Best practice with treatment resistant drinkers

The core component of the model is an individualised care plan with team members (four nurses and an administrator who also does recovery work) delivering or co-ordinating whatever a service user needs. The account of the team's work says there is no typical service but lists a range of working methods as described by a number of interviewees:

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The Nottinghamshire Alcohol-related long term condition team

Following their recent publication and resource pack on how to help long term “treatment resistant” drinkers to change, Alcohol Concern has just published a best practice example of this “blue light” initiative.

The Nottinghamshire Alcohol-related long term condition team is an assertive case management service which works with people who have a long-term physical health condition linked to their alcohol misuse and who are at high risk of readmission to hospital.

This group place a significant burden on health services, costing each local authority area an average of £12.5 million per year.

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The approach

The core component of the model is an individualisednottinghamshire resistant drinkers front cover care plan with team members (four nurses and an administrator who also does recovery work) delivering or co-ordinating whatever a service user needs. The account of the team’s work says there is no typical service but lists a range of working methods as described by a number of interviewees:

  • They pick up a referral and then they coordinate the care with other agencies and bring other services in. They go out to patients and really get to know them.
  • You name it they do it. Arranging multi-disciplinary team meetings, helping people attend appointments, securing emergency housing, liaising with councils, general health checks and making sure they take their medication.
  • They advocate for the patients, attend appointments with them, see patients in their homes. They offer outstanding nursing care.
  • Patients have a very good relationship with the team. The team anchor them through the different services they need to access.
  • They take care of everything: getting them into alcohol services and managing them medically, getting medication sorted, getting people registered with a GP, looking into housing services.
  • They have fairly regular contact with the clients from the medical side, they come with them to appointments to make sure they get there.
  • Normally they work one to one, seeing people in their home, or some of the really complex ones they will meet with them wherever they want to meet.
  • They see them at home, taking them to the doctor to get ascites drains and having their gastro reviews, they give good clinical care and support them in reducing isolation.

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Key findings

In addition to describing the approach of the Nottingham team and presenting a number of case studies, the report undertakes a short cost benefit analysis which found that this five person team saved £360,000 in health care costs alone in one year.

The report concludes with its reiteration of the six key characteristics of an effective approach to working with individuals who are treatment resistant and have long term alcohol-related conditions:

  1. Assertive,
  2. Focused on building a relationship,
  3. Flexible,
  4. Holistic,
  5. Persistent, and
  6. Consistent.

If you have experience of working with the client group and/or have used the resources from the Blue Light project, please share your experiences via the comments section below.

 

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