Exploring the management of alcohol problems in Deep End general practices in Scotland

Alcohol consumption and related harm are key public health issues in Scotland. In 2016/17, over 24,000 people were admitted to a general acute hospital with an alcohol related diagnosis in. In this same period, rates of alcohol-specific death rates and hospital stays were more than eight times higher in the most deprived areas than in the least deprived area of Scotland. In 2015/16, 18% of adults in Scotland reported problem drinking, as measured by a score of eight or more on the Alcohol Use Disorders Identification Test (AUDIT).

There are a range of specialist alcohol treatment services in Scotland covering a wide range of interventions depending on the level of need of the individual. Primary care is one setting which is thought to be well-placed to deliver interventions to help people with alcohol problems, due to having a large population coverage, continuity of care, and long-term relations and trust with their patients. However, there are challenges in managing alcohol problems within primary care in part to resource constraints. Having a specialist alcohol worker located in general practices is one model which has been explored to help address some of these challenges. The ‘Attached Alcohol Nurse’ role was piloted in six GP practices located in deprived areas of Glasgow. Whilst the evaluation of the pilot reported positive outcomes in terms of success in engaging service users, it could not draw any firm conclusions given the small size of the study and its focus measuring activity and outcomes using existing data from services. This study seeks to address some of the gaps in the evidence base by exploring the experiences and perspectives of a range of stakeholders (including commissioners, service providers and service users) about the treatment of alcohol.