binge drinking: the effect on the nhs

Lynn Hilton, (2011).

BINGE DRINKING: THE EFFECT ON THE NHS

ASHLEY LUCAS

http://www.guardian.co.uk/society/gallery/2011/dec/11/?picture=383119703


Ashley Lucas

Page 1

Introduction

The National Health Service’s official definition of binge drinking is: “drinking heavily in a short

space of time to get drunk or feel the effects of alcohol”. Drink Aware. (2012).

The effects of binge drinking can be categorized into four different categories:

1. Harm to the health of the consumer,

2. Crime,

3. Loss of productivity,

4. Social harms, including problems with families.

This research project is specifically focused on the effect binge drinking is having on the

National Health Service, which enters into a number of the four categories above. For example,

in addition to the costs of treating a driver who may have been injured in a drink driving

accident, the National Health Service also pays for the cost of treating any victims of the road

traffic collision. Employers can also be burdened by the effects of binge drinking. It is reasonable

to assume that they will have certain employees who are likely to phone in sick due to

hangovers or other alcohol related illnesses or injuries.

A nationwide study by Eurobarometer shows 12% of the British population had admitted to

binge drinking in a single session. This equates to approximately 7.2 million people, based on a

population of sixty-million. Daily Mail, 2010.

According to the Department of Health and their ‘Statistics on Alcohol: 2011’ report; the

National Health Service is spending around £2.7bn per year treating alcohol related injury and

illness. This works out to be approximately 2.5% of the whole of the NHS budget. This figure can

be broken down to show that around £167.6m is spent treating illnesses directly attributable to

alcohol misuse, £1.022bn spent treating illnesses partially attributable to alcohol misuse,

£372.4m on the Ambulance Services and £645.7m on A&E visits. The table below shows the

breakdown of costs over a twelve month period. Department of Health, 2011.

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If the current Government is to go ahead with their plans to cut the NHS budget, the National

Health Service will soon be constrained by financial demands it simply cannot meet. As well as

causing extreme physical and psychological damage to those who drink to excess, alcohol abuse

is putting undue pressure on already overstretched frontline healthcare professionals.

Within the same Department of Health report, it shows that in the 2009/10 period there were

around 1,057,000 admissions to hospitals nationwide which were related to alcohol

consumption out of all hospital admissions which totals around 16,806,196. HES Online. (2010).This

was a staggering 12% increase in the 2008/09 period. Around 63% - or 665,910 - of these

admissions were male and the remaining 37% - or 391,090 - female. This equates to 1,743

alcohol related admissions for every 100,000 people in England.

According to the BBC, a report was published in September 2003 by the Prime Minister’s

Strategy Unit about Britain’s binge drinking culture. It shows that 17 million working days are

lost to hangovers and drink related illness each year and this was estimated to be costing

employers £6.4bn, and the cost to the NHS was making up £1.7bn of this estimated amount. BBC

News. (2003). So, on top of the £2.7bn the NHS spends on treating patients whose injuries or

illnesses are alcohol related, the NHS loses a further £1.7bn on lost working days taking the total

from £2.7bn to £4.4bn - money which could be spent in other areas.

Although there are no specific statistics on assaults on NHS staff as a direct result of alcohol

consumption, NHS staff believe a major contributor to the 57,830 assaults which took place in

2010-11 was due to alcohol. NHS Security Management Service, 2004. In 2007/08 it was estimated that

physical violence was costing the NHS around £60.5m in anti-violence policing, staff quitting the

service, conflict resolution training, litigation and damages and physical assault incidents. NHS

Security Management Service. (2008). See the table below for a breakdown of the costs.

If you include this £60.5m with the £4.4bn the NHS loses in treating alcohol related illness and

injury and staff sick days, the total cost to the NHS is approximately £5bn.

Patients suffering with alcohol related diseases and injuries as a result of binge drinking, are

also taking NHS resources away from patients who are suffering from diseases and injuries

which are not self-inflicted. For example, 1 in 8 NHS bed days are being used for patients with

alcohol related illness and/or injury, which is approximately 2,000,000, and 1 in 8 NHS day

cases, which is estimated to be around 40,000. Institute of Alcohol Studies, 2009.


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The National Health Service has been told by the Government that they need to save £20bn by

2015. This means the NHS need to start looking into ways in which they are able to reduce the

massive impact binge drinking is having on our National Health Service.

Some initiatives have already been introduced; London Ambulance Service Paramedic Brian

Hayes came up with the idea of the ‘Booze Bus’; a specially adapted minibus that can carry up to

five patients at a time. It is an alternative mode of transport which was set up to meet the

demands of alcohol related calls. The Booze Bus has proved vital in easing demand on the

London Ambulance Service at the busiest times of the week. By treating patients on the Booze

Bus, the Ambulance Service has reduced the number of journeys frontline ambulances need to

make and free them up to go to people with serious illness or injury. The vehicle, crewed by

three Ambulance staff, just one more than a conventional ambulance, can attend people who are

under the influence of alcohol and convey his group of patients to hospital in one trip, whereas

normally one frontline ambulance would be assigned to each patient. London Ambulance Service. (2009).

