We must ACT on drink-related harm

As part of the NHS Long Term Plan Prevention Focus Week, the Centre Director for Public Health England North East looks at the need to tackle alcohol dependency:

It’s fair to say that alcohol dependency causes a great deal of ill health.

Millions of people are admitted to hospital every year with illnesses such as liver disease, heart conditions, stroke, breast, mouth or throat cancer, all of which can be caused by long-term alcohol use. It doesn’t have to be like this.

The long-term key to reducing this avoidable harm and demand on health services is through prevention action that reduces the number of people who drink at harmful levels.

While we strive to achieve this, it is of course critically important that we support and treat people with alcohol harm now and we know that hospital-based alcohol care teams (ACTs) can make a big difference to patients’ health, their lives and those of their loved ones.

That’s why Public Health England and NHS England and NHS Improvement have recommended them as one of the key interventions for preventing illness and reducing health inequalities as part of the 2019 NHS Long Term Plan.

My colleagues in Public Health England (PHE) are working closely with NHS England and NHS Improvement to support local areas in making sure that ACTs are as effective as they can be. To achieve its potential, an ACT needs to form part of a well-planned system that spans NHS and community services, so it’s crucial that local partners also work together at strategic and operational levels.

We know this is recognised in most hospitals and the vast majority have some specialist alcohol care provision, but this is often not adequate for the size of the challenge. To be effective, ACTs need adequate staffing, based in the hospital and with the skills to provide specialist treatment for dependent drinkers while they are inpatients. They need senior clinical and strategic leadership that can integrate the service throughout the hospital and they need to be joined up with local community support services commissioned by local authorities.

So, to slow the revolving door, one part of the solution is the universal provision of high-quality ACTs and the NHS and local authority partners, together, need to plan a system that can recognise alcohol-related illness among hospital patients. This should identify those individuals who are alcohol dependent and likely to need help to stop drinking, engage them in treatment while in hospital and provide longer term support in the community. This will be most effective, and bring the greatest reduction in harm and demand, where it is aligned as part of local alcohol harm reduction strategies that also include other measures such as brief interventions.

ACTs and the community alcohol treatment providers commissioned by local authorities, need to work together as a single system, so there is no break in support. Community alcohol services need to have the resources and capacity to seamlessly continue the care of patients who’ve started their alcohol treatment in hospital and the expertise to support those patients through the difficult process of overcoming their dependence.

The NHS Long Term Plan pledges support to the hospitals with the highest need and, with PHE’s support, NHS England and NHS Improvement is developing a range of resources to help hospitals to assess their ACTs and improve them if necessary. PHE centre teams are working with local authorities to support effective partnership working and provision of alcohol treatment that works. The huge impact of alcohol on health and health services can change, but only if we all work together.

Professor Peter Kelly

Professor Peter Kelly joined Public Health England in September 2016 as Centre Director for the North East having previously been the Director of Public Health for Stockton-on-Tees Borough Council for 4 years.

Previously he was a Director of Public Health for 11 years in various NHS posts in the North East of England, including two years as Acting Regional Director of Public Health.

His current responsibilities include leading the provision of a high quality, responsive expert public health service to support the work of the Local Authorities and NHS partners in the North East.

Peter started his career as a medical statistician following completion of his PhD in statistics in 1987. He worked as a lecturer at Newcastle University Medical School until 1996 and was the founding director of the Centre for Health & Medical Research at Teesside University until 1999.

He joined Pfizer Pharmaceuticals for a brief spell before joining the NHS in 2000. He also had four years’ experience as an acute hospital non-executive director, including being the trust vice chair and setting up and chairing their original clinical governance committee.

He joined Tees Health Authority in 2000 and has held senior public health roles in the North East since then.