NICE has published a good practice guide for the clinical management of alcohol misuse. The guide supports commissioners to design services to improve the identification and treatment of hazardous drinking, harmful drinking and alcohol dependence in children, young people and adults. The guide can help the NHS and local authorities to make best use of resources.
The NICE commissioning guide on services for the identification and treatment of hazardous and harmful drinking and alcohol dependence draws on the suite of recently published NICE guidance on alcohol use disorders1.
The guide will also support commissioners to commission high quality alcohol services that meet the NICE quality standard on alcohol dependence and harmful alcohol use, published today.
In 2009-10, there were over 1 million alcohol related hospital admissions in England, more than twice as many as in 2002-03. Alcohol-related harm, from mental ill-health and alcohol-related physical complications, is estimated to cost the NHS around £2.7 billion per year; this is equivalent to about £6 million per 100,000 population aged 10 years and above. The commissioning guide sets out a whole system approach to commissioning integrated alcohol services across the whole spectrum of care, from preventing hazardous and harmful drinking through targeted screening and brief interventions, to specialist treatment programmes for children, young people and adults, and their families or carers.
The commissioning guide is illustrated with service models from the NHS and also highlights where commissioning alcohol services in line with NICE guidance will support national drivers such as the Quality, Innovation, Productivity and Prevention (QIPP) programme and Commissioning for Quality and Innovation (CQUIN).
The commissioning guide contains:
- a benchmark section that contains further information to help commissioners to assess levels of alcohol dependence and hazardous and harmful drinking in their population. In England the benchmark for the level of harmful drinking and alcohol dependence is 3.8% or 3,800 per 100,000 population aged 16 years and above.
- a commissioning and benchmarking tool that commissioners can use to calculate the costs and savings of increasing access to screening and brief interventions and to specialist alcohol treatment for adults.
Professor Colin Drummond, Professor of Addiction Psychiatry and Consultant Psychiatrist at King’s College London and the South London and Maudsley NHS Foundation Trust, said:
“The latest figures on the level of hazardous and harmful drinking and alcohol dependence in England, including large year on year increases in alcohol related hospital admissions, highlight the importance of commissioning services that are effective in identifying and tackling this growing problem. We know that the majority of people who are dependent on alcohol are not currently being treated, partly because they are not being identified and because of the limited availability of treatment services in some parts of the country. For example, although over one million people in England are dependent on alcohol, only around 10% of these currently receive treatment. It would be helpful to increase the vigilance of health professionals in the NHS to identify people who misuse alcohol, provide brief advice and appropriately refer them to specialist treatment at an earlier stage. This will require wider training for NHS staff and increased capacity of specialist alcohol treatment services.
“This guide sets out a whole system approach to commissioning integrated alcohol services across the spectrum of care, from preventing harmful drinking through targeted screening and brief interventions, to specialist treatment programmes for children, young people and adults. Its purpose is not only to ensure that high quality services are commissioned, but also to enable commissioners to release resources or generate savings in hospital admissions and other unplanned health care use by improving access to evidence based alcohol interventions.”
While the commissioning guide draws on existing NICE recommendations, it does not constitute formal NICE guidance and is intended as a tool to help the NHS improve patient care through effective commissioning of services.
Notes to Editors
About the commissioning guide
- The NICE guide on commissioning services for the identification and
treatment of hazardous drinking, harmful drinking and alcohol dependence
in children, young people and adults is available on the NICE website at http://www.nice.org.uk/usingguidance/commissioningguides/alcoholservices/AlcoholServices.jsp
2. A podcast featuring Steve Simmonds, head of Salford Drug and Alcohol Service and Andrew McDonald, alcohol commissioner in Salford, is also available on the NICE website at http://www.nice.org.uk/usingguidance/commissioningguides/alcoholservices/
3. Details of all the NICE commissioning guides published to date can be found on the NICE website at http://www.nice.org.uk/usingguidance/commissioningguides/bytopic.jsp
4. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and
treatment of ill health.
5. NICE produces guidance in three areas of health:
- public health – guidance on the promotion of good health and the prevention of ill
health for those working in the NHS, local authorities and the wider
public and voluntary sector
- health technologies – guidance on the use of new and existing medicines, treatments, medical
technologies (including devices and diagnostics) and procedures within
- NHS clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS
6. NICE produces standards for patient care:
- Quality standards – these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
- Quality and Outcomes Framework – NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.
1 – Alcohol use disorders: diagnosis, assessment and management of harmful
drinking and alcohol dependence. NICE clinical guideline 115
Alcohol use disorders: physical complications. NICE clinical guideline 100
Alcohol-use disorders – preventing the development of hazardous and harmful drinking. NICE public health guidance 24