Projects & Research Partnerships

Introduction

Drunkenness is a common night-time problem in the UK, and intoxicated individuals are at risk of choking, injury, unconsciousness and death. Traditionally, the very drunk were either detained by police or sent to Emergency Departments (ED). However, recent police guidance restricts custody for the drunk, leading to increased pressure on EDs. This surge in demand causes delays in ambulance handovers, police duties, and patient care. Additionally, the disruptive behaviour of intoxicated individuals can negatively impact the ED environment, affecting other patients and staff.

Alcohol Intoxication Management Services ((AIMS) – also known as Alcohol Treatment Centres, Alcohol Recovery Centres, Alcohol Welfare Centres and, in the media, 'Drunk Tanks' – are designed to receive, treat and monitor intoxicated patients who would normally attend Emergency Departments and to lessen the burden that alcohol-misuse, an avoidable healthcare cost, places on unscheduled care.

They are usually located close to areas characterised by excessive intoxication and are open at times when levels of intoxication peak (e.g. Friday and Saturday evenings). AIMS therefore offer the potential to mitigate some of the pressures on ED at times when it is experiencing a sustained increase in demand.

Project aims

The EDARA project aims to estimate the effectiveness, cost-effectiveness, efficiency and acceptability of AIMS in managing alcohol-related ED attendances. It is organised into three Work Streams (WS):

WS1 will use ethnographic studies; interviews with stakeholders, policy makers and practitioners;
interviews with patients attending AIMS and surveys of ED and AIMS users. It focuses on four
research questions:

1. What is the impact of AIMS on the work practices and professional identities of frontline staff in managing the intoxicated and other related work activities?
2. What are the micro-, meso- and macro-levels factors that contribute to AIMS development and implementation, what are the key ingredients required for successful implementation and what barriers to implementation exist across partnerships?
3. To what extent is treatment in AIMS acceptable to users?
4. To what extent does implementation of an AIMS affect users' views on treatment in EDs?

In WS2 routine data will be analysed to quantify the effect of AIMS in respect of key performance indicators. WS2 addresses the research question 'to what extent does AIMS implementation affect key performance indicators in ambulance and health services?'.

WS3 addresses the question 'what are the costs of setting up and running an AIMS and what cost savings may be realised elsewhere?'. WS3 works alongside WS2 and in addition collates data required for cost-efficiency analyses. If AIMS are found to be effective, in respect of key performance indicators, this WS will feed forward into a separate project that models the likely effect of a national rollout.