Influence change through advocacy

What does this mean?

Find high-profile champions to provide leadership within partner organisations and a focus for action to reduce alcohol harm. This is never easy but a champion within the PCT, the acute hospital, Social Services, local authority, elected members, Probation, the Police and other partners can galvanize change and action. Champions can help build the case for local investment and potential savings to the NHS, the community and the public purse. Particularly, identify a clinical champion who can infl uence and support positive changes in the attitudes and skills of those within health settings responding to, or caring for, individuals with alcohol-related problems.

What is the evidence that this works?

The Community Trials Project (Moore and Holder 2003) lists a number of key elements in making progress on alcohol harm:

• Community leadership
• Making local alliances
• Working with local politics
• Making the case for and seeking additional resources

Every acute hospital should have a named Consultant as their 'Alcohol Lead' from whatever acute specialty is pragmatic for that hospital. This individual should have time allocated within their weekly job plan. (Royal College of Physicians, 2001)

References

Moore, R.S., and Holder, H.D. (2003) 'Issues surrounding the institutionalization of local action programmes to prevent alcohol problems. Results from a community trial in the United States' , Nordic Studies on Alcohol and Drugs, Vol. 20, English supplement, pp. 41-55

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

Case Examples

St Mary's Hospital, London - Emergency Department (ED)

Under the leadership of their Consultant, Professor Robin Touquet, all junior doctors and staff were trained to tackle alcohol misuse. They developed a screening tool specifically designed for their environment, the Paddington Alcohol Test (PAT). All patients presenting to A&E with one of the targeted conditions are screened for alcohol misuse. Patients who are drinking at increased or higher risk are offered the opportunity to return to the hospital the following day (or within a few days) to have a session with the A&E's Alcohol Health Worker. This worker is a trained nurse who carries out a more in depth assessment concerning the individual's lifestyle and alcohol use. The worker then delivers brief advice and education concerning the patient's use of alcohol.

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

Cardiff

Professor Jonathan Shepherd in Cardiff pioneered work demonstrating that A&E departments are capable of collecting valuable data on patients attending as a result of alcohol use and working in partnership with local organisations such as police, social services, public health, industry representatives and local authorities to develop effective strategies for local intervention. The sharing of data across services to develop a full picture of premises and factors that are contributing to alcohol harms in a community has been shown to promote the development of community-based interventions that target specifi c premises and areas.

Derbyshire Violence, Alcohol harm, Licensing (VAL) Project

The project came about through a Police Inspector being seconded to Derbyshire DAAT and given a brief to research how violent crime could be reduced within Derbyshire. From his recommendations the 'Violence, Alcohol harm, Licensing' (VAL) meetings were set up.

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

Bristol Hospital Based Alcohol Nurse Specialist: United Bristol Healthcare Trust

(UBHT) appointed a full-time Alcohol Nurse Specialist (ANS) in October 2006. The full-time role was developed after a part-time pilot in the Hepatology Unit had proved cost-effective through a reduction in re-admission rates and had led to positive health outcomes.

View the full project on HubCAPP www.hubcapp.org.uk/QAM2