Seta Waller

Fast screening for alcohol misuse

UNLABELLED The Fast Alcohol Screening Test (FAST) has been developed from the AUDIT questionnaire. AUDIT The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Geneva, Switzerland: World Health Organization for use in very busy medical settings. One feature of the FAST is its ease and speed of administration, especially since one question identifies over 50% of patients as either alcohol misusers or not. This study further explores the sensitivity and specificity of the FAST across ages, gender, and locations using the AUDIT as the gold standard. Two other quick tests are also compared with the AUDIT and the FAST, namely the Paddington Alcohol Test and the CAGE. All tests were quicker to administer than the AUDIT with the FAST taking just 12 s on average. All tests identified drinkers who would accept a health education booklet (over 70% of those identified) or 5 min of advice (over 40%). The FAST was consistently reliable when sensitivity and specificity were tested against AUDIT as the gold standard.

The Licensing Act 2003: a step in the right direction?

The Licensing Act 2003 (covering England and Wales) introduced greater flexibility to the UK licensing laws, including the possibility of 24‐h licenses. This paper reports a nation wide survey of 225 (63%) local authority chairs of licensing committees/senior members of licensing teams in England evaluating the short‐term impact of the Act. A cumulative impact (saturation) area was only declared in 38 (17%) local authorities. Extended hours applications were more common than new applications in both on‐ and off–licensed premises. The perception of those surveyed was of ‘no change’ in the following alcohol‐related variables; public noise levels (n = 133, 59%) violence and fights (n = 130, 60%), under‐aged drinking (n = 143, 67%), crime (n = 141, 68%), and drink‐driving (n = 157, 86%). Contrary to the picture often presented in certain parts of the mass‐media, the impact of the Licensing Act appears to be neutral. However, these are likely to be the result of a number of intervening factors, rather than the change to a more liberalized licensing regime. The role of the police would seem to be fundamental. Future research will need to disentangle the impact of these intervening factors and it will be a number of years before the impact of these changes can be assessed.

Partnerships: survey respondents’ perceptions of inter-professional collaboration to address alcohol-related harms in England

Tackling alcohol-related harms crosses agency and professional boundaries, requiring collaboration between health, criminal justice, education and social welfare institutions. It is a key component of most multi-component programmes in the United States, Australia and Europe. Partnership working, already embedded in service delivery structures, is a core mechanism for delivery of the new UK Government Alcohol Strategy. This article reports findings from a study of alcohol partnerships across England. The findings are based on a mix of open discussion interviews with key informants and on semi-structured telephone interviews with 90 professionals with roles in local alcohol partnerships. Interviewees reported the challenges of working within a complex network of interlinked partnerships, often within hierarchies under an umbrella partnership, some of them having a formal duty of partnership. The new alcohol strategy has emerged at a time of extensive reorganisation within health, social care and criminal justice structures. Further development of a partnership model for policy implementation would benefit from consideration of the incompatibility arising from required collaboration and from tensions between institutional and professional cultures. A clearer analysis of which aspects of partnership working provide ‘added value’ is needed.

The feasibility of alcohol interventions in accident and emergency departments

Doctors and nurses in three accident & emergency (A&E) departments were interviewed about the feasibility of screening for hazardous drinking as well as the provision of minimal or brief interventions. They were also asked about a more comprehensive approach to alcohol‐related problems that would involve liaising with other services. The feasibility of a comprehensive approach to excessive alcohol consumption is considered. Quantitative data revealed that computerised A&E records did not accurately portray the prevalence of alcohol‐related attendance.