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Problem drinkers and smokers who end up in hospital will be helped by dedicated new services as part of the NHS Long Term Plan.
As part of new NHS prevention measures, people who are alcohol dependent will be helped by new Alcohol Care Teams, while more than half a million patients who smoke, including pregnant women and their partners will also be helped to stop, in a new drive that will see all smokers admitted to hospital encouraged to quit.
The schemes come alongside action on obesity and diabetes as part of a renewed focus on prevention that will benefit patients and make the NHS fit for the future, by curbing demands on the health service.
Alcohol Care Teams will be rolled out in hospitals with the highest number of alcohol-related admissions and will support patients and their families who have issues with alcohol misuse.
This will be delivered in the 25% worst affected parts of the country and could prevent 50,000 admissions and almost 250,000 bed days over five years.
Mums to be will also benefit from NHS-funded one-to-one support to improve their own health and give their newborn babies the healthiest start in life.
The most recent figures show that women in England are amongst the most likely to smoke during pregnancy with 10% still lighting up at the time of their baby’s delivery, which doubles the risk of still birth, substantially increases the likelihood of miscarriage and triples the chances of sudden infant death.
Partners of pregnant women will also be encouraged to kick the habit to give new mums the best chance of not smoking again.
Across the country, there is significant variation in the number of pregnant women who smoke, ranging from 2% in Kensington & Chelsea to over one in five in Blackpool.
The areas with the greatest level of need will be prioritised with 600,000 people being supported to quit over the next five years.
Announcing the plans, NHS England chief executive Simon Stevens said: “Drinking to excess can destroy families, with the NHS too often left to pick up the pieces.
“Alcohol and tobacco addiction remain two of the biggest causes of ill health and early death, and the right support can save lives.
“The NHS long term plan delivers a sea-change in care for a range of major conditions like cancer, mental ill health and heart disease, as well as stepping up to do more on preventing ill health in the first place by giving patients the support they need to take greater control of their own health and stay fitter longer.”
Alcohol-related admissions to hospital have grown by 17% over the last decade – in 2016/17 there were 337,000 estimated admissions – 2.1% of the total.
Alcohol-related harm is estimated to cost the NHS in England £3.5 billion every year.
Alcohol Care Teams in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth have already seen a reduction in A&E attendances, bed days, readmissions and ambulance call outs have significantly reduced.
Now expert teams will work in up to 50 hospitals across the country to deliver alcohol checks and provide access to health within 24 hours if problems are found including counselling, medically assisted help to give up drink and support to stay off of it.
Based in hospitals, the teams will work with local community services to ensure all needs, including any other health needs, are met.
Advice sessions last for 20–40 minutes and involves personalised feedback to people about their level of health risk because of alcohol consumption, practical advice about reducing alcohol consumption, with a range of options for change, and written information to support the advice.
Every smoker admitted to hospital will be offered NHS support to quit and this also includes every patient who is receiving long term support from specialist mental health and learning disability services.
The services are based on a scheme already happening in Manchester, which is expected to save £10 million and over 30,000 hospital beds across the city.
This will be replicated across the country over the next five years so that every patient can access support including personalised bedside care, timely therapy and follow up help when they have been discharged from hospital.
Royal College of Physicians president Professor Andrew Goddard said: “We welcome the Long Term Plan’s commitment to offer help to quit for every smoker admitted to hospital, as recommended in our 2018 report Hiding in Plain Sight. Helping people give up smoking is a cost-effective means of both improving health and reducing demand on NHS services in the future. Every contact a health professional has with a patient is an opportunity to help the patient give up smoking – having a system in place to treat tobacco dependency with allocated funding will help make it happen.
“The focus on the management of alcohol related disease is also very welcome. It is an increasing problem in our hospitals where many patients first come to the attention of the NHS. We mustn’t forget prevention though and further measures to reduce harmful drinking are much needed.”
Deborah Arnott, Chief Executive of health charity ASH, said: “From cancer to cardio-vascular and respiratory disease, dementia to diabetes, and maternity to mental health, stopping smoking improves patients’ life expectancy and quality of life and reduces pressure on our overburdened NHS. So we’re delighted the NHS long-term plan includes provision of support to stop smoking for pregnant women, people with mental health conditions and all patients admitted to hospital. We look forward to publication of the detailed plans, and the timetable for implementation.”
Duncan Selbie, Chief Executive, Public Health England said: “Investing in prevention is the smartest thing the NHS can do. Tobacco kills 1500 people a week so helping people to quit when admitted to hospital helps them, their families and the taxpayer. And it is equally smart for hospitals to have new expertise focused on supporting the most alcohol dependent people. Both measures announced today will save thousands of lives and help the NHS remain sustainable into future years.”