During Christmas party season the effects of excessive alcohol consumption may cause headaches, and not just for those who overindulge. Our health and public services will also suffer.
As well as the harmful short-term consequences of alcohol we should also be aware of the harmful long term consequences of alcohol to health – such as increased risk of liver disease, stroke, dementia and some cancers.
While we know a bit about the individual costs of these long-term consequences, what about the costs to our health system overall?
The cost of liver disease
Recent figures suggest death rates due to liver disease in the UK have increased by 400 per cent since 1970. It’s a shocking statistic, and one that contrasts with the declining death rates from heart disease, lung disease and other conditions.
People die young from liver disease, with 90 per cent of deaths occurring under the age of 70. Much of this is preventable. The cost of liver disease to the NHS has been estimated at approximately £460 million per year.
Although alcohol is ranked the sixth largest risk factor to the burden of disease in the UK , the data we routinely collect on the alcohol-related burden to our health service is insufficient to fully understand the impact.
In fact, we have just added an indicator to QualityWatch which describes how the national picture of the burden of alcohol is changing over time using the data available, namely, alcohol related deaths, alcohol related hospital admissions and drinking behaviour.
Disappointingly, it seems there has been very little improvement in the extent of alcohol related harm over the last five years. However, there are signs that the percentage of people aged 15-44 who report binge drinking in the last week has decreased.
The burden on our health service
The Five Year Forward View recognises the burden of alcohol to our health service citing that, “there are now over 3,000 alcohol related admissions to A&E each day” and commits the NHS to preventative action. From a public health perspective, this recognition is welcome reading.
The Health and Social Care Information Centre breaks down that headline figure further. Of the total number of alcohol related hospital admissions in 2012/13, 65 per cent were long-term conditions partially attributable to alcohol (e.g. some cancers), six per cent were short-term conditions partially attributable to alcohol (e.g. falls) and 20 per cent for mental and behavioural disorders due to alcohol.
But, while understanding alcohol-related hospital admissions is important, they alone do not tell us the whole story.
Alcohol related A&E attendances may be easy to spot if sat in an A&E department, but they are difficult to identify systematically from A&E data. This is because attendances related to alcohol are not captured by a specific code.
However, it has been estimated that alcohol may account for up to 35 per cent of A&E attendances. Alcohol-related ambulance callouts, GP consultations and outpatient appointments are all areas we know little about but have substantial impact on the ability of services to meet demand.
Capturing local data is key
Having clearer sight of the burden of alcohol to our health service would provide greater awareness of how services are used, help us to understand whether alcohol-related initiatives to ease pressures are working, guide commissioners in designing healthcare services around patient needs and would inform debate for policy makers.
Local areas should use the momentum of the Five Year Forward View and work through their Health and Wellbeing Boards to encourage improved recording of alcohol-related problems in locally accessible data. This means close working with provider organisations and digging deeper to understand the local picture.
Publication of the NICE quality standard on preventing harmful alcohol use in the community will also be a useful resource for local commissioners. We all need to turn the local data we have into information, and use this information for action to help us work smarter in preventing alcohol related harm.
So, enjoy your Christmas parties and the festive season and please be mindful of the short and long-term consequences of alcohol to your health and to our health service. Let’s all play our part in easing this headache for our health services and for ourselves, not just this Christmas, but all year round.
Currie C (2014) 'Festive cheer? Alcohol and the NHS' Nuffield Trust comment, 18 December 2014. https://www.nuffieldtrust.org.uk/news-item/festive-cheer-alcohol-and-the-nhs