QOF Plus Year 1 - Imperial College London

Degree of perceived professional consensusThe RCGP supports inclusion of alcohol misuse in the QOF and regards a selective screeningapproach to adult patients in routine care as realistic for clinicians.A consultation with local stakeholders, including representatives from primary care and publichealth, showed overall consensus for the scientific soundness, importance and feasibility of theseindicators in QOF+.Degree of perceived support from patients and carersThere is evidence that patients are supportive of advice on alcohol-related issues (Hutchings etal., 2006).Impact on health inequalitiesThe Independent Inquiry into Inequalities in Health (Acheson, 1998) concluded that:“Deaths from diseases caused by alcohol show a clear gradient with socio-economicposition, with an almost fourfold higher rate in unskilled working men compared to thosefrom professional groups. In addition, alcohol is a contributory factor to deaths fromaccidents, which also show a pronounced socio-economic gradient.”Disadvantaged communities have higher levels of alcohol-related mortality, hospital admission,crime, absence from work, school exclusions, teenage pregnancy and road traffic accidentsassociated with greater levels of alcohol consumption. Within localities, the most disadvantagedindividuals have four to fifteen times greater alcohol-specific mortality and four to ten timesgreater alcohol-specific admission to hospital than the most affluent (North West Public HealthObservatory, 2007, Department of Health, 2008).Health impactEvidence by Wallace et al. (1988) suggests that the consistent implementation of simple alcoholadvice, across the UK, would result in the reduction from hazardous and harmful to low-riskdrinking levels in 250,000 men and 67,500 women each year.There is some limited evidence from a meta-analysis that brief interventions reduce alcoholrelatedmortality (Cuijpers, Riper and Lemmens, 2004).30