Alcohol puts strain on ambulance services

It's all in a days work for paramedics in the West Midlands, for whom dealing people who have had too much to drink is a depressingly common occurrence. A new study, based on calls to the Scottish Ambulance Service, reveals that one in every six calls received is alcohol related, accounting for a total of 86,780 calls in 2019. If replicated in the West Midlands, it would equate to 667 calls every day attributable to alcohol. Or put it another way, the service would receive an alcohol-related every two minutes.

The Scottish study also found that such calls cost the nation's ambulance service £31.5 million that year – a figure that would easily be doubled in the West Midlands, given the greater volume of calls received by paramedics in the region.

Unsurprisingly, weekends and evenings tend to be the busiest times.

Jamie Arrowsmith, of West Midlands Ambulance Service, says: “As a service we cover a lot of large towns and cities and we do see an increase in alcohol related incidents on evenings and weekends. However, this is something that is reflected in our resourcing, with more ambulances on duty at busy times.

“As always when alcohol is involved we would ask people to drink sensibly, taking responsibility for themselves. We also encourage people to look out for their friends.

“Alcohol can cause people to do things they definitely wouldn’t if they were more sober and this can result in our highly trained medical staff being tied up looking after people who have had too much to drink, when they should be available to treat those who have suffered life-threatening emergencies.”

Working with ambulance staff, researchers at the universities of Glasgow, Stirling and Sheffield analysed the figures based on notes taken from paramedics on the scene. They found that 86,780 ambulance call-outs in Scotland were identified as alcohol-related in 2019, more than three times higher than previously thought.

The study detected an increasing trend of call-outs linked to alcohol over the period of 2016-2019 as well as a clear difference in the volume of call-outs on Fridays, Saturdays and Sundays, compared to the rest of the week.

The research team says it was able to build a 'highly accurate' algorithm that searched paramedic notes in patient records for references to alcohol.

Applying this automated method to records from 2019, they found that 16.2 per cent of ambulance call-outs were alcohol-related. This rose to 28.2 between 6pm and 6am and weekends.

A disturbing trend of recent years has been the growing number of violent incidents on what has become known as 'Black Eye Friday' at the start of the weekend before Christmas. Incidents which have taken place in recent years include a 21-year-old man who had to be taken to hospital after drunkenly punching a window in Shifnal, as well as a 17-year-old boy who was so drunk he was struggling to breath.

Over the next few weeks, the performance of the home nations in the European football championships may yet play a role. The number of calls to West Midlands Ambulance Service doubled after England were knocked out of the World Cup, with numerous fights and assaults taking place around the region.

It is not just patients either. In recent years paramedics have come under attack from drunken members of the public while they go about their work. While paramedics were attending to an emergency in Telford, a drunken man attacked their ambulance breaking a mirror.

Professor Jim Lewsey, Professor of Medical Statistics at the Glasgow University, says: "We have shown that there is a high burden of alcohol on ambulance call-outs .

"This is particularly true at weekends, for call-outs involving younger people and for call-outs to addresses in areas with high levels of socio-economic deprivation."

The algorithm shows that age was an important factor, with alcohol being related to approximately a quarter of call-outs for those under the age of 40, but less than seven per cent in those aged 70 and above.

Socio-economic deprivation was also found to be a factor, with alcohol related to one in five call-outs to addresses in the most deprived areas. This fell to just 10 per cent of calls in the least deprived areas.

Based on the average cost of an ambulance call-out in 2019, researchers estimate the total cost of alcohol-related call-outs at approximately £31.5 million, though the exact figure would depend on the complexity of these calls compared with non-alcohol-related call-outs.

The algorithm detected an increase in the number of call-outs linked to alcohol over four years.

In 2016, the daily averages on weekdays and weekends were 161 and 243 respectively, whereas in 2019 they were 202 and 284.

Professor Niamh Fitzgerald, professor of alcohol policy at Stirling University of Stirling, is principal investigator for an overall study evaluating the impact of minimum unit pricing of alcohol on alcohol-related ambulance call-outs in Scotland.

She says: "As we emerge from the Covid-19 pandemic, we all want to protect NHS services for when they are most needed.

"It is timely therefore to consider whether it is acceptable that over 230 ambulance call-outs every day are linked to alcohol when we have policy solutions that can reduce this burden.

"We are also conducting further research to understand what types of call-outs and drinking locations give rise to these figures and how they are experienced by paramedics."

The study is published in the International Journal of Environmental Research and Public Health.

Dr Jim Ward, medical director at the Scottish Ambulance Service says the research will help the service understand the impact of alcohol on the demands it faces.

"Our frontline staff consistently see the serious effects unsafe levels of alcohol have on people's lives and we would urge the public to drink responsibly."