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Alcohol Improvement Programme Heart of Birmingham PCT, NHS South Birmingham, Birmingham DAAT Max Vaughan Alcohol Commis

Alcohol Improvement Programme Heart of Birmingham PCT, NHS South Birmingham, Birmingham DAAT Max Vaughan Alcohol Commissioning Manager Birmingham DAAT. METHODS The approach incorporated the following components: Review of the available literature Analysis of management information

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Alcohol Improvement Programme Heart of Birmingham PCT, NHS South Birmingham, Birmingham DAAT Max Vaughan Alcohol Commis

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  1. Alcohol Improvement Programme Heart of Birmingham PCT, NHS South Birmingham, Birmingham DAAT Max Vaughan Alcohol Commissioning Manager Birmingham DAAT

  2. METHODS The approach incorporated the following components: • Review of the available literature • Analysis of management information • Interviews with stakeholders • Physical and environmental assessment of alternative venues

  3. Available Evidence • Quality of data • Do interventions in A&E, impact on NI39 ? • Women increase • Poly drug use increase • Related Blood Borne diseases increase • WMPHO – HES data

  4. Alcohol-specific admissions for HOBPCT and SBPCT rate per 100,000 population, 2007/2008

  5. Alcohol-related admissions for HOBPCT and SBPCT rate per 100,000 population, 2007/2008

  6. The number of admissions by individuals by Birmingham residents, 2007/2008

  7. Frequent Fliers • Admissions increase = acute issues increase • Operational tracking data better than systems data • Staff ‘fatigue’ • Case management techniques needed • Older age group • Mental Health issues • Homelessness

  8. Options for Alcohol Improvement Programme Investment ! • Brief interventions • External diversion • Internal diversion

  9. Option 1BRIEF INTERVENTIONS “a treatment strategy in which a short, structured therapy is offered (between 5 minutes and 2 hours) and typically on a single occasion. Aimed at helping a person stop or reduce their substance misuse” (Cochrane Drug and Alcohol Group, http://www.cdag.cochrane.org/en/glossary.htm

  10. Barriers to Brief Interventions • Alcohol misuse can be perceived as having a lower significance in comparison to illicit substance misuse. • A lack of willingness or awareness from clinical staff Poor liaison between the acute sector and services in the community • Cultural issues of operating in a hospital environment relating to a lack of support from clinicians • Practical issues relating to delivering BI including ensuing adequate time to access patients in a positive environment

  11. Alcohol Liaison Nurse • Screening at A&E and on key wards • Links to community based provision • Clinical services

  12. Option 2 External diversion Key service delivery issues for diverting alcohol-related patients to a non-acute clinic

  13. Option 3 - Treatment pathway for an Alcohol Medical Assessment Unit Model

  14. OPTION APPRAISAL • Appropriateness • Feasibility • Desirability • Sustainability

  15. The Task ! • Complete the tables in groups

  16. Options evaluation and appraisal- qualitative analysis of key success factors

  17. Options evaluation and appraisal- qualitative analysis of key success factors

  18. Options evaluation and appraisal- qualitative analysis of key success factors

  19. Options evaluation and appraisal- qualitative analysis of key success factors

  20. Options evaluation and appraisal- qualitative analysis of key success factors

  21. Options evaluation and appraisal- qualitative analysis of key success factors

  22. Options evaluation and appraisal- qualitative analysis of key success factors

  23. Options evaluation and appraisal- qualitative analysis of key success factors

  24. The Scores! • Alcohol Liaison Nurses 127 • External diversion 73 • Internal diversion 103

  25. Estimate of the impact of one ALN over three years at one site (based on City Hospital)

  26. The Proposed Approach The study suggests that there are financial gains to the NHS by employing two ALNs in a single hospital. The Proposed Model • 1. two ALNs within each acute setting. • 2. enhanced brief interventions through their “treatment journey” • 3. track patients from the MAU • 4. following-up patients at discharge • 5. (a) screening and brief interventions and (b) clinical management • 6. Times ALNs are employed need to be defined • 7. Work force Planning • 8. Clinical governance • 9. Data capture and evaluation – assess the effectiveness • 10. “tracking” patients

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