Why is it a priority?

Liver disease is the only cause of death that is increasing in England. Harmful drinking (over 14 units per week) increases the risk of liver cirrhosis threefold, and also increases the risk of hypertension. Hazardous drinkers (more than 50 units for men, and 35 for women per week) are seven times more likely to develop liver cirrhosis and also double their risk of hypertension.

Heavy episodic drinking (binge drinking) is more strongly associated than sustained drinking with hypertension and CVD, with binge drinkers having double the risk of death over a 20 year period than moderate regular drinkers. Greenwich has third worst mortality rates from liver disease among people age under 75 in London.

all cause mortality

What could make a difference at a local level?

  • Screening and brief interventions (SBIs) are effective in reducing alcohol consumption in harmful and hazardous drinkers, on average reducing consumption by 5 units per week
  • Within secondary care, there is good evidence that “alcohol liaison services” can reduce A&E attendance by 50% of those harmful and hazardous drinkers engaged
  • PHE recommends that every district general hospital should have an alcohol care team to provide SBIs, and more extensive interventions, including care planning, medically assisted detox and discharge to community support services

What are the opportunities for improvement in Greenwich?

  • The evidence is very strong for scaling up SBIs within both primary care and secondary care, and developing clear pathways into behaviour change support and treatment for harmful, hazardous and dependent drinkers
  • Strengthening the Alcohol Liaison Service at Queen Elizabeth Hospital as part of a wider Our Healthier South East London approach would be cost effective in reducing harmful and hazardous drinking and reducing demand on A&E and hospital beds from alcohol related illness
  • Ensuring that awareness of the long term health impacts of binge drinking informs our local prevention approach and SBIs scaling up

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