The first Booze Bus was piloted by London Ambulance Service in central London between

December 2005 and June 2006. Over the 27 weeks, the Booze Bus saved 880 hours of

ambulance time (the equivalent of 2-4 ambulances per shift). It also saved £246,000 (based on

unit costs of healthcare) within those 27 weeks. This amounts to saving approximately 1760

hours and £492,000 of savings a year, just for the London Ambulance Service alone. Camden Council.

(2008).

If every NHS Ambulance Trust introduced one Booze Bus, the NHS could potentially save around

£5.5m. Most Ambulance Services could possibly warrant the use of more than one Booze Bus.

For example, London Ambulance Service receives most of its alcohol related emergency call

outs to Camden Town, Holborn and Covent Garden. Having a Booze Bus in each of these three

locations could save London Ambulance Service an estimated £1.5m per year.

Leading Healthcare Professionals from the British Society of Gastroenterology, which

represents 2,700 doctors specialising in alcohol problems, are calling for every NHS hospital

accident and emergency department to complete a twenty second questionnaire, known as the

Paddington Alcohol Test first published in 1996, with any patient whose condition is likely to be

drink related.

If the Paddington Alcohol Test flags up a potential case, the doctor can then refer the patient to

an alcohol specialist nurse who can advise them on how they can cut down on their drinking.

The NHS would need to spend money to introduce the testing, but it is estimated they would

save hundreds of millions of pounds a year through fewer patients with drink problems that

would need to be treated in hospital. Campbell, D. (2010).

A more drastic approach to tacking this ever-growing problem could result in payments from

anybody who is admitted to hospital through self-inflicted illness or injury - which would

include alcohol related illness and injury. Although this may be seen as unethical as the National

Health Service has pride itself on providing free health care. There are also concerns as to what

would you class as self-inflicted? Would driving your car too fast and crashing be classed as self-

inflicted? A poll of more than 2000 people by health provider Bupa found 34% of people

supported charges for people who smoke, drink or are obese. BBC. (2005).


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Methodology

As part of this research project, primary data was obtained in the form of thirty nine question

surveys which were produced and distributed to friends, family, work colleagues and members

of the public. These surveys were returned, completed and the information was collated.

However, before this was carried out, other students on the course were asked to fill in a pilot of

the survey to make sure it was easy to follow and the data which was needed was obtained.

After six pilot surveys were returned, it was found that a couple of the questions needed

changing to make them less ambiguous in order to make the final survey fit for the purpose it

was designed for.

The pilot surveys also enabled the researcher to identify questions classed as sensitive, which

the person answering might have issues about answering, or worse still, not answer at all. With

a subject like this, the survey had to be carefully written in order to prevent implying people

were drinking too much or too often. An example of this was when the question ‘Approximately

how many units did you drink last week?’ was asked, a large gap between the answers was left.

Rather than have answer boxes for 0-5, 6-10, I had 0-9, 10-19 and so on.

Whilst obtaining the results of the surveys, ethical issues surrounding the research activity had

to be taken into consideration. To ensure the confidentiality of the participants of the survey, no

personal details were asked for such as name, address or age and a sheet was attached to the

front of the survey informing the participants that the survey was for educational and research

purposes and that it wasn’t being forwarded to any third party.

Any issues concerning discrimination also had to be taken into consideration. By not asking for

the participant’s sex, race or ethnicity as this information was not related to the research, it was

completely irrelevant in terms of information needed for the purpose of the project.

Whilst writing this research project, it was found that a lot of research needed to complete it

was not readily available on the internet. So, it was decided that the research question should be

changed from ‘Should the U.K. increase its minimum legal drinking age to 21?’ to ‘Binge

Drinking: The Effects on the NHS’. This meant a lot of the questions in the survey were

irrelevant; however the questions that were relevant were made use of and included in this

project.


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Survey Results

From the primary data collected, a total of seven participants out of thirty admitted to drinking

twenty units or more. This level of intake, twenty units, was chosen as the limit for the

recommended national guideline - as the sex of the participant was not included. Exceeding this

limit within the last week has categorised participants as having taken part in binge drinking.

See Graph 1.

Of the thirty participants only one person admitted to requiring treatment from a medical

professional, i.e. a paramedic, doctor etc., as a direct result of alcohol. This one person admitted

to drinking only 0-9 units of alcohol in the previous week. This drinker would not be classified

as a binge drinker in this study.

Graph 2 shows the age in which each participant started drinking alcohol.

17

5 3 3

0 1

02468

1012141618

0-9 10-19 20-29 30-39 40-49 Morethan 50

Units of alcohol

Graph 1: Approximately how many units of alcohol did you drink last week?

