Sheffield Alcohol Needs Assessment - 2014 Sheffield Drug and Alcohol Co-ordination Team LOUISE POTTER, DACT FINAL Title Sheffield Alcohol Needs Assessment – Full Report Status FINAL Version 1.0 Date created 30/04/2014 Approved by Sheffield DACT Audience Sheffield City Council, South Yorkshire Police FOI category No restrictions Author Louise Potter, DACT Information & Performance Analyst Owner Sheffield DACT Amendment history Review date A summary of new data will be completed one year post publication Comments Consultation undertaken prior to publication. LOUISE POTTER, DACT FINAL 1 Table of Contents Report Summary ........................................................................................................................................................... 3 Gaps Identified............................................................................................................................................................... 5 Report Introduction ....................................................................................................................................................... 8 Chapter 1 – Alcohol Use/ Misuse and its link to National and Local Strategies ................................................... 12 Chapter 2 - The Estimated Prevalence of Alcohol Misuse in Sheffield by alcohol category .............................. 16 The Estimated Prevalence of Alcohol Misuse in Sheffield ..................................................................................... 16 Estimated number of people who require alcohol treatment per annum in Sheffield ............................................ 19 Chapter 3 - Commissioning the alcohol treatment pathway in Sheffield .............................................................. 22 Chapter 4 - Sheffield Alcohol Treatment activity in 2013/14, compared with 2011/12 and 2012/13 .................... 24 Pharmacological treatment ........................................................................................................................................ 28 Psychosocial Interventions (PSI) ............................................................................................................................... 30 Extended Brief Interventions (EBI) ............................................................................................................................ 33 Inpatient Detoxification .............................................................................................................................................. 34 Residential rehabilitation ............................................................................................................................................ 34 Treatment Outcomes – .............................................................................................................................................. 35 Mutual Aid (MA) ......................................................................................................................................................... 36 Chapter 5 - Treatment performance (NATMS) and information on the treatment cohort .................................... 39 Chapter 6 - Alcohol identification/ screening and brief advice (IBA) ..................................................................... 43 Chapter 7 - Health Problems due to Alcohol Misuse ............................................................................................... 49 Alcohol Related Hospital Admissions ........................................................................................................................ 49 Mortality/ Alcohol related deaths................................................................................................................................ 52 Hospital initiatives to address the health harms caused by alcohol misuse in Sheffield ........................................... 57 Chapter 8 - Alcohol Related Crime and Anti-Social Behaviour .............................................................................. 62 Criminal Justice routes into alcohol treatment ........................................................................................................... 68 Chapter 9 - The Night time economy, the safe sale of alcohol and a safe drinking environment ...................... 70 Chapter 10 - Alcohol Misuse - Diversity and vulnerabilities .............................................................................. 75 Chapter 11 - Alcohol Misuse – Children and Young People ................................................................................... 78 Chapter 12 - National Changes Ahead / Recent changes / future direction .......................................................... 81 Appendix 1 – LAPE 2014 for Sheffield compared to core cities ............................................................................. 83 Appendix 2 - Alcohol Neighbourhood profiles data, 2011 Published by PHE analyst team ............................... 85 LOUISE POTTER, DACT FINAL 2 Report Summary The Government’s National Alcohol Strategy 2012 acknowledges that the vast majority of people drink sensibility (an estimated 73.5% drink within Department of Health safer limits or abstain) but there is a cohort (estimated 20% increasing risk, 6.5% higher risk and 20.1% binge) who drink at levels higher than DH recommendations. Drinking at such levels can have negative repercussions on an individual’s health, social functioning and offending. Alcohol consumption can also have wider societal impacts on anti-social behaviour, health system costs and capacity, criminal justice system cost and capacity, children and adult social care and other public sector services.1 Local data suggests that Sheffield is similar to the national picture, with an estimated 71.4% drinking within national NHS guidelines or abstinent. However an estimated 28.6% of Sheffield’s adult population (17.7% increasing risk, 10.9% higher risk and 26.9% binge) drink at levels greater than the DH recommendations. In Sheffield there is an established night-time economy promoting a safe and enjoyable city centre culture. This is a product of partnership working with South Yorkshire Police, Sheffield City Council licensing and trading standards, health services, and Sheffield DACT. Sheffield’s Purple Flag status (2011 and re-assessed and awarded in 2014) is a symbol of such positive work. However, the effects of binge drinking are still apparent: fixed penalty notice waivers continue to be issued in response to minor alcohol specific offences; and audits completed in A&E still find a significant proportion of their caseload at weekends are for alcohol related injuries. One of the methods of identifying the extent of the negative effects of alcohol in Sheffield is to benchmark against the national average and a number of core cities. Local Alcohol Profile for England (www.lape.org.uk) data demonstrates that Sheffield performs well compared to other ‘core cities’ being in the top three cities for health and crime indicators. Local Alcohol Profiles for England (2014) data shows there are three indicators where Sheffield fares significantly better than national average; alcohol related admissions to hospital (Broad) which is where the primary or secondary reason for admission was alcohol attributable; the percentage of Sheffield employees working in bars; and alcohol specific admissions to hospital for under 18s. Sheffield has three red indicators (significantly worse than England average) which are Alcohol specific mortality –males; admission episodes for alcohol related conditions (narrow); and binge drinking synthetic estimates. The remaining 21 indicators are found ‘not significantly different to the England average. Despite better than average performance on many of the LAPE measures, Sheffield should not be complacent. Trend data shows that the rate of alcohol related admissions (both broad and narrow) has increased between 2008/09 and 2012/13. CCG activity data shows that there were over 2,200 admissions for alcohol specific conditions in 2013/14, equating to just under 2,000 individuals. This is an average of 1.58 admissions per patient per year. There are an increasing number of individuals accessing health services, increasing costs to the health economy. There is a significant need for high impact change to reduce the increasing alcohol admissions trends observed. Whilst focusing on hospital admissions there is also a significant need for prevention and early intervention. Over the last few years one of the key initiatives has been to increase the use of alcohol screening tools which identify those at risk and provide brief advice (IBA). Such tools can be used with targeted populations or - more controversially - for universal screening. In Sheffield over a 2 year period, more than 2,000 individuals have been screened for increasing risk alcohol use through a new locally designed electronic screening tool based on AUDIT PC2. 76 GP surgeries are signed up to an alcohol screening DES in 2014/15 covering 88% of the Sheffield patient population, the highest since its introduction. In addition all those who receive an NHS health check in 2014/15 will be asked alcohol screening questions. Although increased identification and brief advice is efficacious in its own right3, there is a local emphasis on ensuring onward referral for those drinking at increasing risk e.g. scoring 15+ on AUDIT. Specialist treatment should be offered to all those drinking