NHS North Yorkshire NHS North Yorkshire and Yorkand York

Safer and Sensible Drinking and Promoting Health and Wellbeing

George Lee: Senior Commissioning Manager

Aims of this Aims of this PresentationPresentation

Offer an NHS perspective on the risks of over drinking, or the misuse of alcohol

Highlight some of the general impacts on health and local issues for Harrogate and District.

Aspirations for the future, what

Alcohol and The NHS Alcohol and The NHS PerspectivePerspective

Recognition that the greater the level of exposure to alcohol over a life time, the greater the risks of ill health and associated personal and societal harms

Alcohol related hospital admissions are increasing

The costs of providing treatment are increasing, and are not sustainable

How big is the issue?How big is the issue?

153,000 drinking above low risk

29,300 drinking at harmful levels

16,200 dependent

drinkers

Hospital AdmissionsHospital AdmissionsAcute Chronic

Accidental poisoning by and exposure to alcohol

Alcoholic gastritis/ myopathy/polyneuropathy

Toxic effects of alcohol Alcoholic cardiomyopathy

Intentional self-harm/Event of undetermined intent

Alcohol-induced pseudo-Cushing's syndrome

Drowning/Fall injuries Degeneration of nervous system due to alcohol

Firearm injuries Alcoholic liver disease and Liver cirrhosis

Inhalation of gastric contents/Inhalation and ingestion of food causing obstruction of the respiratory tract

Gastro-oesophageal laceration-haemorrhage syndrome/ Oesophageal varices

work/machine injuries Acute and chronic pancreatitis

Air/space/road/water transport accidents (driver/rider/passenger)

Malignant neoplasm of lip/ oral cavity/ pharynx/oesophagus

Accidental excessive cold Epilepsy and Status epilepticus

Assault Cardiac arrhythmias

Spontaneous abortion Hypertensive Disease

Attributable FractionsAttributable Fractions mainly chronic degenerative conditions in which alcohol is associated with

a relatively modest increase in risk, such that overall less than 20% of cases are estimated to be attributable to alcohol

• Malignant neoplasm of breast

•Malignant neoplasm of colon

•Malignant neoplasm of liver and intrahepatic bile ducts

•Malignant neoplasm of rectum

•Heart failure

•Haemorrhagic stroke

Local Issues Local Issues

Alcohol Hospital Specific Admissions under 18s

Alcohol Hospital Specific Admissions females

Hazardous drinking (synthetic estimate)

Binge drinking (synthetic estimate)

NHS PrioritiesNHS Priorities

Work with partners to promote safer drinking

Extend treatment provision for Tiers 1,2 and 3

Identification and brief advice in primary care

A and E workers

Health liaison worker in hospitals

Stepped Care PathwayStepped Care Pathway