Tackling the Harms and Costs of Alcohol Misuse ALCOHOL HEALTH WORK A&E liaison via PAT Includes CDU, Douglas & Joseph Toynbee ward Ward referrals can be made directly Alcohol withdrawal management St Mary’s alcohol guidelines being reviewed Advice & support for ward staff Psychiatric liaison Where dual diagnosis is an issue Brief assessment of substance misuse Referral to community alcohol services Thursday 23rd August 2007

Tackling the Harms and Costs of Alcohol Misuse PAT pathway Thursday 23rd August 2007

Tackling the Harms and Costs of Alcohol Misuse Referral & Reduction For every two (hazardous/harmful drinking) patients referred for AHW there will be one less re-attendance within the next 12 months. Crawford MJ et al, Lancet, 2004;364:1334-39 NB Inclusion criteria from the REDUCE Study: Men consuming 8 or more units (I UK Unit=10ml=8gms alcohol), and women consuming 6 or more units, on at least one occasion per week. Any patient who declares their visit to ED related to alcohol consumption – Question 4, PAT. 18 yrs and over, Alert & orientated, Speak sufficient English, Resident within London orbital M25, Accept offer of help Verbal consent & accept written info. Exclusion Criteria: Requested help at outset, i.e. treatment-seeking, Already in contact with alcohol services, Refused consent. Thursday 23rd August 2007

ST. MARY’S HOSPITAL: IMPACT OF ALCOHOL HEALTH WORK Tackling the Harms and Costs of Alcohol Misuse ST. MARY’S HOSPITAL: IMPACT OF ALCOHOL HEALTH WORK 2004/5 540 patients accepted referral, and 119 attended their AHW appointment (22% of referrals). 2005/6 973 patients accepted referral, and 453 attended their AHW appointment (46% of referrals). 2005/6 1083 patients accepted referral, and 593 attended their AHW appointment (55% of referrals). Thursday 23rd August 2007