Staff from Gateshead’s substance misuse service have a presence at the borough’s main hospital four days a week. This gives them a chance to identify and engage patients who have alcohol-related problems.
Gateshead has high rates of problem drinking. The 2016 Adult and Health and Lifestyle survey showed 27 per cent of adults locally were higher-risk drinkers – consuming more than 14 units a week. This is leading to high and rising rates of hospital admissions linked to alcohol. Each year there are about 200 admissions. That is the equivalent of an age-standardised rate of just over 1,000 admissions per 100,000 people, compared to a national average of 632.
A wide range of support is offered through a single, integrated drug and alcohol service delivered by the Gateshead Recovery Partnership, led by the provider Change Grow Live. It includes group and one-to-one work, housing support, detox and a recently-launched 12-step intensive structured rehab course.
Over the past five years the substance misuse service has sought to work closely with the major hospital in the area; Queen Elizabeth (QE) Hospital, Gateshead. Health and wellbeing leads from the service are now based at the hospital. Initially this only involved visits for a few hours a week, but now the service has a presence four days a week from 1pm to 5pm. Telephone support is provided on the fifth day and direct contact is available outside of these hours, which is utilised most weeks.
The leads visit all wards, including A&E, critical care and the emergency assessment unit. As well as linking in and sharing relevant information with QE staff regarding existing users, they will also meet with individuals deemed to need support for the first time Working alongside the hospital’s specialist alcohol nurse, they will explain about the support available.
A specialist in-reach service has also been developed for young people. The service, Platform, is delivered by Humankind and has a named contact in the safeguarding team so information can be shared. The safeguarding team makes referrals to the service, making the parents of the young person aware if they do. When a referral comes in from A&E, the substance misuse service contacts children’s social care to check if they are already involved.
Health and Wellbeing Lead Carol Johnston said the work at the hospital has been really successful in focussing on the needs of individuals. “It feels like we are one big team even though we work for different organisations.” On average she will have contact with around 40 people a week. One of those who has been helped said; “I feel so grateful that I have had this opportunity. It has, quite simply, saved my life. I am nearing the end of my six month programme, and while the future holds some fears, I am confident that I can face them and continue to grow in life and sobriety.”
One of the challenges in terms of tackling alcohol-related problems is getting people engaged. The in-reach work with adults and young people has enabled the service to hone its approach.
With adults, the service initially made set appointments for clients for when they are discharged. But now the leads encourage the clients to contact the service themselves and keep in touch with them as a reminder that support is available.
Public Health Programme Lead, Julia Sharp said: “There was an extremely high rate of non-attendance so we wanted to do something to empower individuals. They can now just drop-in at one of our hubs and get help that way. Before, people would miss their appointments, and think that was it. Now they know all they have to do is come in and they will be seen straight away.”
Meanwhile, for young people and children, there is a policy in place to offer three appointments. If the young person does not attend and there has been no contact with the parents or carer a fourth letter is sent stating that if they do not make contact, the substance misuse service will pass their concerns on to the safeguarding team. This normally prompts the parents to engage.
How is the approach being sustained?
The council is planning to conduct a selfassessment review of the service to see how it can develop further the approaches and interventions at all levels. Ms Sharp said the hospital in-reach work will form part of that process. “One of the things I am aware of is how we support those who maybe do not qualify for specialist help, but are drinking too much and whether there are additional opportunities that we can utilise to provide the lower risk drinking advice. “In recent years we have been running brief intervention training on alcohol for people in the voluntary sector and front-line community staff, such as librarians. We have trained about 80 people since the end of 2017. This is something we could extend.”
Julia Sharp: Public Health Programme Lead, Gateshead Council firstname.lastname@example.org