Send email for updates

Effectiveness bank home page. Opens new windowAnalysis

This entry is our analysis of a document considered particularly relevant to improving outcomes from drug or alcohol interventions in the UK. The original document was not published by Findings; click Title to order a copy. The summary conveys the findings and views expressed in the document. Below is a commentary from Drug and Alcohol Findings.

Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text
Copy title and link | Comment/query |

Services for the identification and treatment of hazardous drinking, harmful drinking and alcohol dependence in children, young people and adults: Commissioning guide.

National Institute for Health and Care Excellence.
National Institute for Health and Care Excellence, 2011.

From the UK health service standard-setting agency, guidance for commissioners on how to organise and procure alcohol treatment and brief intervention services in an area which implement related national clinical guidance and satisfy policy requirements.

Summary This guidance from the UK National Institute for Health and Care Excellence (NICE) aims to support commissioners in England to in their attempts to provide services for the identification and care of hazardous, harmful and dependent drinkers which implement other relevant NICE guidance on alcohol, and to commission high quality services that meet the quality standard on alcohol dependence and harmful alcohol use. Essentially it extracts the messages for commissioners from related NICE and other official guidance and distils these in to a single document to guide the organisation and procurement of treatment and brief intervention services in an area which embody those messages. In doing so it offers reasons for organisations responsible for spending health service resources to devote these to services for drinkers.

The guide highlights the benefits of commissioning for outcomes – principally reducing consumption, alcohol-related hospital admissions and alcohol-related mortality by improving access to evidence-based interventions that promote recovery.

It is estimated that only a small proportion of the £2.7 billion annual expenditure on alcohol-related harm is spent on identifying and treating alcohol misuse. NICE guidance advocates an invest-to-save approach by prioritising the prevention of alcohol-use disorders. This commissioning guide sets out a whole system approach to commissioning integrated alcohol services across the whole spectrum of care, from preventing harmful drinking through opportunistic screening and brief interventions, to specialist treatment programmes for children, young people and adults, and their families or carers.

The guide describes the following service components required to deliver a high quality service:
• opportunistic screening and brief interventions for adults who are hazardous and harmful drinkers;
• diagnosis, assessment and management of harmful drinking and alcohol dependence in adults, in specialist services;
• services for children and young people who are vulnerable to alcohol-related harm;
• whole system commissioning of high quality alcohol services.

Each section offers examples of service models, including case studies and ideas for using Quality, Innovation, Productivity and Prevention (QIPP) and Commissioning for Quality and Innovation (CQUIN) to drive improvements to alcohol services. There is also an outline service specification to assist commissioners when tendering or contract managing alcohol services.

The benchmark section contains further information to help commissioners to assess levels of alcohol dependence and hazardous and harmful drinking in their population. A population benchmark has been provided for the number of people in England aged 16 or above who are hazardous, harmful or dependent drinkers.

The guide contains a commissioning and benchmarking tool that can be used to calculate the costs of increasing access to opportunistic screening and brief interventions and to specialist alcohol treatment for adults. Providing evidence-based packages of care using the stepped-care model may reduce the unit cost of treatment per person by offering the least intensive, most cost effective intervention that is appropriate. Whole system commissioning may generate savings by reducing alcohol-related harm and alcohol-attributable hospital admissions

Findings logo commentary Other related NICE guidance documents are listed below.

Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence Assessment of what evaluation research means for alcohol dependence treatment in Britain, featuring reviews of the literature on the topics it covers.

Alcohol-use disorders: preventing the development of hazardous and harmful drinking Prevention guidelines which prioritised population-wide changes like price rises and outlet restrictions which affect everyone, independent of the choices they make.

Alcohol use disorders: diagnosis and clinical management of alcohol-related physical complications Clinical guidelines on the medical care of people suffering acute alcohol withdrawal or alcohol-related lack of thiamine, liver disease, or inflammation of the pancreas.

Alcohol dependence and harmful alcohol use quality standard Concise statement of 13 practices which constitute high quality health care for problem drinkers and good practice in identifying and advising hazardous drinkers. The standards may be used to assess and reward providers and health service commissioning authorities.

Last revised 03 March 2012. First uploaded

Give us your feedback on the site (two-minute survey)
Open Effectiveness Bank home page
Add your name to the mailing list to be alerted to new studies and other site updates

Top 10 most closely related documents on this site. For more try a subject or free text search

DOCUMENT 2011 Alcohol dependence and harmful alcohol use quality standard

REVIEW 2010 Alcohol-use disorders: Preventing the development of hazardous and harmful drinking

STUDY 2008 Reducing alcohol harm: health services in England for alcohol misuse

STUDY 2011 Reducing the impact of alcohol-related harm to Londoners – how well are we doing?

STUDY 2011 An evaluation to assess the implementation of NHS delivered alcohol brief interventions: final report

STUDY 2011 Supporting partnerships to reduce alcohol harm: key findings, recommendations and case studies from the Alcohol Harm Reduction National Support Team

STUDY 2012 Alcohol screening and brief intervention in primary health care

STUDY 2012 Alcohol screening and brief intervention in emergency departments

STUDY 2013 Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial

DOCUMENT 2017 Drug misuse and dependence: UK guidelines on clinical management