Listen to this month’s podcast here
In this month’s Alcohol Alert podcast, we spoke to Professor Julia Sinclair and Arlene Copland about the crucial role of Alcohol Care Teams (ACTs) in acute hospitals – and the growing threat they face.
ACTs are small, multidisciplinary teams, often led by specialist nurses, that support hospital patients whose alcohol use is impacting their health – whether or not it’s the reason they were admitted. Their work includes expert clinical support, navigating complex care needs, training other staff, and linking patients into community services on discharge.
As Professor Sinclair, a Professor of Addiction Psychiatry at the University of Southampton, puts it:
Alcohol is a poison that gets into every organ of the body. So any condition you come into in the hospital may be caused by alcohol or you may also be drinking at levels that are harmful, so technically anybody in the hospital may be dealing with somebody who has an alcohol problem.
That’s what makes ACTs so important: they meet patients where they are, not just physically but emotionally. Many are not treatment-seeking or ready to change, and ACTs build trust and provide compassionate, non-judgemental care in a system that can stigmatise addiction.
Arlene Copland, Alcohol Nurse Consultant and visiting professor, describes how her team becomes the patient’s advocate:
Nurses in addiction sometimes will go and see people in emergency departments and the patients in crisis, they’re in a terribly vulnerable state, and we have to go and form very quick relationships with the patient. They have to realise very quickly that they can trust us, that they can rely on us, and we can become their advocates.
And then we become the person that speaks to the doctor and speaks to the nurse and speaks to the relatives and speaks to the ward and gets the physio involved and gets the dietician involved; we’re the link really that kind of permeates throughout the whole hospital and community services.
ACTs have been shown to improve care, reduce repeat admissions, and save money. A regional study in the North East found that for every £1 invested in ACTs, the NHS saved £5. Despite this, many of the 47 teams set up with NHS England funding are now at risk. That funding ends in 2025, and most teams have no guarantee of continued support.
As Copeland warns:
ICB’s say “yeah we know you do a really good job, we know you’re fantastic, but there’s no money” and for a lot of services that just ends the conversation there.
The podcast also explores why addiction services are so vulnerable to cuts. From the lack of a national strategy to persistent stigma, ACTs often find themselves misunderstood and underfunded – despite working with some of the most disadvantaged patients in the NHS. Around half of those seen by ACTs are in the lowest socioeconomic quintile.
Sinclair explains that these teams are working with the people with the greatest needs, but that stigma towards people with alcohol problems means that it’s an easy service to cut.
The national evaluation of ACTs, led by Sinclair and colleagues, aims to provide definitive evidence of their impact, cost-effectiveness, and wider value. But for many teams, that evidence may come too late.
This episode is a powerful insight into the reality of frontline alcohol care – the hope ACTs offer, and the risk we face in losing them.