By Dr Avi Suri, GP Alcohol Lead in Walsall WHAT TYPE OF PRIMARY CARE INTERVENTION WORKS IN REDUCING ALCOHOL RELATED MORBIDITY AND FINANCIAL BURDEN By Dr Avi Suri, GP Alcohol Lead in Walsall

Excessive alcohol consumption has consequences for both the health of the individual, such as chronic liver disease, cardiovascular disease, cancer, poor mental health and wellbeing and accidents, as well as impacting upon the wider societal determinants of health such as family breakdown, antisocial behaviour and crime

The 2007 DPH Annual Report – spurred the local health economy into action. Whilst the national DES for primary care was taken up by all practices locally, the GP with Special Interest for alcohol advised a more proactive contract was required and a locally enhanced scheme was drafted and put in place.

WALSALL ALCOHOL DATA Shows that Walsall is worse in: Alcohol specific mortality in males Mortality from Chronic Liver Disease in males Alcohol attributable hospital admissions are also higher than in surrounding boroughs and nationally

ALCOHOL DES This was to obtain drinking habits of all newly registered patients over the age of 16 in a GP Practice in units and advise patient to reduce alcohol consumption. This did not go far enough to have any impact hence the implementation of LES.

ALCOHOL LES TRAINING All Walsall Practices were trained to do screening by FAST test Those FAST positive were categorised into hazardous, harmful and addicted Harmful and hazardous drinkers were given brief intervention Those addicted were given either extended brief intervention or community detox by Alcohol Outreach Workers – trained nurses in Primary Care setting

ALCOHOL LES From April 2012 to March 2013 22645 patients were screened of these 1076 were hazardous drinkers 458 were harmful drinkers 475 were dependent drinkers There were 933 patients who received Brief Intervention and 143 patients had community detox

OUTCOMES All admissions with an alcohol specific diagnoses revealed 1447 patients in 2011 versus 1239 at the end of March 2013 386 patients were diagnosed with Alcohol Liver Disease in 2010/11 reduced to 303 at the end of March 2013 56 patients were diagnosed with alcohol induced pancreatitis in 2011 to 19 at the end of March 2013 I rest the case that alcohol LES works and should be promoted everywhere to reduce alcohol related harm, admissions and financial burden