The Alcohol Liaison Service
The focus of the service is to:
- assess any patient admitted through A&E or in the hospital who have alcohol dependence / problematic drinking or substance misuse (crack/heroin/methadone use) within 24 hours.
- provide advice and information for patients to access services in the community for alcohol dependency/problematic drinking and drug use.
- provide brief interventions to increase insight and awareness of alcohol/drugs and their effect on lifestyle.
- provide information/advice and education on alcohol treatment for staff at both sites to increase awareness of alcohol/drugs and their impact on the demands for hospital services.
- monitor and provide advice on the management of any patient on both sites undertaking an oxazepam alcohol detoxification regime in the hospital setting.
- plan and signpost patients into community services on discharge from hospital.
- We will also assess/plan care for any prescribed or illicit benzodiazepine or Z-drug dependent patients admitted to the Royal Free sites.
With alcohol screening being promoted within the hospital in general the information below is useful to know.
Types of common patterns for Alcohol use
Drinking risk categories: the categories of alcohol consumption/pattern are now focused upon:
Low risk drinking: ‘low risk’ is not regularly exceeding 14 units per week, spread evenly over the week. This level of consumption represents a low risk of long term or short-term health harm for a healthy adult.
Increasing risk drinking (brief interventions and information and advice should be given to patient in this cohort)
Increasing risk means drinking in a way that raises the risk of ill health from drinking alcohol. For both men and women, this means regularly drinking more than the low risk guideline of 14 units per week and up to 35 units for women and 50 units for men.
Higher risk drinking (Treatment and engagement with alcohol services should be encouraged)
Higher risk drinking for women is regularly drinking more than 35 units per week and for men regularly drinking more than 50 units per week. People in this group are likely to already be experiencing health damage from their alcohol use, even if it is not yet evident. This will include pancreatitis or jaundice, for example.
Binge drinking (Treatment and engagement with alcohol services should be sought).
Binge drinking really means drinking enough on a single occasion to get drunk (The technical definition of binge drinking is drinking 6+ units (women) or 8+ units (men) in a single session). Drunkenness can lead to risky behaviour and an increased risk of injury.
Alcohol dependent drinking: (Treatment and engagement with alcohol services must be encouraged)
Alcohol dependence is a disorder of regulation of alcohol use arising from repeated or continuous use of alcohol and often resembles a daily pattern with more than 8-10 units of alcohol consumed daily.
Assessment
The Alcohol liaison service will see all types of patients who suffer from problems with alcohol and prescribed or illicit drug use.
If in doubt we are happy to discuss possible referrals to the service. Please use the contact details below to make or discuss a referral.
The preferred and easiest way to refer patients to the service is to refer through the EPR system with the alcohol liaison referral form or contact us on the details below.
Working Hours
Services are offered between Monday to Friday 8-6 pm at the Royal Free Site and 9-5 pm at the Barnet site.
Outside these hours there will be a mobile advice line in the future. However, in the interim please email Jeff Fernandez, Lead Nurse for Alcohol/drug liaison.
Contact details
Jeff Fernandez: Lead Nurse for Alcohol/drug liaison
Royal Free Hospital /Barnet General
Email: jfernandez@nhs.net
Tel: 0207 794 05000
Ext: 34003
And
Kevin Raeburn (based at Royal free hospital)
Royal Free Hospital/Barnet General
Email: k.reaburn@nhs.net
Telephone number: 0207 794 0500 ext: 36764
For the Barnet Sites
Contact Jeff Fernandez Lead Nurse for Alcohol/drug Liaison Service
All queries that are about patients Jeff Fernandez should be contact for specialist advice in the first instance.
email: jfernandez@nhs.net
and
Caroline Keeney
Alcohol/drug Liaison worker for Barnet Hospital
caroline.keeney1@nhs.net
Alcohol Treatments:
Most patients admitted to hospital who have a dependent or problematic pattern of alcohol use will be started on an alcohol detoxification programme using oxazepam. This drug is used as it is a better medication than chlordiazepoxide in patients with decompensated liver disease, as it places less stress on the liver.
The oxazepam guideline and further information and guidance can be obtained from the Hospital Liaison drug and alcohol team. The team can advise the ward staff on how to tailor the detoxification and make it more manageable for the patient.
The service will offer brief assessment and information gathering for the patient and outline the alcohol treatment available whilst the patient is in hospital.
- Advice on the oxazepam detoxification: This can be given to make the detoxification process more manageable for the patient and the ward staff.
- Sign-posting: This is the process where a patient is referred on discharge to local alcohol services for further treatment or referred on to their GP for expert advice.
- Offered an out-patients appointment: The service will operate an out-patients clinic where on-going prescribing can be initiated, and patients monitored for their compliance. The long-term prescribing can then be transferred to the GP.
- Sites where we are visible for opportunistic admissions such as A+E will have regular presence of the alcohol liaison nurse/worker to ensure maximum coverage.
The service will provide on-going education for staff at the Royal Free Hospital and Barnet sites.