The Alcohol Care Team Model: A Holistic Approach to Address Alcohol Dependence and Withdrawal

Darren Quelch, Carol Appleyard, Bev John, Gareth Roderique-Davies, Sally Bradberry, Arlene Copland

Research output: Contribution to journalArticlepeer-review


Alcohol-related ill health is an important cause of acute hospital presentations. Service demand and resource limitations often lead to a reactive rather than proactive approach in the ED and acute medical units. For the patient, perceived and real treatment barriers can result in disillusionment, despair, repeat attendance, deteriorating health, and, ultimately, disproportionately high mortality rates. An Alcohol Care Team (ACT) is a dedicated group of hospital-based specialist nurses and practitioners experienced in the timely identification, assessment, and management of a range of alcohol-related conditions and their complications. An ACT can help improve both patient outcomes and service delivery performance through a targeted holistic approach that recognizes the
complexities of addiction and the need for the patient to be the driver of lifestyle change. The ACT works with existing community-based alcohol service providers to optimize patient experience, outcomes, and resource use in addressing alcohol-related care needs. The authors present outcomes from the first 5years of the ACT at the Sandwell and West Birmingham (SWB) National Health Service Trust. Implemented in 2018, the SWB ACT now consists of 11 core members of the staff delivering timely assessment and interventions for individuals presenting to acute services with alcohol-related health problems, as well as delivering outpatient support and guidance after discharge. Key milestones in the ACT’s inception, growth, and development are highlighted, all of which align with the achievement of performance targets, outcome measures (including the number of inpatient bed days avoided, the percentage of patients reviewed within 1 hour acutely or 24 hours if admitted, income generated through clinical work, and avoidance of admission), and improvements in care from a hospital resource distribution and patient satisfaction perspective. This model is translatable to other regions and settings. Key steps that other organizations might take toward developing an ACT are outlined.
Original languageEnglish
Article numberCAT.23.0337
Number of pages23
JournalNEJM Catalyst
Issue number5
Early online date17 Apr 2024
Publication statusPublished - 17 Apr 2024


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