An interview with Ariella, National Alcohol Lead, about the CGL Alcohol Toolkit
1. Please tell us about the new CGL alcohol model
The National Alcohol model is a new toolkit to support anyone that presents to CGL with alcohol issues. It is suitable for people with a low level use that is causing slight problems, right through to dependency.
The model is evidence-based and supports best practice, all with the aim of improving service user experience and outcomes.
2. What is the purpose behind the alcohol toolkit?
The aim was to create a clear visible model that all CGL staff are working to, right across the country.
We wanted to develop a range of tools to support every single person who is working with anyone who is coming into our hubs and talking about alcohol.
The model is designed so staff can provide support in a really useful, appropriate, safe and effective way.
3. How was the toolkit created?
We created the toolkit in line with NICE clinical guidance 115, which completely underpins this model. I think it’s really important we reassure service users, staff, stakeholders and other professionals that we are working within current guidance.
Our project team was drawn from departments and practitioners across CGL so we’ve heard lots of feedback from people who have been using parts of the toolkit. It’s been a very organic process to ensure that workers feel it’s a very useful and vibrant product offer.
We want service users to know that we absolutely recognise and value them and hear what they need in terms of alcohol interventions and I feel that we’ve done this so far by gauging their view across the country. We really want to build on that moving forward.
4. What are the resources available?
The toolkit features a wealth of resources including a linear alcohol pathway, service user workbooks, facilitator’s manuals, service user maps, fact sheets and alcohol extended brief interventions (EBI).
We’ve also included an EBI session plan that workers can used to deliver EBI’s in a five week format. These sessions are designed to be very simple and are very map-based to enable workers to run them at any location. They can be used in recovery hubs, or in GP practices, in community hubs, or wherever workers meet with service users.
5. Tell us more about the linear pathway
The pathway is a map that shows workers which interventions to recommend for any service user, who comes into any service, via any referral route. It shows what happens to them, why it happens and what the thinking is behind it.
Every individual who comes into our open access provision is screened and scored using our audit tool and then, based on those scores, that’s where their journey begins.
For lower scores people’s drinking patterns have a low risk. At this level people don’t require interventions. Workers reinforce the benefits of drinking at a low safe level and no further actions are required at this point.
For medium to high scores this tells us people are drinking at increasing risk. This means the amount they are drinking may have an impact on their mental and physical health and wellbeing and may impact on their relationships.
The pathway supports us to deliver a single session of brief advice. This is followed up within a week with a recovery check-in. Research shows just one intervention can significantly reduce the likelihood of a person’s drinking increasing. Depending on their score they may also access our five week programme of EBIs.
For high scores they will automatically have a severity of alcohol dependence questionnaire (SADQ) screening to check the person will get the exact intervention they need based on their scores. This tells us that with high scores they are dependent and may need a clinically supported withdrawal from alcohol. Alcohol detox a safe an effective way to support people to become abstinence and is managed and monitored by registered nurses.
High risk drinkers are also offered access to EBI session groups while they wait for a community or inpatient detox and they are allocated a recovery coordinator. They will be referred for an alcohol nurse assessment and to their GP for further tests.
Anyone scoring 30 of above would have an immediate consideration for referral for an inpatient detox.
6. What next for the alcohol toolkit?
We are currently expanding the model to create templates to complement the delivery of each of the EBI interventions. We are also developing a number of additional programmes including alcohol awareness training and an example of ambulatory detox programme.