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| Britain on the booze: how a night of alcohol impacts the NHS | Britain on the booze: how a night of alcohol impacts the NHS |
| (35 minutes later) | |
| 12.30am GMT | |
| 00:30 | |
| A sad post from our GuardianWitness callout to readers | |
| Older drinkers | |
| My brother had been an alcoholic all my life - I am 45. Somehow, he has reached 65. He has had two strokes, resulting in left-sided weakness, tremors, cellulitis and many other ailments. It doesn't stop him drinking and smoking. We are talking a bottle of rum a day. Two days ago, my brother was persuaded by social worker, community nurse and I to go into a rehab bed, having refused any interventions since his last hospital admission in late August '15. Even as we were waiting for the ambulance, he asked the social worker to pass him his bottle of rum, and he was glugging it from the bottle. It is not just young drinkers causing the problems within the NHS. He has had at least 25 hospital admissions in the last 3 years. The NHS gets him to a certain state, and then he discharges himself against medical advice and the process starts again. He has trashed our childhood home. It is devastating to watch someone enact this slow, sorry suicide. I am sat in a hotel room, worried that the hospital will phone to say he is discharging himself again. This is his last chance.... But then he has no-one other than his other brother and I. Could and should we turn our backs on him?? | |
| Sent via Guardian Witness | |
| By Alizou | |
| 23 January 2016, 0:10 | |
| Updated | |
| at 12.35am GMT | |
| 12.23am GMT | |
| 00:23 | |
| Jessica Elgot | |
| It’s choc-a-bloc at Royal Stoke A&E at midnight, but senior sister Nicola Beckett is actually trying to find a patient. One man, a regular alcohol abuser, has run off from hospital, and she has to send police to find him, because he is now deemed a vulnerable adult as he has not had full medical check ups. | |
| The hospital now has so many regular attendees they have a special group for them all, which flags up if someone has been in more than three times a month. Sometimes Beckett sees someone twice a day. | |
| “You do get friendly with them, they are as nice to you as you are to them. You do see them decline, the physical decline. You admit them to rehab but you just know you’ll see them again. It’s an addiction, an illness. So many, you are discharging them and they say ‘I’ve got no home to go to.’ You sometimes do get a sense they are here for a hot meal and a bed and a kind face.” | |
| Beckett has seen some terrifying moments too. “I don’t want to make it too dramatic. But yes, I have feared for my life. You are trained in conflict management, self-defence. But if someone is drunk and aggressive, I can’t handle that myself.” | |
| Updated | |
| at 12.38am GMT | |
| 12.17am GMT | |
| 00:17 | |
| Josh Halliday | |
| “She was a bit intoxicated, visibly so, just wanted to go home, but she didn’t have a credit card, so we called her a taxi. She’s going home for tea, toast and biscuits.” | |
| 12.13am GMT | |
| 00:13 | |
| Zoe Williams | |
| “We’re a very respectable bar,” said White Goodman, 26, the security guard outside Santa Chupitos. | |
| “You can see how cosmopolitan it is,” a passer-by says. | |
| Two guys approach and are respectfully turned away. They didn’t look drunk to me, but maybe I haven’t got my eye in. | |
| “No, we’re an over-21 bar now,” Goodman explains. It’s a bit early in the night to be turning away drunks, but when they are turned away, Goodman says, “they’re turned away everywhere. It’s not if they’re violent or not violent, things turn when people are drunk. They won’t be getting in anywhere.” | |
| I don’t want to say it in this company, and of course, it’s early days yet… but it looks a little bit like Continental cafe society. | |
| 12.01am GMT | 12.01am GMT |
| 00:01 | 00:01 |
| One patient has a can of Skol under the trolley... | One patient has a can of Skol under the trolley... |
| Jessica Elgot | Jessica Elgot |
| Patients are queuing on beds in the corridor at the ambulance triage in Stoke where paramedic Tracy Proud is liaising with A&E staff to speed up the transfer of people. | Patients are queuing on beds in the corridor at the ambulance triage in Stoke where paramedic Tracy Proud is liaising with A&E staff to speed up the transfer of people. |
| “It’s ridiculous,” she said, looking over her shoulder at the queue of beds behind her. One patient has a can of Skol under the trolley. | “It’s ridiculous,” she said, looking over her shoulder at the queue of beds behind her. One patient has a can of Skol under the trolley. |
