1. 12.20 7,50 5.90 8,88 Alcohol in Safer Hands – A Joint Working case study Integrated Care Service Specification Project Dr Joe McGilligan

2. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 2 Joint Working Project  This project is a joint working initiative between East Surrey CCG and Lundbeck Ltd  It is bound by a Joint Working Agreement and Project Initiation Document (PID) including terms of reference for an assignment role  Project Reporting lines:  Project Executive / Sponsor: Dr Joe McGilligan  Clinical Lead (advisory/support role): Dr Jill Rasmussen  CCG Overseeing Manager: Hayley Bath, Engagement & Delivery Manager  Alcohol Project Manager - Assignment: Allister Upton from Lundbeck  See www.lundbeck.com/uk/our-focus/joint-working

3. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 What’s the issue? “...the concentration in England on "binge drinking" youngsters and on the antisocial or criminal consequences of heavy drinking.... has allowed politicians to project the problem onto a small minority of the population, missing the point that there are hundreds of thousands of people - the silent majority - who in their own homes are quietly opening a bottle of wine each evening and over the week are unknowingly drinking well over the recommended limits, storing up problems for the future.” Professor Sir Ian Gilmore – commenting on national alcohol policy, February 2010 http://www.smmgp.org.uk/html/newsletters/net028.php#De bate

4. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 4 Above DoH Guidelines? Risk in context CONDITION MEN (increases risk by) WOMEN (increased risk) HypertensionFour timesDouble Stoke DoubleFour times Coronary Heart Disease 1.7 times1.3 times PancreatitisTriple Double Liver Disease13 times

5. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 5 In East Surrey: 13,011 alcohol related A&E visits Sources: HES A&E data; MORI (2003); National Schedule of Reference Costs 2011-12 for NHS trusts and NHS foundation trusts

6. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 6 2,912 alcohol related inpatient admissions Sources: HES 2011/12 & NWPHO 2008

7. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 Why? Alcohol Impact Model: ES CCG Type of cost (£000s)Actual or modeled dataE Surrey 1. Alcohol-related inpatient admissions: Diagnosis codes Wholly attributableActual data£1,249,000 Partly attributableActual data£5,239,000 External Cause codes Wholly attributableActual data£0.0 Partly attributableActual data£230,000 2. Alcohol-related outpatient visitsModeled data£1,275,000 3. Alcohol-related A&E attendancesModeled data£1,506,000 4. Alcohol-related emergency ambulance journeysModeled data£1,659,000 5. Alcohol-related GP consultationsModeled data£305,000 6. Alcohol-related practice nurse consultationsModeled data£42,000 7. Alcohol dependency-prescribed drugsActual data£3,000 8. Specialist alcohol treatment servicesModeled data£199,000 9. Other alcohol-related healthcare usageModeled data£243,000 Aggregated data Total cost (£000s)Various£11,949,000 Adult population (16+)Actual data136,985 Cost per adult (£)Various£87

8. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 SCN grant to fund gaps in service  Bid to gain funding to pump prime T1 service interventions  Locally commissioned service proposal  Telephone helpline delivering confidential screening & signposting  Practice & Pharmacy based “Healthy Living Clinic” to deal with increasing and high risk drinkers  Bolster Alcohol Liaison Services in Acute Trust  Deliver T1 point of contact for those identified or motivated to seek help  £182k to fund identification, screening and advice to reduce drinking risk

9. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 9 What are main parts of the new pathway?  The 4 work streams have evolved into 4 pathway segments: 1.Prevention – whole life cycle proposed  Scratch cards, simple screening with all health and social care partners signposting into telephone support/services 2.Screening and early identification  Telephone line, Alcohol Liaison and HCPs directing people into the HEALTHY LIVING CLINIC 3.Diagnosis, Support and Risk Management  Diagnosis and treatment in primary care or signposting to specialist services 4.Specialist Treatment  Awareness and making the most of PH funded services

10. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 Interactive Tool

11. 12.20 7,50 5.90 8,88 12.20 7,50 5.90 8,88 Questions