Specialist support can help address alcohol problems in deprived areas

A new study led by a University of Dundee researcher has shown that embedding specialist addiction nurses in general practices has the potential to appropriately support people with alcohol problems.

Dr Andrea Mohan, from the University’s School of Health Sciences, was principal investigator on the study exploring perceptions of the Primary Care Alcohol Nurse Outreach Service (PCANOS) project.

PCANOS sees an Addictions Nurse located within Deep End GP practices, those which serve the 100 most disadvantaged populations of Scotland. Alcohol-related deaths are 4.3 times higher in the most disadvantaged areas of Scotland compared to the least.

The primary aim of this project was to engage patients who have no or little involvement with specialist community alcohol services, and to refer them on to mainstream services upon discharge.

The study that Dr Mohan and her colleagues from the University of Stirling carried out explored the experiences and perceptions of alcohol problem management in Deep End practices in Glasgow. They found that the service was viewed positively by both practice staff and patients due to its person-centred approach, flexible nature, and ability to be tailored to support specific individuals.

The study also found that the model enabled collaborative working between practice staff, leading to faster referrals and coordinated care with wider community services after discharge by the Addictions Nurse.

Dr Mohan and her colleagues have called for long-term funding to be provided for PCANOS to enable the continued support of people with alcohol problems who have complex needs. They also want further research to be conducted into unique services such as PCANOS, in supporting people with alcohol problems who do not engage with alcohol services.

“People from deprived backgrounds in Scotland continue to experience serious harms such as illness and early death due to alcohol,” said Dr Mohan. “Supporting this group can be challenging as they often have complex health and social needs and find it difficult to access appropriate services. This research study found that benefits can be achieved when a specialist alcohol service such PCANOS works closely with general practices.

“It is crucial that a service like PCANOS continues to be funded as our study has shown that it is filling an important gap in alcohol service provision.”

Alcohol continues to cause a significant amount of harm in Scotland, with the latest alcohol death figures from the National Records for Scotland (NRS) showing an increase from 1,020 alcohol-related deaths in 2019 to 1,190 in 2020.

In 2020/21, there were 35,124 alcohol-related hospital stays in Scotland (at a rate of 641 per 100,000 in the population).  Alcohol consumption is a causal factor for more than 200 disease and injury conditions. Additionally, alcohol harm costs the Scottish Government £3.6 billion per year (equivalent to £900 per person), including £405 million in NHS services.

The Dundee/Stirling report, ‘Exploring the management of alcohol problems in Deep End practices in Scotland’, is published today by Scottish Health Action on Alcohol Problems (SHAAP), the organisation that commissioned the research.

SHAAP Director Elinor Jayne said, “Alcohol harm disproportionately affects people living in Scotland’s most disadvantaged communities, so targeted, innovative services such as this Addictions Nurse model in Deep End practices in Glasgow are to be celebrated.

“It’s really important that not only is this service continued but is expanded to all Deep End practices so that we can begin to reduce the harm caused by alcohol in all of Scotland’s most disadvantaged communities. Investment in this type of person-centred, holistic care is not only the right thing to do but will ultimately reduce the burden placed on other overstretched NHS services, so I would encourage all health boards in Scotland to take this model forward.”