Characteristics of alcohol care teams in England: results of the ProACTIVE national survey

Aims

This study aimed to identify (i) the number of alcohol care teams (ACTs) in England, (ii) the characteristics of patients supported by ACTs, and (iii) the service structure and care components offered by ACTs.

Methods

All acute hospitals (i.e. those providing short-term high-dependency medical care) in England were approached to complete a survey of alcohol care provision. Surveys were completed through researcher-guided interviews by staff familiar with the hospital’s alcohol provision. It featured questions on service structure, patient characteristics, service functions, and policies. Data collection took place between May and October 2023.

Results

Of 170 hospitals approached, 122 completed a survey and 80 reported having an ACT. Most ACT patients were male (mean 64.1%; 95% confidence interval (CI) 61.8–66.4), white (mean 79.2%; 95% CI 75.1–83.4), aged 45–54 (mean 27.8%; 95% CI 25.0–30.5), and experiencing severe alcohol dependence (mean 66.2%; 95% CI 36.8–95.7). Most services had a clinical lead but only 58% funded this role. Fifty-nine percent of services operated 7 days per week. Most services reported identification and brief advice, though it was rarely systematized. Nearly all supported medically assisted alcohol withdrawal, though a quarter of patients did not complete medically assisted alcohol withdrawal before discharge.

Conclusions

ACT numbers increased significantly between 2019 and 2024. They offer a clinical service to highly vulnerable and complex patients. There is significant variation in ACT operational models, training, and leadership which will impact the effectiveness of identification strategies and management of patients with comorbid alcohol use disorder within acute medical settings.