A mixed method outcome evaluation of a specialist Alcohol Hospital Liaison Team

Title: A mixed method outcome evaluation of a specialist Alcohol Hospital Liaison Team in England Background: The World Health Organisation (WHO) states that the protection of health by preventing risky drinking (increasing and high risk drinking) is a public health priority. The number of alcohol related deaths in the United Kingdom (UK) has risen from 9.1 deaths per 100,000 people in 1992 to 14.3 per 100,000 in 2014, with alcohol related hospital attendances costing the National Health Service £3.5 billion annually. The Royal College of Physicians recommended that major UK hospitals employ specialised alcohol care teams, who should co-ordinate care across all hospital departments. Evidence suggests that such teams are effective at reducing alcohol related hospital admissions, and can improve the care and health outcomes of patients admitted for alcohol use. Objective: To evaluate the effectiveness of an alcohol hospital liaison team at reducing alcohol specific hospital attendances and admissions. Methods: In a mixed method evaluation 96 patients who accessed the team were monitored using data for alcohol specific hospital attendances and accident and emergency (A&E) admissions before, during, and after engaging with the team. A feedback survey was sent to patients and a focus group was held with staff from the team to identify barriers and facilitators to the successful delivery of this service. Results: No differences were observed when looking at alcohol admissions or A&E attendances before patients engaged with the service to those after discharge. Whilst hospital admissions decreased slightly, and A&E attendances increased slightly, these differences were not significant. Hospital admissions and A&E attendances increased significantly during engagement with the service. The focus group identified confusion over who should be delivering brief interventions, and that the team were holding onto patients for too long. Conclusions: The results of this evaluation demonstrated that this team were not effective at reducing alcohol attendances or admissions due to a number of factors. Policy makers should make note of the barriers to effectiveness highlighted in this paper before commissioning alcohol care teams in the future.