| “I think if you went through most of the patients, 85% shouldn’t be here. People have a different view about what an emergency is. If I’m called to look after a teenager or young person who is drunk, I call their parents straight away. Parents don’t realise it, but it’s not our job to just be watching a drunk person who has passed out.” | “I think if you went through most of the patients, 85% shouldn’t be here. People have a different view about what an emergency is. If I’m called to look after a teenager or young person who is drunk, I call their parents straight away. Parents don’t realise it, but it’s not our job to just be watching a drunk person who has passed out.” |
| Agitated patients have lashed out in the back of moving ambulance. “I had one patient who I thought was asleep and he came to, and he turned on me. I had to jump out the side door of the van.” | Agitated patients have lashed out in the back of moving ambulance. “I had one patient who I thought was asleep and he came to, and he turned on me. I had to jump out the side door of the van.” |
| Legal highs are a terrifying new problem, on top of alcohol. “They don’t know what they’ve taken. And they are totally off their heads.” | Legal highs are a terrifying new problem, on top of alcohol. “They don’t know what they’ve taken. And they are totally off their heads.” |
| On top of the added burden of inebriated patients, consultants and junior doctors working in the resuscitation area are also dealing with patients who are critically ill with sudden or pre-existing conditions. The medics have just restarted the heart of Kyle Baker, a local South African, who has a condition which can lead to irregular heartbeats. He started feeling the telltale symptoms around 5pm and called an ambulance an hour ago. | On top of the added burden of inebriated patients, consultants and junior doctors working in the resuscitation area are also dealing with patients who are critically ill with sudden or pre-existing conditions. The medics have just restarted the heart of Kyle Baker, a local South African, who has a condition which can lead to irregular heartbeats. He started feeling the telltale symptoms around 5pm and called an ambulance an hour ago. |
| “I live near the hospital in case I need to come in. This happens all the time,” he said. “They do such an amazing job.” | “I live near the hospital in case I need to come in. This happens all the time,” he said. “They do such an amazing job.” |
| Consultant Ruth Kinston is coaching her fifth year medical student as the team sedate Baker, preparing to stop and restart his heart back to its regular rhythm with a defibrillator. He is woozy as he comes around after the shocks, asking for his mobile phone almost straight away, but will be well enough to go home tonight. | Consultant Ruth Kinston is coaching her fifth year medical student as the team sedate Baker, preparing to stop and restart his heart back to its regular rhythm with a defibrillator. He is woozy as he comes around after the shocks, asking for his mobile phone almost straight away, but will be well enough to go home tonight. |
| Drunken patients can cost the NHS in ways you may not expect. Doctors have to be sure the symptoms are not other medical issues, especially if a patient cannot communicate. If Kinston orders a CT scan for a patient, it may well be just alcohol causing the problem with memory loss or headaches, but medics have to be sure. And that can cost hundreds of pounds. “We didn’t come into medicine to judge people, we came in to treat people. If I start to lose my empathy, we shouldn’t be doing this job,” she said. | |
| Updated | Updated |
| at 12.10am GMT | |
| 11.52pm GMT | 11.52pm GMT |
| 23:52 | 23:52 |
| Kate Lyons | Kate Lyons |
| On some nights the Polamb - police-ambulance alcohol treatment vehicle in Leicester - is a hub for treating people with alcohol-related injuries, attending up to 15 incidents in a night. It gets to the point that some of the locals recognise the Polamb and the paramedics who drive it. Jane Squire, East Midlands Ambulance Service paramedic, says one man she used to see regularly in the streets, a heavy drinker who would often call the ambulance for help, called her his “green angel”, for the dark green of the ambulance service uniform. | On some nights the Polamb - police-ambulance alcohol treatment vehicle in Leicester - is a hub for treating people with alcohol-related injuries, attending up to 15 incidents in a night. It gets to the point that some of the locals recognise the Polamb and the paramedics who drive it. Jane Squire, East Midlands Ambulance Service paramedic, says one man she used to see regularly in the streets, a heavy drinker who would often call the ambulance for help, called her his “green angel”, for the dark green of the ambulance service uniform. |
