Salford alcohol assertive outreach team: a new model for reducing alcohol-related admissions
- Neill R Hughes1,
- Natalie Houghton2,
- Haitham Nadeem3,
- Jackie Bell3,
- Suzanne Mcdonald2,
- Noel Glynn3,
- Christopher Scarfe4,
- Bev Mackay2,
- Anthony Rogers3,
- Melanie Walters5,
- Martin Smith1,
- Andrew Mcdonald6,
- David Dalton5
- 1Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK
- 2Alcohol Assertive Outreach Team, Salford Royal NHS FT, Salford, UK
- 3Salford Drug and Alcohol Service, Greater Manchester West NHS Mental Health Foundation Trust, Salford, UK
- 4Department of Adult Social Care, Salford City Council, Salford, UK
- 5Salford Royal NHS Foundation Trust, Salford, UK
- 6Salford Drug and Alcohol Action Team, Salford, UK
- Correspondence to Dr Neill R Hughes, Emergency Department, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK; Neill.hughes{at}srft.nhs.uk
- Received 29 August 2012
- Revised 25 October 2012
- Accepted 19 December 2012
- Published Online First 23 January 2013
Abstract
Objective Alcohol-related admissions are increasing. A significant number of these admissions are attributable to a small number of complex patients with other comorbidities who do not engage well with mainstream services. Assertive outreach teams have been used in the field of psychiatry to engage patients who are poorly compliant. This study examines whether an alcohol assertive outreach team (AAOT) can engage with this group and reduce hospital admissions.
Design The AAOT is a multidisciplinary team with medical, psychiatric, substance misuse, psychology, nursing and social work specialists. The team worked with patients with the highest number of alcohol-related admissions and case managed in a community setting for 6 months. The admission and emergency department attendances of the cohort were compared for the 3-month period before and after the intervention. Christo inventory for substance misuse services (CISS) scores were determined pre and post the intervention period.
Results 54 patients were case managed. The total number of admissions in 3 months fell from 151 prior to the intervention period to 50 following the intervention. Emergency department attendances also fell from 360 in 3 months to 146 following the intervention period. CISS scores fell from 11 preintervention to eight postintervention.
Conclusions An AAOT model appears to reduce hospital admissions and emergency department attendances in a complex group of patients that display high alcohol-related admissions.
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