New evidence being presented today at the British Association for the Study of the Liver (BASL) conference in Glasgow shows that an innovative new service treating people who are alcohol dependent is having dramatic effects and saving the NHS money.
The liver unit from University Hospitals Plymouth NHS Trust has developed a new service that has turned traditional ways of treating people with alcohol dependency on its head. They analysed data over the first six months of the pilot service, and found that their new service had saved £78,400 in acute hospital bed days alone, not counting additional savings including ambulance and social services costs.
The Assertive Alcohol Outreach Service (AAOS) in Plymouth identifies frequent users of A&E who are alcohol dependent. They then provide targeted intensive bespoke care that is highly individualised for six months. By visiting their homes, liaising with family members, and other services such as social care, housing, and debt services they are achieving improved health outcomes for the individual patients as well as saving money.
People who frequently attend A&E departments for alcohol-related reasons place a disproportionate burden on hospital bed usage. Although A&E staff are generally sympathetic to the needs of people with complex drinking and related problems, they do not have the resources or training to provide the kind of personalised support that people who frequently attend A&E with alcohol-related problems often need. One in ten people in the hospital system in the UK are alcohol dependent.1
The Plymouth team set out to address these alarming statistics by trying a completely different approach.
Louise Dunn who leads the nurse led service said, “These patients have complex needs and often don’t interact with traditional service models. This service puts the patient at the centre, builds relationships and really considers what is needed for each particular individual.”
Users of the service reported how it had improved their family relationships, quality of life family dynamics, improved health, and enabled them to engage more effectively.
One user commented, “I've never got on with other services as they treat you like they have a recipe book and if you’re not on their ingredients list, they can't help you. But AAOS have thrown away the recipe book, looked at the ingredients, (me) and just cooked with what you've got and that's why I think it's finally worked!"”
Pam Healy, Chief Executive of the British Liver Trust said, “The NHS Long Term Plan has recommended hospital-based alcohol care teams as one of the key interventions for preventing illness and reducing health inequalities. This new evidence suggests that this may be an excellent model for how they could deliver their services to ensure that they are integrated and truly meet the needs of patients.”
- A major review published in July 2019 pulled together the results of 124 previous studies involving 1.6 million hospital inpatients revealed that one in ten people in the hospital system are alcohol dependent. https://onlinelibrary.wiley.com/doi/10.1111/add.14642