| “Sometimes they’ll come up have a conversation with you and say ‘I’ve cut my finger, can I have a plaster?’” says Squire. “Other times they’ll come up and say, ‘I’ve hurt my hand, can you take me to hospital?’ and I’ll say: ‘It says ambulance, not taxi.’” | “Sometimes they’ll come up have a conversation with you and say ‘I’ve cut my finger, can I have a plaster?’” says Squire. “Other times they’ll come up and say, ‘I’ve hurt my hand, can you take me to hospital?’ and I’ll say: ‘It says ambulance, not taxi.’” |
| But the first call-out the Polamb has received now that the policeman for the evening, Constable Joe Couchman, is on board is more serious - treating a man in his 40s who suffered a cardiac arrest on the street. This isn’t a typical call-out for the Polamb, not being alcohol-related, though it is believed the man was a heavy drinker, but they go where the need arises. | But the first call-out the Polamb has received now that the policeman for the evening, Constable Joe Couchman, is on board is more serious - treating a man in his 40s who suffered a cardiac arrest on the street. This isn’t a typical call-out for the Polamb, not being alcohol-related, though it is believed the man was a heavy drinker, but they go where the need arises. |
| Updated | Updated |
| at 12.00am GMT | at 12.00am GMT |
| 11.44pm GMT | 11.44pm GMT |
| 23:44 | 23:44 |
| Josh Halliday | Josh Halliday |
| Street Angels on the move... | Street Angels on the move... |
| 11.42pm GMT | 11.42pm GMT |
| 23:42 | 23:42 |
| Zoe Williams | Zoe Williams |
| A hundred or so yards back from the Brink is Leaf, “Like us, only with alcohol,” the manager of the Brink told me, as he pulled down his shutters. It isn’t dissimilar in wholesomeness - Lebanese style butter bean stew on the menu, an illuminated wall saying “Where there’s tea, there’s hope.” Mellow tables of twos and fours talk to one another equably. The main difference is that the lighting is much more flattering, and nobody is desperate to go home. | A hundred or so yards back from the Brink is Leaf, “Like us, only with alcohol,” the manager of the Brink told me, as he pulled down his shutters. It isn’t dissimilar in wholesomeness - Lebanese style butter bean stew on the menu, an illuminated wall saying “Where there’s tea, there’s hope.” Mellow tables of twos and fours talk to one another equably. The main difference is that the lighting is much more flattering, and nobody is desperate to go home. |
| Becky, 44, has lived in Liverpool all her life, and says, “It’s always been exactly the same. There are three generations of us here (she’s with her two daughters and her aunt), “nobody’s threatened, everybody’s relaxed.” “Every holiday I’ve been on,” says Molly, 18, “there’s been more trouble than I’ve ever seen in Liverpool. I’ve been in Amsterdam and there’s been a kick-off in a coffee shop.” “Trouble,” says Jan, 59, the above-named aunt, “is only there for people who go out and look for it.” | Becky, 44, has lived in Liverpool all her life, and says, “It’s always been exactly the same. There are three generations of us here (she’s with her two daughters and her aunt), “nobody’s threatened, everybody’s relaxed.” “Every holiday I’ve been on,” says Molly, 18, “there’s been more trouble than I’ve ever seen in Liverpool. I’ve been in Amsterdam and there’s been a kick-off in a coffee shop.” “Trouble,” says Jan, 59, the above-named aunt, “is only there for people who go out and look for it.” |
| Updated | Updated |
| at 12.09am GMT | at 12.09am GMT |
| 11.19pm GMT | 11.19pm GMT |
| 23:19 | 23:19 |
| Steven Morris | Steven Morris |
| As in Edinburgh, the street pastors are also out and about in Cardiff. | As in Edinburgh, the street pastors are also out and about in Cardiff. |
| They carry bottled water, flip-flops, emergency blankets, power-banks to charge up phones of people who have run out of charge, plastic gloves to protect themselves against infection. | They carry bottled water, flip-flops, emergency blankets, power-banks to charge up phones of people who have run out of charge, plastic gloves to protect themselves against infection. |
