NHS long-term plan ‘will help problem drinkers and smokers’

As part of new health service prevention measures, people who are alcohol dependent will be helped by new “alcohol care teams”, said NHS England today.

“Alcohol and tobacco addiction remain two of the biggest causes of ill health and early death”

Simon Stevens

In addition, more than half a million patients who smoke will be “helped to stop” in a new drive that will see all smokers admitted to hospital encouraged to quit.

This will include pregnant women and their partners, noted the government arms’-length body in a statement released today.

The schemes came alongside action on obesity and diabetes that formed part of a “renewed focus on prevention that will benefit patients and make the NHS fit for the future by curbing demands”.

The 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.

NHS England said this move would cover the 25% worst affected parts of the country and could prevent 50,000 admissions, and almost 250,000 bed days over five years.

“Investing in prevention is the smartest thing the NHS can do”

Duncan Selbie

NHS England cited figures showing that alcohol-related admissions had grown by 17% over the last decade – in 2016-17 there were 337,000 estimated admissions – representing 2.1% of the total.

Alcohol-related harm was estimated to cost the NHS in England £3.5bn every year, it said.

It said alcohol care teams in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth had already seen a fall in emergency attendances, bed days, readmissions and ambulance call outs.

Now such teams would work in up to 50 hospitals across the country to deliver alcohol checks and provide access to health within 24 hours if problems were found, including counselling.

Based in hospitals, the teams would work with local community services to ensure all needs, including any other health needs, were met.

Advice sessions lasted for 20-40 minutes and involved personalised feedback about level of risk from alcohol consumption, practical advice about reducing consumption, with a range of options for change and written information to support the advice.

Meanwhile, it said mothers-to-be would 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 implementation of the entire plan just like the recently announced new maternity package cannot be done on a shoestring”

Sean O’Sullivan

It highlighted that women in England were among the most likely to smoke during pregnancy, with 10% continuing at the time of their baby’s delivery, despite the increased risk of still birth, miscarriage and sudden infant death.

Across the country, there was significant variation in the number of pregnant women who smoked, ranging from 2% in Kensington and Chelsea to over one in five in Blackpool, noted the body.

It stated that the areas with the greatest level of need would be prioritised with 600,000 people being supported to quit over the next five years.

In addition, every smoker admitted to hospital will be offered NHS support to quit including every patient receiving long-term support from specialist mental health and learning disability services.

NHS England said the new services were based on a scheme already happening in Manchester, which is expected to save £10m 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 after discharge.

Over the festive period, the government announced that a maternity shake-up will form part of the long-term plan. Ministers promised a major redesign of neonatal services, led by an expansion in staff numbers including more specialist nurses. In addition, child health records – the “red book” – will be digitised and digital maternity records for 100,000 women will be piloted by the end of 2019.

Meanwhile, NHS England said that national funding for children’s hospices is to rise by as much as £25m a year. However, the total annual increase would be dependent on local commissioning bodies agreeing to match the rise in funding on offer from NHS England.

Other policies set to be in the plan have previously been revealed as well, including supporting earlier diagnosis of cancer, new mental health crisis services, and providing early intervention for people with a learning disability or autism.

Announcing the plans on alcohol and smoking, 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,” he noted.

Duncan Selbie, chief executive of Public Health England said: “Investing in prevention is the smartest thing the NHS can do.

“Both measures announced today will save thousands of lives and help the NHS remain sustainable into future years,” he added.

“Every contact a health professional has with a patient is an opportunity to help the patient give up smoking”

Andrew Goddard

Royal College of Physicians president Professor Andrew Goddard said: “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,” he said.

“The focus on the management of alcohol related disease is also very welcome,” he said. “It is an increasing problem in our hospitals where many patients first come to the attention of the NHS.”

Sean O’Sullivan, head of health and social policy at the Royal College of Midwives, said it especially backed the plan’s focus on tackling smoking rates during pregnancy.

“The commitment to fund intensive support for women to stop smoking during pregnancy and to encourage their partners who also smoke to quit is particularly welcome,” it said.

But he said the college would like to see a major investment in smoking cessation specialist midwives to make the plan “become a reality”.

It highlighted a recent RCM survey in which heads of midwifery from across the UK reported that 69% of them did not have a smoking cessation specialist midwife in their maternity teams.

Also, midwives needed access to appropriate training and time off to complete it to become a specialist but short staffing meant planned training was postponed “far too often”, as they were called back to understaffed labour wards”, said Mr O’Sullivan.

“The government must ensure local authorities have enough money to invest in stop smoking services”

Alison Cox

He added: “While the RCM supports this part of the NHS long-term plan, the implementation of the entire plan just like the recently announced new maternity package cannot be done on a shoestring.

“Successful implementation of any such plans will need real investment in the recruitment and retention of midwives, in the training of more specialist midwives,” he warned.

Alison Cox, Cancer Research UK’s director of prevention, said: “Most smokers want to quit so it’s great news that NHS England is promising to help them end their addiction.

“But smokers outside the hospital setting need help to give up too,” she said. “The government must ensure local authorities have enough money to invest in stop smoking services.”

The long-term plan was initially due to be published in December 2018, but has been pushed back and is now expected early this year.