Alcohol misuse and alcohol‐related problems, especially binge drinking and alcohol‐ related liver disease, are major public health concerns. Recently, much attention has focused on social policy and measures to reduce drinking. There is an additional need to provide care for a large and growing group of patients with alcohol‐related problems, where national quality standards are lacking and the absence of coordinated policies means care is imperfect and spending is poorly targeted and ineffective.
In 2006/7, alcohol misuse cost the UK economy £25.1 billion. Of this, the NHS expenditure was £2.7 billion. In 2008, over 78% of the costs were incurred as hospital‐ based care. This booklet paper is based on the expectation that a substantial proportion of this spending is avoidable and that alcohol services could be significantly more effective, cheaper and person‐centred, if each health district had a plan, integrated between primary and secondary care, to deliver evidence‐based care in an appropriate setting.
This paper, which focuses particularly, but not exclusively, on secondary care, makes 11 key recommendations relevant to a typical British District General Hospital, serving a population of 250,000. If implemented, they should improve quality and efficiency of care, lower mortality and reduce admissions and readmissions for patients with alcohol‐ related problems. The paper provides the evidence‐base for effective policies and an appropriate workforce required to implement them.