Daily Archives: 17/02/2016

Three in four people in A&E at weekend are there because of alcohol

A+E hospital visitsThis is not the first time I’ve written about alcohol and its impact on A&E and to me that means both paramedics and A&E staff (read more here & here).

This was featured by the BBC & The Telegraph in December.

Three in four people in accident and emergency units at the weekend have been admitted because of alcohol, new figures have shown.

The new research, which was carried out at an A&E unit in the North East of England shows the huge burden that excess drinking places on the NHS.

Young men aged between 18 and 24 made up the bulk of the admissions, with most there because they have been injured in fights or falls, alcohol poisoning or because they were suffering mental health problems.

Dr Jim Connolly of the Department of Emergency Medicine at the Royal Victoria Infirmary in Newcastle carried out breath testing of A&E attendees during four weeks in 2012-13.

The alcohol-related attendance rate varied substantially from four per cent to 60 per cent on weekdays, but rose to 70 per cent at the weekend. Based on the figures, researchers calculated that it costs each emergency unit around £1 million a year just to treat drink related problems and injuries.

“This indicates a significant NHS burden if all such emergency departments in the UK are sustaining similar demands associated with alcohol related attendance,” said Dr Connolly.

“Although older people may cost more per patient, younger people as a group are more costly to the NHS because they have more alcohol related attendances.

“Our results suggest that emergency departments would benefit from routinely providing staff to cover the night and early morning shifts, particularly at weekends, to cope with the high proportion of alcohol related attendances at these times.”

Dr Connolly also found people who didn’t live in the city twice as likely to test positive than local residents, suggesting that city centres attract revellers from elsewhere, while hospitals and other public services in city centres pick up the tab.

Hospital admissions for disease and injuries associated with alcohol has risen 100 per cent between 2003 and 2013 and 21,000 deaths each year are directly caused by alcohol.

Dr Clifford Mann, President of the College of Emergency Medicine, warned that alcohol was currently cheaper than bottled water and said that many young people were risking their health by ‘preloading’ on cheap drink before going out to bars and clubs. He has called for a minimum pricing of 50p per unit

“The pattern of alcohol intoxication has changed significantly in the past 10 years. No longer do people set out sober, in the early evening, to attend licensed establishments where they consume alcohol.

“Instead the phenomenon of ‘preloading’ has become endemic. In consequence, people, especially young people, purchase relatively cheap but potent forms of alcohol and drink large quantities at home, either alone or with friends, before setting out much later in the evening to continue imbibing alcohol in pubs and clubs into the early hours.

“The economic, social, and medical consequences of current alcohol strategies create a compelling argument for improved legislation and regulation of alcohol sales. Currently it is perfectly feasible to purchase a volume of alcohol that represents a safe weekly maximum for less than £10. Alcohol at this price is cheaper than bottled water.

“The financial burden of alcohol is dramatic, yet the response of governments has been woefully inadequate.”

The team carried out breath testing of A&E attendees during the same 4 weeks in 2012-13 to find out who had been drinking.

The research was published in the Emergency Medicine Journal.

And this was the BBC headline (read more by clicking link)

A&E visits for alcohol poisoning ‘double in six years’

Half of all A&E attendances likely to be due to alcohol poisoning – when a person drinks a toxic amount of alcohol, usually over a short period of time – took place on a Friday, Saturday or Sunday, peaking between midnight and 2am.

Three in four arrived by ambulance – putting a strain on already stretched resources, said the Nuffield Trust.

Further coverage:

Report warns over growing burden of alcohol on hospitals

So the NHS is invariably on it’s knee’s at this time of year because of the winter bed crises and as the lack of finances pinches further due to the approach of the end of the fiscal year & yet it has to continue to manage the added pressure of the impact of booze …… The service and its staff are only human – we are not miracle workers!!

Edited to add 5th May 2016:

Frequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions

The central aim of this study was to provide detailed insights into the characteristics, views and experiences of individuals who repeatedly present to A&E with alcohol-related health conditions in order to optimise the development, implementation and evaluation of interventions for them | Alcohol Research UK, UK

The 3rd national emergency department survey of alcohol identification and intervention activity

This survey followed up on the preceding National Surveys (Patton & O’Hara 2013, Patton et al., 2007) exploring the implementation of alcohol screening activity for adult and adolescent patients, with additional focus on older drinkers and people frequently attending EDs for alcohol-related reasons | Alcohol Research UK, UK

Edited to add 18th July 2016:

Preventing violence-related injuries in England and Wales: a panel study examining the impact of on-trade and off-trade alcohol prices

To examine the influence of real on-trade and off-trade alcohol prices and socioeconomic and environmental factors on rates of violence-related emergency department (ED) attendances in England and Wales over an 8-year period. | Injury Prevention, UK

Edited to add: 6th Feb 2017

The NHS chief executive Simon Stevens said binge-drinkers are “selfish to get so blotto” they end up in an ambulance or A&E.  “More than a third of A&E attendances at peak times are caused by drunkenness – casualty nurses and doctors are understandably frustrated about the NHS being used as a national hangover service,” he added. Telegraph