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Preventing the cycle of alcohol-related harm

To meet the Secretary of State’s goal of truly prioritising prevention, we need a comprehensive new alcohol strategy, argues Dame Professor Kumar

Dame Professor Parveen Kumar

15 February 2019

Alcohol misuse continues to be a leading cause of ill-health

You don’t have to spend long in the NHS to see the harmful impact that alcohol has. Doctors working in General Practice, accident and emergency departments, hospital wards or in public health teams, routinely see the devastating consequences. This is borne out in the stark data: in England alone, there are over 5,500 deaths specifically as a result of alcohol, and over 1.1 million hospital admissions related to alcohol misuse, resulting in overall estimated costs to the NHS of £3.5 billion per year.

Working in a deprived area of London as an NHS doctor, I have seen the devastating impact of alcohol ranging from the immediate effects of drunken fights causing injuries, to the long-term effects of cirrhosis and death from complications.  The hidden consequences however are heartbreaking, with broken families, poverty when the household money has gone in to buying cheap alcohol, crime, and imprisonment. And yet this does not have to be the case. Alcohol-related harm can be prevented.

 

New alcohol care teams are a welcome development

It is pleasing that the new long-term plan for the NHS in England includes a focus on the role the NHS has to play in prevention. For alcohol specifically, there was an announcement of expanded alcohol care teams in those hospitals that have particularly high rates of admission related to alcohol dependence – a move to be welcomed by all those working in the NHS.

Alcohol care teams coordinate care across acute departments, providing access to brief interventions and appropriate services and developing a community-based approach. This early intervention can help to prevent some individuals from being admitted to hospitals - it is estimated that if delivered in 25% of the worst affected hospitals, this could prevent as many as 50,000 NHS England admissions over five years. This potential benefit suggests there is a strong case for expanding their use into all areas. They will have individual health and wider-economic benefits for the NHS, as well as reducing the pressure on the system. The BMA has highlighted the year-round pressures now facing the NHS. For example, our analysis found that during January and February 2018, 95% of NHS general and acute beds were occupied, leading to the cancellation of routine appointments. In 2017-18 there were 16.6 million hospital admissions in England. Any measures to relieve some of this pressure are welcome.

 

We need a wide-ranging alcohol strategy that prevents harm before people require hospital services

The recognition of the role of the NHS in preventing alcohol-related harm is important, but it is just one of many measures needed. It is widely acknowledged that most of the things that influence health happen outside of the health service. As the BMA has highlighted in our submission to the forthcoming alcohol strategy, a comprehensive package of key measures is needed if the government is to deliver its vision of a truly preventative approach to healthcare.

This should include the introduction of a minimum unit price for alcohol – bringing England in line with the rest of the UK – consistent and mandatory labelling on all alcohol products as well as the widescale promotion of the chief medical officers’ guidance on safe levels of drinking. This would ensure that consumers are able to make an informed choice.

The expansion of alcohol care teams and a more significant role for the NHS in prevention are important pieces of the jigsaw, however, to meet the Secretary of State’s goal of truly prioritising prevention, we need a comprehensive new alcohol strategy including a range of ambitious measures.

Written by Dame Professor Parveen Kumar, chair of the British Medical Association Board of Science. You can also hear her speak about the issue on our Alcohol Alert podcast (link below).

All IAS Blogposts are published with the permission of the author. The views expressed are solely the author's own and do not necessarily represent the views of the Institute of Alcohol Studies.