Alcohol consumption and harm in England 2010

A paradoxical picture of declining alcohol consumption but increasing alcohol-related hospital admissions is provided by the latest compendium of alcohol statistics from the NHS Information Centre.

However, the NHS statistics on alcohol-related hospital admissions have been criticized as unreliable and unfi t for purpose, and there is currently a consultation underway on the best way of recording them. This follows criticism made by the Institute of Alcohol Studies of the official statistics on the affordability of alcohol. As a result of IAS representations, the method of calculating alcohol affordability has been changed. (See page 16)

The new figures

The alcohol consumption figures presented show a small decline in total consumption in 2010 compared with 2009. They also show a continuing trend of proportionately more alcohol being consumed within the home than outside it in licensed premises. In 2010, 65% of the alcohol consumed was home consumption.

There has been a long term downward trend in the proportion of adults who reported drinking in the week prior to interview. In 1998, 75% of men and 59% of women drank in the week prior to interview, compared to 68% of men and 54% of women in 2010.

Changes in attitudes and behaviour are also evident in children of secondary school age. 13% of secondary school pupils aged 11 to 15 reported drinking alcohol in the week prior to interview in 2010, down from 18% of pupils in 2009 and 26% in 2001. In 2010, 32% of pupils thought it was okay for someone of their age to drink once a week, compared to 46% in 2003. Similarly, only 11% of pupils thought that it was OK for someone of their age to get drunk once a week, compared to 20% who thought that in 2003.

In 2010/11 there were 198,900 hospital admissions where the primary diagnosis was attributable to the consumption of alcohol. This is a 2.1% increase since 2009/10 when there were 194,800 admissions of this type and a 40% increase since 2002/03 when there were around 142,000 such admissions.

The figures on alcohol mortality are mixed, showing a small increase in male alcohol-related deaths in 2010 compared with the previous year, but a small decrease in female deaths.

In 2011, there were 167,764 prescription items for drugs for the treatment of alcohol dependency prescribed in primary care settings or NHS hospitals and dispensed in the community. This is an increase of 4.7% on the 2010 figure (160,181) and an increase of 63% on the 2003 figure (102,741). The Net Ingredient Cost (NIC) of these prescription items was £2.49 million in 2011. This is an increase of 3.3% on the 2010 figure (£2.41 million) and an increase of 45% on the 2003 figure (£1.72 million). It is estimated that the total cost of alcohol harm to the NHS in England is £2.7 billion in 2006/7 prices.

Hospital admissions

As reported previously in Alert (See Issue 1 2012 ‘NHS alcohol statistics: the war of numbers’) the statistics of alcohol-related hospital admissions have been condemned as invalid because of failing to take into account changes in hospital coding practices, which resulted in the admissions figures being artificially inflated. The issue hinges around the distinction between cases in which alcohol enters into the primary diagnoses and which, therefore, constitutes the main reason for admission to hospital, and secondary diagnoses, cases in which alcohol is an associated or underlying factor.

As stated above, the figures for alcohol-related primary diagnoses show a 2.1% increase in admissions for 2010 compared with the previous year. However, the issues concerning how alcohol-related admissions are coded result in the latest NHS Information Centre showing two sets of figures in relation to total admissions (both primary and secondary), one set being based on the old method of calculation and the other being adjusted to allow for changes in coding practices.

The problem, as commentator Nigel Hawkes was quick to point out, is that, in one set, total alcohol-related admissions rose between 2009-10 and 2010-11 from 1,056,900 to 1,168,300, but according to the other set they fell over the same period from 1,208,100 to 1,168,300.

Statistics on Alcohol: England, 2012.
The Information Centre for Health and Social Care.
NHS. 2012