Description of needs | Ways in which services can respond |
2.1 Identifying alcohol problems Members of primary health care teams, including GPs, local authority social work and housing services teams, staff in maternity services, general dental practitioners, and staff in relevant voluntary sector services should: acknowledge that their remit extends to some aspects of their clients' alcohol problems; identify actual or potential alcohol problems; know about services available to help; and
provide relevant interventions themselves within the scope of their own skills. | Ensuring staff have information on alcohol problem screening and assessment, and on care management. Case finding: use of screening in high risk groups (by virtue of previous history, associated illnesses) by Occupational Health Nurse or Adviser, using appropriate screening tools such as the Alcohol Use Disorders Identification Test (AUDIT). Provision of brief interventions by a range of healthcare and social work staff, with other professional support for staff delivering such interventions if needed.
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2.2 Single-shared assessment There should be a single-shared assessment process and tool applicable to people with alcohol problems, drawn up in collaboration with all the relevant agencies. The assessment should identify the person's needs and how to meet them. | Agreed Single Shared Assessment (SSA) process. SSA uses a lead professional, appropriate specialist inputs, seeks information only once and gives a holistic result acceptable to all agencies to provide a faster gateway to services. SSA needs to be linked to delegated resources within the joint resourcing framework. The roles of all the agencies that may be involved in assessment need to be clear, including the voluntary sector, either as the lead assessor if so delegated, or contributing as a provider. There should be agreed protocols for sharing information and protecting confidentiality.
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2.3 Care management and local integrated care pathways An integrated spectrum of services, with clear criteria for eligibility, should be provided including treatment, access to crisis care, relapse prevention, rehabilitation, accommodation, education, training and employment. Individuals should have access to services that meet their identified needs, regardless of the point at which they are on the care pathway. In some cases, individuals will refer themselves to services. Response times for people seeking services should be carefully managed. | Brief interventions by a range of professional staff. Medical services, including community and home detoxification. Mutual support groups such as AA. Psychosocial/psychological interventions, including counselling, such as provided by Local Councils on Alcohol. Access to occupational therapy, physiotherapy, dietetics services. Community-based rehabilitation, including day programmes. Access to specialist and mainstream education, training and employment opportunities. Local agreement about how all the agencies involved should work together, including respective roles, criteria for onward referral, standards of care, leading to joint treatment and management of cases.
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2.4 Support for groups who have difficulties accessing mainstream services Such groups require to be identified locally. They may include: young people; vulnerable groups of young people e.g. looked after children, those excluded from school or truanting, offenders, homeless young people, young carers; women, who are experiencing or have experienced domestic abuse; people in remote and rural areas: disabled people; minority ethnic groups; people with a learning disability; people at risk of problematic use of alcohol to alleviate depression, anxiety or other mental health problems: homeless people and those at risk of homelessness; older people; and Lesbian, Gay, Bisexual and Transgender groups.
| Mainstream services to be sensitive to the needs of these groups, where specialist services for them are not appropriate or feasible. Agreements between agencies and local specialist liaison worker about referral to effective groups (either staffed or offering mutual help such as AA). Services should encourage access e.g. through providing child care, confidentiality, premises accessible for people with disabilities or other special needs. Women's health (including sexual health and family planning) and maternity services to identify and address alcohol problems. Appropriate links to support groups such as AlAteen. Treatment and support services for young people that link into prevention, education and diversion in schools and in the community. Through the Supporting People initiative to provide practical support and counselling to enable people with alcohol problems to remain in their own homes in the community.
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It's happening already: Libra offers one-to-one counselling and support groups for women affected by alcohol problems in the Lothian area. Contact: Jane Aldous, Libra | Support for homeless people to tackle alcohol problems as part of addressing more general problems with health, accommodation, and access to other services. Includes streetwork, detoxification, supported accommodation (both wet and dry), and continuity of support alongside the provision of accommodation. Support can be provided in specialist accommodation, or to someone in mainstream accommodation who is at risk of becoming homeless.
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