5. Alcohol advice and support services
Older People's Forum
(R) That this meeting of RCN Congress calls on UK governments and local authorities to protect and promote referral and access to alcohol advice and support services
Result
The resolution was passed.
For: 97.5% (464)
Against: 2.5% (12)
Abstain: 8
Debate report
“Alcohol studies estimate that one in five people over 65 drink in a manner that poses a significant risk to their health”, asserted Sue Edwards of the Older People’s Forum, who proposed the debate ‘Alcohol advice and support services’ at Congress.
Sue’s opening argument focussed on alcohol misuse amongst older people with complex health needs, while subsequent speakers highlighted concerns over alcohol issues across all age groups.
Speakers overwhelmingly supported the proposal, calling for better assessment and support for people with alcohol problems, as well as more specialist nursing jobs and a strategy to reduce alcohol consumption across the UK population.
“We need to find different ways to tackle the issue, providing balanced care that addresses the underlying cause as well as the effects of alcohol misuse,” said Heather Henry of Central Manchester. “More of the same will not work.”
Patricia Pullen of Buckinghamshire Branch identified the increasing trend of third sector organisations providing alcohol services in the absence of accessible NHS offerings. Neil Thompson of the UK Safety Representatives Committee said that this needs to be changed: “free expert support at the point of need would save costs”.
The resolution was passed, with a 98 per cent majority voting in favour.
Background
Alcohol misuse is a significant public health challenge. It affects thousands of individuals, families and communities and accounts for 80 per cent of deaths from liver disease (British Liver Trust, 2012). It is the second biggest risk factor for cancer after smoking (Alcohol Concern, 2011) and is directly linked to at least eight different types of cancer. It also causes or contributes to many other illnesses, such as pancreatitis, stroke, atrial fibrillation, high blood pressure and depression.
Although the annual estimated costs of alcohol misuse to the National Health Service (NHS) are considerable (£3.17 billion in England, £3.6 billion in Scotland, £122 million in Northern Ireland and £73 million in Wales), it is important to acknowledge that these costs are not largely due to young binge drinkers, but rather the cumulative effect of drinking over long periods of time at levels many people consider safe, but which are above those recommended (Alcohol Concern, 2011).
In 2011 the Royal College of Psychiatrists (RCPsych) reported that alcohol is among the top ten risk factors for mortality and morbidity in Europe and that substance misuse by older people is a growing public health problem.
Between 2001 and 2031, there is projected to be a 50 per cent increase in the number of older people in the UK. The percentage of men and women drinking more than the weekly recommended limits has risen by 60 per cent in men and 100 per cent in women between 1990 and 2006.
The RCGP recommended that clinical skills in the areas of alcohol screening, assessing motivation to change,as well as delivering brief interventions should be core competencies for health professionals.
From 2013, local authorities in England and Wales will be responsible for commissioning public health services, including alcohol misuse and prevention services. In Scotland, the Government has focused significant effort and resources on developing access to brief interventions as part of a wider strategy to tackle high levels of alcohol misuse. NHS boards have exceeded targets set in 2008 with over 272,000 interventions carried out over four years.
In Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) has committed to a range of measures including reviewing local community alcohol support services and increasing consistency. The role and capacity of alcohol liaison nurses is also being reviewed with consideration given to ensuring they are available in all relevant health and social care sites.
To tackle harm effectively, Alcohol Concern (2011) recommends that it is important to shed the stigma associated with alcohol misuse and recognise that alcohol must be part of every discussion about health and wellbeing.
References and further reading
Alcohol Concern (2011) Making alcohol a health priority: opportunities to reduce alcohol harms and rising costs, London: AC. Available at: www.alcoholconcern.org.uk/assets/files/Publications/2011/Making%20alcohol%20a%20health%20priority-opportunities%20to%20curb%20alcohol%20harms%20and%20reduce%20rising%20costs.pdf (accessed12/03/13) (Web).
British Liver Trust (2012) Reducing alcohol harm: recovery and informed choice for those with alcohol- related health problems, Ringwood: BLT. Available at: http://79.170.44.126/britishlivertrust.org.uk/wp-content/uploads/2012/12/Alcohol-liver-report_v5-01-02-2012.pdf (accessed 12/03/13) (Web).
Royal College of Psychiatrists (2011) Our invisible addicts: first report of the Older Persons’ Substance Misuse Working Group of the Royal College of Psychiatrists, London: RCPsych. Available at: www.rcpsych.ac.uk/files/pdfversion/cr165.pdf (accessed 12/03/13) (Web).
