New research with people who are repeatedly hospitalised due to alcohol (Alcohol Frequent Attenders – AFAs) highlights the need for improved services. The study was conducted by researchers at the University of the West of Scotland alongside medical colleagues at the Royal Alexandra Hospital in Renfrewshire and was commissioned by expert alcohol medical group, Scottish Health Action on Alcohol Problems (SHAAP).

In 2021/22, there were 35,187 alcohol-related hospital admissions in Scotland, representing a major challenge to the overstretched NHS.

The study aimed to ascertain whether an alternative service approach to AFAs may be more effective in relation to both patient care and use of NHS resources.

Researchers interviewed 20 frequent attenders at the Royal Alexandra Hospital in Renfrewshire to gather information about their alcohol-related problems, their reasons for attending hospital services, and to gain their views on their use of services.

Read the report: A Qualitative Study of the Views of Alcohol Frequent Attenders at Royal Alexandra Hospital, Renfrewshire (shaap.org.uk)

Main findings included:

• Women have very different experiences and needs to those of men
• The link between mental health and trauma and alcohol consumption and problems
• A lack of joined-up approach between mental health and alcohol services, meaning that people seeking help often fall into the cracks between services
• The importance of family support and recovery communities
• A lack of service signposting for patients
• How difficult it can be for people to make changes and/or seek help for their alcohol problems
• Barriers to accessing and maintaining treatment

In light of these findings, SHAAP and the report authors are calling for consideration be given to designing a dedicated service for the complex needs of AFAs and to support recovery: particularly with reference to gender, mental health and trauma needs. They believe that this intervention will reduce alcohol harms in Scotland and in turn save lives.

Dr Mathis Heydtmann, Consultant Hepatologist, formerly at Royal Alexandra Hospital, NHS Greater Glasgow and Clyde (NHSGG&C), now at NHS Dumfries & Galloway, said:

“Alcohol frequent hospital attenders represent a population of long-term, harmful and dependent drinkers, who present with wide-ranging and complex needs, sometimes in crisis. Their impact on both emergency departments and hospital admissions is very significant. Throughout my medical career, I have witnessed this first-hand.

“A unique service dedicated to helping people with alcohol problems who repeatedly arrive at the hospital entrance would help to prevent further admissions, would reduce the strain on the NHS and would save lives.”

Dr Alastair MacGilchrist, Chair of SHAAP, commented:

“This study makes clear that it is essential that people who are frequently attending hospital due to alcohol are identified as early as possible, and that a rapidly available, effective treatment service should then swing into action.

“This service should be tailored to the specific needs of this complex group, ensuring that no patient falls between the cracks of services in the future.

“The upcoming UK Alcohol Treatment guidelines should address multifaceted groups like alcohol frequent attenders specifically and must aim to mitigate against barriers which they experience in accessing treatment.”

Ken Barrie, Senior Lecturer, University of the West of Scotland (UWS), commented:

“Our research clearly shows that alcohol frequent attenders are an extremely complex group with specific treatment and care needs.

“Alcohol frequent attenders have a high alcohol-related mortality. Consequently, appropriately targeted interventions for this vulnerable group are vital, and would be lifesaving.

“The Scottish Government must ensure that alcohol treatment services and mental health services work together effectively to guarantee that there truly is a ‘no wrong door’ policy and individuals do not continue to fall between the cracks.”