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CMG38 Alcohol services: Steve Simmonds and Andrew McDonald

Steve Simmonds, head of Salford Drug and Alcohol Service and Andrew McDonald, alcohol commissioner in Salford, discuss NICE’s commissioning guide on alcohol services.

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This podcast was added on 31 Aug 2011

Podcast transcript

Steve Simmonds, head of Salford Drug and Alcohol Service and Andrew McDonald, alcohol commissioner in Salford, discuss NICE’s commissioning guide on ‘Services for the identification and treatment of hazardous drinking, harmful drinking and alcohol dependence in children, young people and adults’.

Jennifer: “Hello and welcome to this podcast from NICE.

“Today NICE has published a guide to help commissioners to develop high quality alcohol services for children, young people and adults.

“My name is Jennifer Hopes, commissioner adviser for this guide. Joining me to discuss the commissioning guide are:”

Steve: “Steve Simmonds, head of the Drug and Alcohol Service in Salford, for Greater Manchester West NHS Trust.”

Andrew: “And Andrew McDonald, I’m the alcohol commissioner and I work for NHS Salford and also for Salford City Council.”

Jennifer: “Thank you.”

Q1: “So Steve, how big a problem is alcohol misuse in England, and can you give me examples of the impact of alcohol-related harm on Salford?”

Steve: “Nationally it is estimated that one in four people drink alcohol in a way that is potentially harmful to health. Alcohol related harm comes from A&E [accident and emergency] admissions, treatments for high blood pressure, liver disease, depression and other mental health disorders.

“The total estimated health cost of all this is approximately 2.7 billion pounds.

“In Salford, as well as suffering from multiple social deprivation, we experience the 8th highest rate of hospital admissions in the country.

“In addition to the health impact, we also know that alcohol is related to incidents of domestic violence, that it impacts on children’s welfare and the ability of people to care for children, on safety and also on worklessness and unemployment. In addition there is a cost to employers through days lost through sickness.

“The estimated cost of all this is around 150 million pounds for a typical borough in Greater Manchester.”

Q2: “Steve, in what ways do you think the public might benefit from better quality alcohol services?”

Steve: “Well from the information we’ve just given you, it’s likely that everyone is going to know somebody, at some stage, who has struggled with an alcohol problem, and will be well aware of the impact that this can have.

“We in services believe that people can, and do, get better and we witness this on a daily basis. People will want to know how they can access services, and that the services they access are of good quality and are locally accessible to them.

“We feel we can’t treat alcohol problems in isolation. We need to get a wide picture of the individual and the possible causes of alcohol misuse. From this, we would seek to develop a package of care, which can help people to help themselves in a recovery journey.

“The services need to be accessible, ideally local, non-judgemental and responsive to need.

“The benefits of treatment extend well beyond the individual to improved relationships, reductions in domestic violence, parents who are better able to care for children and reductions in alcohol related crimes such as anti-social behaviour.”

Q3: “And Andrew, can you explain some of the advice that the commissioning guide offers to help commissioners to develop better quality alcohol services?”

Andrew: “Yes, the key part of the guidance is around early intervention, which for the majority means that they’ll be having what we call a brief intervention. That is, talking to the individual for about 5 minutes to identify, whether or not, they are someone who is an increasing risk of harm drinker, or indeed someone who is a dependent drinker.

“And, the aim of the [commissioning] guidance is so that these interventions can be developed in a wider range of facilities, such as GP surgeries and accident and emergency.

“So if you’re a dependent drinker, we would then see you in a specialist service and the aim at that point is to ensure that we get in early and prevent the development of more complex problems, such as liver disease.

“If however you’re a young person, it’s much more about identifying which of those young people, and it’s usually the majority, just need good information about drinking. Or whether you’re one of the minority of young people who might be already developing a dependency for alcohol. And the importance there is that that’s seen within the context of your whole family. And one of the key things about the guidance is that it seeks to demonstrate an integration between adult and young people’s services so that that is a much more seamless transition.”

Q4: “And Andrew, is there anything that is preventing commissioners from developing high quality [alcohol] services?”

Andrew: “Yes, the key issue is really getting the message across about just how broad the impact is of alcohol related harm.

“It’s obvious to the NHS and the criminal justice system, but it’s in some ways less obvious to other partners in the system. And particularly at times of increasing demand and increasing cost.

“The NICE guidance is incredibly helpful in that it’s a gold standard for commissioners and also at the same time supports local innovation. Such as a partnership we have in Salford between Salford Royal and the Metal Health Trust, which Steve works for, around targeting frequent attendees [to A&E].

“The activity that the NICE commissioning guidance in particular supports, is the annual Joint Strategic Needs Analysis [Assessment], which is an intelligence based assessment of need and inequalities in the local area. And the [commissioning] guidance and the tools within the guidance particularly help local commissioners to develop that JSNA.”

Jennifer: “Steve and Andrew thank you.

“For more information about the NICE alcohol commissioning guide please visit our website at www.nice.org.uk/usingguidance/commissioningguides

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This resource should be used alongside the published guidance. The information does not supersede or replace the guidance itself.

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.