Patients to be quizzed by GPs about drinking under new alcohol strategy

Doctors may be paid to monitor patients' drinking in effort to tackle spiralling cost of alcohol-related disease

GPs could be paid extra to question patients on their drinking habits and catch related problems early under proposals in the government's controversial new alcohol strategy.

Ministers hope the payments would provide an incentive to doctors to monitor the alcohol intake of their patients, to help tackle the spiralling costs of treating disease related to the consumption of drink.

Experts have advised the government to make the move as many drinkers do not come to a doctor citing a problem because they are not aware of the risks. Even couples who share a bottle of wine over dinner most evenings unwittingly increase their chances of cancer and strokes.

From next year, patients over the age of 40 will be questioned on their alcohol intake as part of general health checks which occur every five years. But the government is also looking to encourage GPs to routinely ask patients of all ages about their drinking habits when they come into practices.

Doctors are currently able to increase their practices' income by carrying out a checklist of services, and spotting illnesses and diseases listed under a system of good practice called the Quality and Outcomes Framework (QOF).

They are currently paid extra for monitoring chronic diseases such as asthma, diabetes and coronary heart disease.

Now the new strategy, says the Department of Health will "look at the data from the recently published Screening and Intervention Programme for Sensible Drinking (Sips) research to see if it can support further action by GPs [on alcohol] via the Quality and Outcomes Framework."

A standard "alcohol identification" test used by GPs involves a patient being asked a series of questions about their alcohol intake and the impact of drink on their day-to-day life.

Those who show signs of dependency or high use will be given 10 minutes of advice by nurses or referred to a specialist.

The strategy document says: "Identification and Brief Advice (IBA) is a simple intervention aimed at individuals who are at risk through drinking above the guidelines, but not typically seeking help for an alcohol problem. IBA has been proven to reduce drinking, leading to improved health and reduced calls on hospital services. At least one in eight at-risk drinkers reduce their drinking as a result of IBA."

Professor Ian Gilmore, special adviser to the Royal College of Physicians and the chair of the Alcohol Health Alliance, said he believed it was an important step that would prove cost effective.

"The evidence suggests that this actually works," he said. "Opportunistic detection of people, particularly professionals, works because they do respond. It works because you are asking people to reflect on their drinking, asking them if there might be a problem coming up."

However, the policy was described as an "extension of the nanny state" by Tory MP Philip Davies. "I would expect this sort of nonsense from the Labour party, not the Conservative party. I thought the whole point of our reforms was to put trust in GPs," he said. "I am sure they know how to look after their patients and don't need to be told how to do it. This is just more unnecessary government intervention, putting their nose in where it isn't needed."

Last week the government announced its intention to have a minimum price for alcohol amid growing concerns over the UK's drinking habits. The risk of hypertension (high blood pressure) is particularly acute for drinkers, yet about a third of men aged between 25 and 64 and a fifth of women in the same age group, say they drink at levels above the lower-risk guidelines. Furthermore, 8% of men and 4% of women in this age group admit to drinking at levels more than twice the lower-risk guidelines.

Despite the evidence, four out of five people who regularly drink above the guidelines do not think their drinking is putting their long-term health at risk. Whereas most smokers wish to quit, only 18% of people who drink above the lower-risk guidelines say they actually wish to change their behaviour.


Daniel Boffey, policy editor

The GuardianTramp

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