Doctors are "missing opportunities" to help people with alcohol problems, a new report suggests.
Experts have estimated that many deaths from alcohol-related liver disease could be avoided. Researchers, who examined the detailed patient notes of 385 patients who died from alcohol-related liver disease across England Wales and Northern Ireland, found 135 cases of "missed opportunities" to help influence the patient's health outcome.
As many as 32 of the deaths could have been avoided, according to a new report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Only half of the cases reviewed received "good care", the report states.
Even though three-quarters had been admitted to hospital on more than one occasion, a third of patients were never referred on to alcohol support services to help them curb their drinking habits.
A quarter of people were never seen by a gastroenterologist or hepatologist while they were in hospital. Indeed, consultant hepatologists were only present in 28% of the 191 hospitals examined.
The NCEPOD said that all patients who attend hospital should be screened for alcohol misuse. And all those who have displayed harmful drinking behaviour should be referred on to alcohol support services, the report suggests. Any patient admitted with urgent alcohol-related liver disease should be seen by a specialist within 24 hours, experts said.
Report co-author Dr Mark Juniper, clinical co-ordinator at NCEPOD, said: "Many people with alcohol-related liver disease have multiple admissions with this condition. This gives clinicians an ideal opportunity to offer appropriate treatment and advice to patients to help them stop drinking and improve their future health. Unfortunately, this isn't happening, and in over a third of patients reviewed in this study, referral for support to stop drinking was not made, despite most hospitals reporting to have alcohol liaison services.
"This is partly because the services are not available at all times that they are needed. Similarly, patients were not always seen by a specialist in liver disease, and when they did, this was often not for several days after admission. We know that abstinence works, and that when simple advice is offered to patients, one in eight will reduce their harmful drinking levels - that's better than the results from 'stop smoking' support services."
Sir Richard Thompson, president of the Royal College of Physicians, said: "Admissions to hospital for alcohol-related liver disease and deaths are on the increase and particularly affect younger patients. This report emphasises the variation across the country in specialist care in hospital for these patients, and suggests how much needs to be done to bring hospital services up to an acceptable standard. Every patient should also have access to an alcohol support service.
"There is a feeling that these sick patients are denied active treatment in high-dependency beds because they are thought to be irrecoverable. I hope that this report will stimulate trusts to appoint more gastroenterologists with an interest in diseases of the liver and seven-day alcohol support nurses."