Number of People

0

11 10

7

0

2

4

6

8

10

12

10-12 13-15 16-18 19 or older

Graph 2: At what age did you start drinking this amount on average?

Number of People


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Table 1 show the participants view on whether the minimum legal drinking age should be

increased and whether they think the Government and NHS would save money. This has been

categorised by age.

Table 1

Should the legal drinking age be

increased?

Would the Government and NHS save

money if it was increased?

Yes Unsure No Yes Unsure No

18 and under 10 3 8 10 1 10

19 and over 5 1 1 5 0 2

Non-drinker 0 0 1 0 1 0

From Table 1, the majority of participants of the survey who started to drink alcohol at the age

of nineteen and above believe the minimum legal drinking age should be increased, and the

majority believe the Government and NHS would save money.

Participants who started to drink at the age of 18 or under are split as to whether the drinking

age should be increased and are split as to whether they think the Government and NHS would

save money.

This research also shows that 4/30 - or 13% - of the survey participants had been in trouble

with the police as a direct result of alcohol abuse. See Graph 3.

24

4

0

5

10

15

20

25

30

No Yes

Graph 3: Have you ever been in trouble with the police as a direct result of alcohol?

Number of People


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Discussion

A study by Eurobarometer shows 12% of the British population admitted to binge drinking in a

single session. This equates to approximately 7.2 million people, based on a population of 60

million.

This research show 7/30 –or 23% - of the participants took part in binge drinking in the

previous week which doesn’t back up Eurobarometer’s study with a difference of 11%. This

could be due to the age or ethnicity of the participants who took part in this research as most of

the participants were college students who are more likely to undertake binge drinking than

most 30+ year olds. And Eurobarometer’s research included survey responses from many more

people than this research.

According to the Department of Health and their ‘Statistics on Alcohol: 2011’ report; 6.3% of all

hospital admissions are either directly or partly attributable to alcohol consumption.

Within this research project, it shows 1/30 - or 3.3% - of the participants had required

treatment from a medical professional. This shows a difference of 3% from this research to the

Department of Health’s report. This research also shows this one participant was not a binge

drinker.

By analysing data provided by Stockport NHS and Herefordshire NHS, each hospital admission

due to alcohol related illness and injury costs on average, £1,577. This is based on 2106 alcohol

related admissions for Stockport NHS costing approximately £3.5m (NHS Stockport. (2010))and 3600

admissions for Herefordshire NHS costing approximately £5.5m (Herefordshire NHS. (2012)).

Conclusion

The research project was specifically focused on looking at the effect of binge drinking on the

National Health Service and how they can save money in this area.

The cost to the National Health Service:

The NHS is wasting approximately £2.7bn - or 2.5% - of their budget on treating injury

or illness directly attributable or partially attributable to alcohol,

NHS staff taking days off due to alcohol related illness, injury or hangovers is costing the

service approximately £1.7bn,

Patients and patient’s friends or relatives under the influence of alcohol are a major

contributor to around 57,830 assaults on NHS staff a year. Costing around £60.5m,

Alcohol related cases account for 1 in 8 NHS bed days - approximately 2million, and 1 in

8 NHS day cases - around 40,000.

Alcohol is costing the NHS approximately £5bn per year.

The National Health Service can reduce this amount, or recoup some of the money, by:

Introducing ‘Booze Buses’ to cities and towns with high numbers of binge drinkers.

Saving approximately £500,000 per bus.

Introducing the Paddington Alcohol Test which aims to help binge drinkers cut back on

the amount of alcohol they drink. Saving hundreds of millions of pounds per year.


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Fining self-harming patients who are admitted to NHS hospitals.

This research shows only one alcohol related admission and no other costly effects.

This research could be improved next time by producing a survey relevant to the topic, as this

researcher’s survey only had around three relevant questions.

Questions such as ‘Have you ever been admitted to hospital due to an alcohol related illness or

injury?’, and ‘Have you ever taken a day off of work through an alcohol related illness, injury or

a hangover?’ This would have given the researcher more to data to analyse to include within

this research.


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Page 9

References

Lynn Hilton, (2011). a-young-woman-collapsed-j-001.jpg [ONLINE]. Available at:

http://www.guardian.co.uk/society/gallery/2011/dec/11/london-booze-bus-pictures

[Accessed 25 May 12].

Drink Aware. (2012). Binge drinking: the facts. Available:

http://www.drinkaware.co.uk/facts/binge-drinking. Last accessed 18th May 2012.

Daily Mail. 2010. UK is the binge-drink capital of Europe: Statistic shows the failure of 24-hour

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named-binge-drink-capital-Europe.html. [Accessed 25 May 12].

Department of Health, 2011. Statistics on Alcohol: England, 2011. [pdf] London: Department of

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<http://www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/Alcohol_2011/NHSIC_Sta

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binge drinking: the effect on the nhs

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