| “We are a visible presence on the street,” said team leader Tristan French, a hotel worker by day. “We help people who are vulnerable.” They help ease pressure on A&E by taking those who are so drunk that they need medical attention to the ATC - alcohol treatment centre. If they can they walk them to the centre, if not they have wheelchairs stashed around the city centre and can push them there. They are linked into the police and ambulance so can call for help from them if needed. | “We are a visible presence on the street,” said team leader Tristan French, a hotel worker by day. “We help people who are vulnerable.” They help ease pressure on A&E by taking those who are so drunk that they need medical attention to the ATC - alcohol treatment centre. If they can they walk them to the centre, if not they have wheelchairs stashed around the city centre and can push them there. They are linked into the police and ambulance so can call for help from them if needed. |
| Meanwhile, the ATC - alcohol treatment centre in Cardiff – has treated its first patient. A 30-year-old reveller had gone flying on the dance floor and ended up in a heap. She blamed a slippy dance floor. John, the ambulance paramedic, thought it might have had more to do with Jägerbombs. | Meanwhile, the ATC - alcohol treatment centre in Cardiff – has treated its first patient. A 30-year-old reveller had gone flying on the dance floor and ended up in a heap. She blamed a slippy dance floor. John, the ambulance paramedic, thought it might have had more to do with Jägerbombs. |
| She is taken to the ATC where the staff establish she has a broken wrist. It means she will have to go to hospital – but straight to the X-ray department rather than into A&E – a good example of how this scheme takes the pressure off emergency rooms. | She is taken to the ATC where the staff establish she has a broken wrist. It means she will have to go to hospital – but straight to the X-ray department rather than into A&E – a good example of how this scheme takes the pressure off emergency rooms. |
| Updated | Updated |
| at 11.39pm GMT | at 11.39pm GMT |
| 11.18pm GMT | 11.18pm GMT |
| 23:18 | 23:18 |
| Libby Brooks | Libby Brooks |
| At Greenside parish church on Royal Terrace, in the centre of Edinburgh, the city’s Street Pastors are preparing for the night with tea, home baking and a rousing hymn or two.Street Pastors is an initiative of the Ascension Trust and was pioneered in London in 2013. It is now active in 270 towns and cities across the UK. | At Greenside parish church on Royal Terrace, in the centre of Edinburgh, the city’s Street Pastors are preparing for the night with tea, home baking and a rousing hymn or two.Street Pastors is an initiative of the Ascension Trust and was pioneered in London in 2013. It is now active in 270 towns and cities across the UK. |
| Street Pastors are volunteers from local churches who patrol in teams of men and women, usually from 10 p.m. to 4 a.m. on a Friday and Saturday night, to care for, listen to and help people who out on the streets, whether celebrating on a hen night or homeless. Two teams are going to Grassmarket and another to George Street, with backpacks containing flasks of hot drinks and biscuits. As team leader Tony Clapham explains, some of these volunteers have been working on the night time streets and have built up strong relationships with local homeless people, as well as police and paramedics and other concerned with health and safety of the night time economy. | Street Pastors are volunteers from local churches who patrol in teams of men and women, usually from 10 p.m. to 4 a.m. on a Friday and Saturday night, to care for, listen to and help people who out on the streets, whether celebrating on a hen night or homeless. Two teams are going to Grassmarket and another to George Street, with backpacks containing flasks of hot drinks and biscuits. As team leader Tony Clapham explains, some of these volunteers have been working on the night time streets and have built up strong relationships with local homeless people, as well as police and paramedics and other concerned with health and safety of the night time economy. |
| The Street Pastor’s secret weapon is the flip flop, which are famously doled out free to wearers of high heels that are no longer functional, safe or comfortable.They also prevent those worse for wear deciding to walk home in bare feet and risking accidents with broken glass. Tony says the snapping of shoe straps tends to be an issue later in the night but a stock have been packed just in case. | The Street Pastor’s secret weapon is the flip flop, which are famously doled out free to wearers of high heels that are no longer functional, safe or comfortable.They also prevent those worse for wear deciding to walk home in bare feet and risking accidents with broken glass. Tony says the snapping of shoe straps tends to be an issue later in the night but a stock have been packed just in case. |
