Our policy is not to adopt a universal screening programme for alcohol misuse, as the evidence base indicates this would not be cost-effective. Instead, we are encouraging health care professionals and others to implement opportunistic alcohol case identification and to deliver brief advice about alcohol. This can take place at any opportunity when an individual is consulting with a health care professional or indeed any agency about a health issue, which may have a link to excessive alcohol consumption.
International research has shown that this approach works well in primary care. We believe these results would be replicated in some targeted clinics within secondary care, such as genito-urinary medicine, fracture clinics or facial injury clinics.
While there is good evidence confirming the value of this approach, there are some gaps in the research. This is why the Department has commissioned a programme of research into opportunistic alcohol case identification and delivering brief advice that is now under way in a selection of general practitioner (GP) practices, accident and emergency departments and probation departments. The purpose of this research is to refine which identification tool works best in which setting, with which target groups, and what methods of providing advice are most effective.
We have put in place from April 2008, a new national health service indicator to measure the change in the rate of hospital admissions for alcohol-related harm—the first ever national commitment to monitor how the NHS is tackling alcohol health harms. This indicator is expected to encourage primary care trusts to invest in earlier identification of people who drink too much linked to advice and support from GPs or other health care staff. This has been shown to be the best way of reducing the kind of ‘everyday’ drinking which over time leads to liver disease and other problems.