The latest National Confidential Enquiry into Patient Outcome and Death [NCEPOD] report, Measuring the Units, finds that hospitals are missing opportunities to provide early intervention in the care of people with alcohol-related illnesses.

Led by author Dr Mark Juniper, Consultant Physician at the Great Western Hospitals NHS Foundation Trust, Swindon, the report found that 47 out of 138 cases involving patients known to have an alcohol-related liver disease were not referred for support to stop drinking, despite most hospitals reporting to have alcohol liaison services. Those who were referred were not always seen by a specialist in liver disease, and this was often not for several days after admission.

Overall, NCEPOD Advisors judged that the care of less than half (47%) of the patients included in this report was good and identified 32 deaths (out of 385) that may have been avoided. Other key findings were:

  • 25% (117/467) of patients were never seen by a gastroenterologist or hepatologist during their admission
  • Consultant hepatologists were only present in 28% (53/191) hospitals
  • Only 23% (47/203) of hospitals had a multidisciplinary alcohol care team
  • In 135 cases there were missed opportunities to influence the patients’ health outcome
  • Three quarters (76%) of patients had been admitted to hospitals on previous occasions
  • Treatment limitation or withdrawal was found to be inappropriate in 17% of cases (52/308).

Commenting on the report, Sir Richard Thompson, president of the Royal College of Physicians, said: “This report emphasises the variation across the country in specialist care in hospital for these patients, and suggests how much needs to be done to bring hospital services up to an acceptable standard. Every patient should also have access to an alcohol support service. There is a feeling that these sick patients are denied active treatment in high dependency beds because they are thought to be irrecoverable. I hope that this report will stimulate trusts to appoint more gastroenterologists with an interest in diseases of the liver and seven day alcohol support nurses”.

Annually nearly 9,000 people die from alcohol-related liver disease, with the number of admissions to hospital rising to 198,900 in 2010/11, a 40% increase since 2002/3 when it was first measured, revealing how the incidence of the illness in the UK has been increasing for decades.

For more information on the report, please visit the NCEPOD website.