| Updated | Updated |
| at 11.21pm GMT | at 11.21pm GMT |
| 11.08pm GMT | 11.08pm GMT |
| 23:08 | 23:08 |
| The view from the professionals | The view from the professionals |
| Sarah Johnson | Sarah Johnson |
| We’ve had some heartbreaking responses from professionals about the people they routinely come across. The general message seems to be that doctors and nurses try not to judge those with alcohol problems who repeatedly end up in hospital, but sometimes find it hard not to be moved by this tragedy. | We’ve had some heartbreaking responses from professionals about the people they routinely come across. The general message seems to be that doctors and nurses try not to judge those with alcohol problems who repeatedly end up in hospital, but sometimes find it hard not to be moved by this tragedy. |
| Susi Harris, a West Yorkshire GP, said that two young people particularly unsettled her. | Susi Harris, a West Yorkshire GP, said that two young people particularly unsettled her. |
| He simply didn’t heed the warnings about his liver; he would turn yellow, be admitted, detoxified and discharged again and again for a year and a half until finally on one admission he died. He was a good-looking guy; his girlfriend and family deserted him because they were so angry that he chose alcohol over them, so he died alone. | He simply didn’t heed the warnings about his liver; he would turn yellow, be admitted, detoxified and discharged again and again for a year and a half until finally on one admission he died. He was a good-looking guy; his girlfriend and family deserted him because they were so angry that he chose alcohol over them, so he died alone. |
| She was the life and soul of the clinic; she was like a ray of sunshine whenever she walked in. She was so chatty and sociable, knew everyone’s names, and was afraid of no one. She had migrated on to alcohol from heroin, and saw this as real progress, she kept stopping to prove she could do it, and that was her undoing. She got Wernicke’s encephalopathy from recurrent detoxification which caused memory problems, confusion and a severe tremor, which meant she lost the ability to care for herself and had to go into a nursing home. I heard a year or two later she died there. | She was the life and soul of the clinic; she was like a ray of sunshine whenever she walked in. She was so chatty and sociable, knew everyone’s names, and was afraid of no one. She had migrated on to alcohol from heroin, and saw this as real progress, she kept stopping to prove she could do it, and that was her undoing. She got Wernicke’s encephalopathy from recurrent detoxification which caused memory problems, confusion and a severe tremor, which meant she lost the ability to care for herself and had to go into a nursing home. I heard a year or two later she died there. |
| Others are less patient. Beverley Bostock, a nurse practitioner in Gloucestershire has a novel suggestion. | Others are less patient. Beverley Bostock, a nurse practitioner in Gloucestershire has a novel suggestion. |
| I’m appalled by the amount of time and resources spent by the NHS treating people who get drunk. New army recruits spend much time preparing for active service without necessarily engaging in it. Why can’t incapacitated drunks be assessed and treated by trained army personnel on the streets or in mobile units? This takes the pressure off paramedics and healthcare professionals in A&E and gets army personnel actively and visibly serving their communities, teaching them how to manage people who are incapacitated through alcohol and/or drugs, how to contain situations where aggression may be a problem and how to defuse volatile situations. It is not the role of the NHS to babysit people who don’t know when they’ve had enough. We should also charge people who abuse the NHS in this way – and by charge I mean financially, legally or both. | I’m appalled by the amount of time and resources spent by the NHS treating people who get drunk. New army recruits spend much time preparing for active service without necessarily engaging in it. Why can’t incapacitated drunks be assessed and treated by trained army personnel on the streets or in mobile units? This takes the pressure off paramedics and healthcare professionals in A&E and gets army personnel actively and visibly serving their communities, teaching them how to manage people who are incapacitated through alcohol and/or drugs, how to contain situations where aggression may be a problem and how to defuse volatile situations. It is not the role of the NHS to babysit people who don’t know when they’ve had enough. We should also charge people who abuse the NHS in this way – and by charge I mean financially, legally or both. |
