Title: An evidence-based model for estimating requirements for specialist alcohol treatment capacity in England
Funder: Department of Health (England)

Abstract: Background The risks of alcohol-related harm associated with harmful drinking and alcohol dependence are high and costly to individuals and their families, the National Health Service, and society. Aims The aim is to develop a capacity model to estimate the number of individuals that would access specialist alcohol treatment services and require different types of treatment options each year in England at both national and local levels. The model will inform and support resource allocation and the planning and commissioning of specialist alcohol treatment services according to needs, resources and outcomes. Research plan and method The University of Sheffield in collaboration with the National Drug Evidence Centre at the University of Manchester, and the National Addiction Centre at Kings College London propose a collaboration to carry out this study. The study will be carried out in three stages: scoping and feasibility, full implementation, and pilot testing. We will consider three recent reviews of the effectiveness and cost-effectiveness of specialist alcohol treatments by NICE in 2013, Drummond et al in 2011 and Raistrick et al in 2006; and update these reviews with more recent literature. We plan to use the Adult Psychiatric Morbidity Survey 2007 to fit a statistical model to predict alcohol use disorders identification test (AUDIT) scores from alcohol consumption and other covariates. The fitted model will then be applied to individuals in the pooled General Lifestyle Survey (GLF) and the Health Survey for England (HSE) to predict expected AUDIT scores. These GLF and HSE individuals will be used to establish the prevalence (and associated confidence intervals) of dependent drinkers in each local authority area. We define these drinkers as the “in-need” population. We will analyse the National Alcohol Treatment Monitoring System (NATMS) data to summarise the proportion of the “in-need” population accessing the treatment service in each local area, and, when data allow, estimate the extent of referral of patients between different local areas. Further case history analysis will be used to establish transition probabilities between treatment options, and the success/failure rate of treatment option or care package. The capacity model consists of 3 parts: a harmful and dependent drinker estimator, a service demand estimator and an outcome estimator. The key advantages of the proposed model include 1) using England-specific data sources and patient “care pathways”; 2) estimating both “amenable” and “acceptable” levels of service provision; 3) evaluating the impact of treatment services on resource usage and changes in alcohol-related health and crime harms We will identify key stakeholders through consultation with the Department of Health. The first stakeholder meeting will be held during the scoping and feasibility stage to seek general suggestions for the overall project and specific advice on the development of the capacity model including model structure, data requirements and functionality of the model. We plan to hold the second meeting in the middle of the full implementation stage focusing on reaching consensus on “amenable” and “acceptable” levels of service provision. We will hold the third meeting 8 weeks before the completion of the project to seek comments on the validity of the model and to pilot testing the model. Research team The multi-disciplinary team brings together experience of developing statistical models of alcohol policy, analyses of NATMS data and understanding of alcohol treatment services. The team has expertise in the areas of alcohol dependency, specialist treatment and criminal justice, statistical analysis and modelling and evidence reviewing and synthesis. Potential impact The study will help national and local government, and local Clinical Commissioning Groups in England, commission and plan specialist alcohol treatment services with the ultimate goal to reduce alcohol-related harms


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: STROKE;CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL