Wednesday, 26 September 2018

Finally, a successful alcohol policy

Something extraordinary has happened at NHS Walsall. It has seen a 54 per cent drop in alcohol-related Accident and Emergency admissions and a 68 per cent reduction in bed days as a result of taking action on the 'frequent flyers' who come to A & E time and time again.

The NHS Trust identified ten people who were visiting A &E a great deal. How many times do you think they were admitted to hospital in a six month period? Ten? Sixty? A hundred?

The answer - incredibly - is 499. On average, each of them was being admitted twice a week.

It's an incredible statistic but the same thing is happening up and down the country. A small number of people who have a problem with alcohol - often combined with problems with drugs and mental health - take up a vast amount of NHS time.

So the Trust decided to focus on prevention among this small minority. They identified 38 frequent flyers and co-ordinated different service providers to help them out. As Daniel Hodgkiss, patient safety manager at the trust, explains:

'We identified a small number of hospital patients with complex needs that were discharged only to return multiple times and which accounted for a very disproportionate number of admissions.
'This was due to a lack of cohesion between social care, mental health services, police and a range of other services. By bringing these agencies together to co-ordinate patient care, we were able to substantially reduce admissions.'

The results have been astounding. A & E attendances have been more than halved! If other NHS Trusts achieved a fraction of this, it would result in huge savings (it is estimated that the initiative has saved NHS Walsall £250,000).

And yet I haven't seen any mention of this remarkable success story in the timelines of the anti-alcohol pressure groups or the 'public health' academics who profess expertise on alcohol policy. They are too busy whining about the PHE/Drinkaware collaboration and campaigning for (illegal) cancer labels on wine bottles in Ireland.

Could it be that dealing with the minority while leaving the majority alone doesn't quite fit their dogmatic belief that 'population-wide interventions have the greatest potential for prevention'?

As my friend Dick Puddlecote always says, it's not about health.

No comments: