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Last Updated: Tuesday, 28 September, 2004, 02:58 GMT 03:58 UK
A&E urged to tackle booze culture
A&E department
One third of people admitted to A&E have been drinking
Accident and emergency units should employ counsellors to cut the number of patients admitted after drinking, a study says.

One in three of the 14m A&E admissions each year is linked to patients drinking alcohol.

The study focused on 599 A&E patients at St Mary's Hospital, London, who had been drinking excessively.

Patients referred for counselling began drinking much less and were readmitted to A&E less often, the study found.

After a year, the patients who had been referred to health workers on their initial visit drank 14 units less per week - equal to seven pints - than those who were not.

They were also admitted to A&E fewer times in the year - an average of 1.2 times compared to 1.7 times in the group who were not counselled.

This would be equivalent to a fall of 1.4m admissions if applied to all patients who had been drinking.

In total, 287 patients were referred to counselling and received a leaflet, which gave contact details for alcohol support groups and helplines.

Another 312 patients received only the leaflets during the study featured in The Lancet medical journal.


Health workers are generally employed by mental health trusts in the UK and tend to work in primary care rather than in hospitals.

But the researchers, from Imperial College London, St Mary's Hospital NHS Trust, St George's Hospital Medical School, King's College London and Central and North West London Mental Health Trust, said they believed there could be huge benefits if A&E departments started intervening.

There is real scope here for A&E departments
Dr Mike Crawford, of Imperial College London

Professor John Henry, co-author of the report and a member of the British Association for Accident and Emergency Medicine's research committee, said: "A&E is largely funded to patch people up and send them out but it also has a wider remit.

"If you can get people to change their drinking habits by spotting them at an early stage it will make a huge difference.

"Drinking is a habit that is built up over a long period of time. Once it is more established it is harder to change but A&E departments could tackle it at an early stage."

But Prof Henry, who is also the professor of A&E at St Mary's Hospital, conceded A&E departments would need more funding to offer such counselling.

His hospital employs an alcohol health worker for three mornings a week but is one of only a handful in the country to do so.


Dr Mike Crawford, from Imperial College London, who also helped to compile the report, said: "There is real scope here for A&E departments.

"We are not talking about people here who are alcohol dependent but people who have a problem with alcohol.

"A huge proportion of A&E admissions happen after drinking so it would also save a great deal of money."

While a third of A&E admissions are people who have been drinking, the figure rises to two thirds after midnight.

Alcohol misuse costs the British economy 20bn a year, according to government statistics.

Alcohol Concern said using counselling was a well-known method of combating alcohol abuse.

A spokeswoman said: "We welcome such intervention at all levels of health care.

"We are not sure about the long-term effects of this brief intervention but there is strong evidence it works in the short term."

Public backs alcohol crackdown
08 Sep 04  |  Health

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