Embedding specialist addiction nurses within general practice teams can help address drug and alcohol problems in deprived areas, according to a study published by the Scottish Health Action on Alcohol Problems (SHAAP).
The research, undertaken by the University of Dundee and the University of Sterling, examined the experiences of healthcare professionals and patients in the management of alcohol problems in disadvantaged areas of Scotland.
The presence of specialist addiction nurses within practices was found to benefit both patients and healthcare workers, allowing support to be tailored to individual patients’ needs and increasing collaborative working amongst surgery staff.
Within Scotland, alcohol-related deaths are more than four times higher in the most disadvantaged areas compared to the least disadvantaged areas. In 2020/21, there were over 35,000 alcohol-related stays in hospital, with alcohol consumption a causal factor for more than 200 disease and injury conditions.
Addressing alcohol dependence
This research builds on a pilot scheme launched in 2015 to address alcohol dependence in a group of surgeries known as ‘Deep End’ practices which represent the 100 most disadvantaged populations in Scotland. The aim was to engage patients with alcohol problems who have either not engaged or have low engagement with specialist community alcohol services.
The pilot was successful and developed into a funded service known as ‘Primary Care Alcohol Nurse Outreach Service’ (PCANOS). This study analyzes the work of the PCANOS and looks at how specialist addiction nursing could be most successfully integrated into primary care.
Dr Andrea Mohan from the University of Dundee, who led the study, said: ‘People from deprived backgrounds in Scotland continue to experience serious harms such as illness and early death due to alcohol.’
She added: ‘Supporting this group can be challenging as they often have complex health and social needs and find it difficult to access appropriate services.’
The researchers found that the service was viewed positively by both practice staff and patients due to its person-centred approach, flexible nature, and the ability to offer tailored support to individuals. Having a specialist addiction nurse within primary care was also found to enable more collaborative working between practice staff, leading to faster referrals and better coordinated care with wider community services.
Dr Andrea Williamson, a Deep End GP working in Glasgow, said: ‘This research describes some of the key ingredients of high-quality care for Deep End patients – relational care, collaboration between GP practice teams and the specialist nurse, and ‘no wrong door’ when it comes to patients accessing appropriate specialist care and treatment.’
Dr Mohan and her colleagues have called for long-term funding to be provided for the integration of specialist addiction nurses into general practice.
She said: ‘This study found that benefits can be achieved when a specialist alcohol service works closely with general practices. It is crucial that a service like PCANOS continues to be funded as our study has shown that it is filling an important gap in alcohol service provision.’
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