How did IBA fare in the new national alcohol strategy?

12 Apr

IBA was not mentioned at all in the Drug Strategy 2010 and the focus was very much on “severe alcohol dependence” (3) and recovery.  So I have been waiting with bated breath to see what the alcohol strategy would bring.  Well IBA definitely fares better in the new alcohol strategy than treatment.  The new alcohol strategy makes some positive comments about the evidence base for IBA, encouraging local areas to implement IBA locally.  Reference is made specifically to learning lessons from SIPS; IBA delivered by Alcohol Liaison Nurses in hospital settings, particularly for pregnant women; and alcohol intervention pathways for offenders.  The most concrete gain for IBA in the UK is the introduction of alcohol into the NHS Health Checks which will extend primary care provision beyond new registrations.  The planned social marketing activity focused on young people will also improve prevention work nationally.

Two concerns (I’m sure there are more …):

  • Terminology: Cameron’s foreword reads like a modernised Hogarthian vision of a “Broken Britain” and the language throughout is not much better.  Why are we still talking about the “drunks” “drunken” “the drunks” in punitive terms?  Where is the language of Lower, Increasing and Higher Risk?  One of the major barriers to people accessing support for alcohol is terminology and stigma: how productive is Cameron’s language?
  • NHS Health Checks: Will local areas invest in IBA training for NHS Health Check practices AND clear local pathways into support?  As we know screening, Brief Advice and the pathways from alcohol Direct Enhanced Service (DES) screening are poor or patchy, we need to act now to ensure that this major improvement isn’t scuppered by poor delivery.

So that’s my first ever blog post done!   Hope it makes sense!

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2 Responses to “How did IBA fare in the new national alcohol strategy?”

  1. James Morris April 16, 2012 at 5:07 pm #

    Yep, the foreword’s language is not in that sense. The foreword and arguabley overall weight of the strategy still seems to play politics in the sense that the issue is far more point-scoring to address as a crime and disorder issue, rather than a health issue that includes -or is in fact led by- the home drinking middle classes.

    I think it could have been a bit more comittal to IBA. IBA should have been in NHS health checks from the start, and the current DES is obviously limited. It mentions aspirations relating to the QOF and SIPS findings – let’s hope these materialise in a meaningful way. Also no mention of oportunities within the workplace.

  2. Niamh Fitzgerald April 16, 2012 at 7:40 pm #

    The inclusion of alcohol in the health checks programme is a step forward, and thankfully a recognition that goes beyond the traditional assumptions about alcohol being good from a cardiovascular point of view. It is less than ten years since one health board produced a leaflet recommending alcohol consumption to reduce risks of coronary heart disease, which was pulled only at the last minute!

    One might rightly hope that suitable training will now be provided to Health Checks practitioners, but that is by no means certain. Many health checks practitioners received little or no training about the other lifestyle issues that were included from the start, such as diet and exercise, so on that basis, the picture is not encouraging. I also know that in a similar programme rolled out in Scotland, where practitioners were given generic health behaviour change training, they consistently ignored alcohol when actually delivering. There is something about alcohol that makes them feel more awkward (see my other post on Who needs IBA?).

    Interestingly, we have just been commissioned to deliver training on brief interventions for health checks practitioners in one area, but our training has to cover all the lifestyle issues, as well as brief intervention techniques.

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