This was a news story featured on the BBC website in April looking at how alcohol detox centres being set up could save the NHS millions.
The NHS could save £27m a year by changing the way it deals with alcoholic patients, new research seen by the Victoria Derbyshire programme suggests. We spent a week in a unit which is pioneering a different approach.
It’s Derek Pilling’s first day in the Chapman Barker unit. He was drinking up to 30 pints a day.
“When I was 15 I drunk socially and over the last few years I’ve come out of work and gradually got to the point where I’ve become dependent. Couldn’t go hours and hours without a drink. It’s scary,” he explains.
Derek was brought by his family, but others have come straight from the emergency department or inpatient ward at a Manchester hospital. Instead of getting patched up and sent home they arrive at this small building to undergo treatment for their alcohol addiction for a whole week.
Asked how he feels out of 10, Derek replies “one”. “To be honest I’m terrified. It’s my first admission. And it’s like, I’ve got to go further. . . and a lot more work after this. I just can’t let my family down,” he says.
Alcohol abuse costs the NHS £3.8bn a year, £145 for each UK household. One in three of all A&E admissions are alcohol related. On a weekend that can rise to 70%.
Dr Chris Daly, the lead consultant at the unit, believes the NHS is wasting money by often treating people for the effects of alcohol problems without dealing with the underlying problem.
“We were very surprised that a significant proportion, maybe as much as 50% of the patients [that we see], were not open to any services and some of them had never been seen by alcohol services before, so it’s almost as if we’re dealing with a different sort of population,” he says.
“These are people who are maybe only using their A&E department as their main source of treatment for their alcohol problems.”
The Radar ward at Chapman Barker is the first of its kind in the UK. Set up three years ago it takes alcohol-dependent patients directly from 11 A&E departments across Manchester.
Some 75% of the people who come through the unit do not go back to hospital for at least the next three months.
The scheme, now in its third year, is designed for people like John Courtney. A former RAF man and veteran of the first Gulf war, at his worst he was drinking a bottle of vodka a day.
He has been repeatedly in and out of hospital, often after collapsing and having a fit when sober and withdrawing from alcohol.
He says: “I can’t remember the number of different treatments I’ve had, from the assertive outreach team to surgical wound infections. It goes on and on. I can’t remember how much help I’ve had, and a lot of this is when I’ve been sober.”
The Radar ward is split with separate eating and living spaces for both sexes. Four in 10 of the places here are taken by women, from teenagers right up to pensioners in their 80s.
Patients are treated with talking therapies, support and counselling, but also specialist medical care they would not always get in a large hospital.
Around half of all alcohol-dependent patients can develop clinical symptoms when they try to quit, including seizures, fits and hallucinations.
Without the right support the most severe cases often end up back in hospital.
Nurse Clare Hilton says: “Most the patients here have severe alcohol problems. So it’s a matter of treating the physical addiction to drink then starting to look at the underlying cause.”
She says many people may think patients have caused the problem themselves.
“It’s so important to us that we don’t judge them. They’ve walked in and said, I don’t want to do this any more. We go, great, let’s sort it. What can we do to help you? So the team here all work with people because they know they want to make that change in their lives.”
An independent analysis of the unit by academics at Liverpool John Moores University published in April 2015 found it saves the NHS £1.3m a year.
If the same approach was taken across the country the researchers say it could save the NHS £27.5m in England alone.
This unit has secured funding to operate for another year but the future is always uncertain. The people working there say ignoring these patients will cost the NHS more in the long run.
Four days after Derek was admitted, he is getting ready to move into longer term residential rehab – paid for in part by his local council.
Asked how he feels now he says: “About eight-and-a-half out of 10. The panics have gone away, physically I can actually walk now. I used to be pretty much bed-ridden for maybe a week at a time.
“I feel a lot safer here and I feel a lot safer that my family know I’m here as I’m one of the youngest of nine.
“My family have been through a lot of heartache, it’s not as easy as you think. It’s really, really difficult. But there’s not really any option. It’s got to be done.”
Derek admits he has done some “pretty severe” damage to his body.
“I spoke to one of the doctors yesterday, I had some bloods taken and some more. . . I don’t want to ask, so I thought it obviously doesn’t sound good. I know from the past I’ve got severe liver damage, so basically I’m running on nothing now.
“I’m never going to pick up a drink again, but can anyone ever say never? I’m always going to be an alcoholic aren’t I? What can I do about that, you’ve just got to accept it. I despise it, I see it as a poison.”
We need more of these working in this way to help start to resolve the issues we have with alcohol and to take the pressure off A&E’s. I’d happily work at one 🙂
Edited to add: 11/07/2015 this unit was recently discussed in The Lancet too
A new UK unit, which takes alcohol-dependent patients straight out of the emergency setting to a specialist detox centre, is a promising approach, say experts.