Hospitals to target smokers and heavy drinkers

Author: Ingrid Torjesen
Hospitals to target smokers and heavy drinkers

Dedicated new services in hospitals will target problem drinkers and smokers who end up in hospital, NHS England has announced.

The services are included in new NHS prevention measures to be announced in the NHS Long-Term Plan published later today.

People who are alcohol dependent will be helped by new Alcohol Care Teams, while more than half a million patients who smoke, including pregnant women and their partners will also be helped to stop, in a new drive that will see all smokers admitted to hospital encouraged to quit. The schemes come alongside action on obesity and diabetes as part of a renewed focus on prevention that will benefit patients and make the NHS fit for the future, by curbing demands on the health service.

Alcohol Care Teams will be rolled out in hospitals with the highest number of alcohol-related admissions and will support patients and their families who have issues with alcohol misuse. This will be delivered in the 25% worst affected parts of the country and could prevent 50,000 admissions and almost 250,000 bed days over five years.

Expert teams will work in up to 50 hospitals across the country to deliver alcohol checks and provide access to health within 24 hours if problems are found including counselling, medically assisted help to give up drink and support to stay off of it. The teams will be based in hospitals but also work with local community services to ensure all needs, including any other health needs, are met.

Alcohol-related admissions to hospital have grown by 17% over the last decade – in 2016/17 there were 337,000 estimated admissions – 2.1% of the total.

The introduction of Alcohol Care Teams in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth have already been associated with a reduction in A&E attendances, bed days, readmissions and ambulance call-outs have significantly reduced. Advice sessions last for 20–40 minutes and involves personalised feedback to people about their level of health risk because of alcohol consumption, practical advice about reducing alcohol consumption, with a range of options for change, and written information to support the advice.

The NHS Long-Term Plan will announce that every smoker admitted to hospital will be offered NHS support to quit, including patients receiving long-term support from specialist mental health and learning disability services.

The services will be based on a scheme already happening in Manchester, which is expected to save £10 million and over 30,000 hospital beds across the city. The service will be replicated across the country over the next five years so that every patient can access support including personalised bedside care, timely therapy and follow-up help when they have been discharged from hospital.

Pregnant women will benefit from one-to-one support. The most recent figures show that women in England are amongst the most likely to smoke during pregnancy with 10% still lighting up at the time of their baby’s delivery, which doubles the risk of still birth, substantially increases the likelihood of miscarriage and triples the chances of sudden infant death.

The areas with the greatest level of need will be prioritised with 600,000 people being supported to quit over the next five years. Across the country, there is significant variation in the number of pregnant women who smoke, ranging from 2% in Kensington and Chelsea to over one in five in Blackpool.

Partners of pregnant women will also be encouraged to kick the habit to give new mums the best chance of not smoking again.

Royal College of Physicians president Professor Andrew Goddard said: “We welcome the Long-Term Plan’s commitment to offer help to quit for every smoker admitted to hospital, as recommended in our 2018 report Hiding in Plain Sight. Helping people give up smoking is a cost-effective means of both improving health and reducing demand on NHS services in the future. Every contact a health professional has with a patient is an opportunity to help the patient give up smoking – having a system in place to treat tobacco dependency with allocated funding will help make it happen.

“The focus on the management of alcohol-related disease is also very welcome. It is an increasing problem in our hospitals where many patients first come to the attention of the NHS. We mustn’t forget prevention though and further measures to reduce harmful drinking are much needed.”