and drugs services as part of its inclusive and co-ordinated approach.

View the full project on HubCAPP: www.hubcapp.org.uk/JIR3

Middlesbrough voluntary sector partnership -best practice example

An alternative to employing a nurse is to employ alcohol workers from the third sector to work within the A&E. In Middlesbrough the Albert Centre provides services in Middlesbrough James Cook University Hospital and is funded via the Safer Middlesbrough Partnership (SMP). The service is called the Primary Alcohol and Drugs Service (PADS) and has been running for over 12 months. The service is cost effective offering 2 full time (equivalent) PADS workers and part time administration support for around £73k. Employment of two staff provides enhanced capacity to see patients and allows for cover during sickness and hoildays. The third sector workers are trained in 'talking therapies' and have motivational interviewing, CBT, counselling skills amongst others. They can offer a holistic approach covering all factors which may be affecting patients drinking behaviour such as housing, debt, bereavement, etc and can liaise with community based services, arrange appointments and advocate on behalf of the patient. The PADS workers also provide training to the doctors and nurses who rotate job roles at regular intervals. PADS workers visit wards where more chronic dependent drinkers are treated for medical conditions associated with their drinking; ensuring that community treatment services can prioritise patient follow up.

SMP have asked Teesside University to carry out a assessment /review of the effectiveness of the PADS service which will be completed in the summer 2009.