| 11.01pm GMT | 11.01pm GMT |
| 23:01 | 23:01 |
| Caroline Bannock | Caroline Bannock |
| Don’t forget: we’d like to hear from you too. Do you work in an A&E department or the ambulance service? Have you or people you know had to call go to because of the effect of alcohol? Tell us what your night’s like tonight. Just click on the blue button to share your your stories and photos - or get in touch. | Don’t forget: we’d like to hear from you too. Do you work in an A&E department or the ambulance service? Have you or people you know had to call go to because of the effect of alcohol? Tell us what your night’s like tonight. Just click on the blue button to share your your stories and photos - or get in touch. |
| 10.59pm GMT | 10.59pm GMT |
| 22:59 | 22:59 |
| Steven Morris | Steven Morris |
| Up and down the country there are units and voluntary organisations that aim to keep people out of A&E. | Up and down the country there are units and voluntary organisations that aim to keep people out of A&E. |
| The Alcohol Treatment Centre in Cardiff looks after around 1,000 people a year who are suffering the effects of alcohol or have sustained minor wounds. The idea is to keep them safe – and out of the A&E department at the University Hospital of Wales. | The Alcohol Treatment Centre in Cardiff looks after around 1,000 people a year who are suffering the effects of alcohol or have sustained minor wounds. The idea is to keep them safe – and out of the A&E department at the University Hospital of Wales. |
| There’s a senior nurse, sister and healthcare support worker here. A police officer and two ambulance crews are also based at the ATC. They’ve just started shift and will carry on to around 4am, though they can be stuck here until 7am. | There’s a senior nurse, sister and healthcare support worker here. A police officer and two ambulance crews are also based at the ATC. They’ve just started shift and will carry on to around 4am, though they can be stuck here until 7am. |
| They are referred people not just from the city centre (via pub and club door staff, ambulance, street pastors and police) but from neighbouring villages and towns. They can treat people who have drunk too much with saline drips. They can also close wounds and treat fractures. | They are referred people not just from the city centre (via pub and club door staff, ambulance, street pastors and police) but from neighbouring villages and towns. They can treat people who have drunk too much with saline drips. They can also close wounds and treat fractures. |
| Thirty nine people were treated here on New Year’s Eve – that’s 39 that kept out of A&E. | Thirty nine people were treated here on New Year’s Eve – that’s 39 that kept out of A&E. |
| Senior nurse Wayne Parsons said they had to deal with challenging – and often vulnerable – patients. “There are some who play up. But you can’t judge them. We are there to help.” | Senior nurse Wayne Parsons said they had to deal with challenging – and often vulnerable – patients. “There are some who play up. But you can’t judge them. We are there to help.” |
| One of the trickiest jobs is spotting patients who come in looking drunk – but end up being diabetic or having a hidden head injury. | One of the trickiest jobs is spotting patients who come in looking drunk – but end up being diabetic or having a hidden head injury. |
| Parsons has just looked on his screen to check the number of people waiting in A&E up the road at the University Hospital – there are already 36 there, par for the course at this time of night. | Parsons has just looked on his screen to check the number of people waiting in A&E up the road at the University Hospital – there are already 36 there, par for the course at this time of night. |
| Updated | Updated |
| at 10.59pm GMT | at 10.59pm GMT |
| 10.53pm GMT | 10.53pm GMT |
| 22:53 | 22:53 |
| Josh Halliday | Josh Halliday |
| Manchester’s Street Angels, a group of eight volunteers, have just had a briefing from Inspector Phil Spurgeon in the city tonight. Dubbed Operation Custodian, the volunteers are shown mugshots of two individuals wanted by police - we can say no more - and pictures of cars suspected to be involved in drug dealing. | Manchester’s Street Angels, a group of eight volunteers, have just had a briefing from Inspector Phil Spurgeon in the city tonight. Dubbed Operation Custodian, the volunteers are shown mugshots of two individuals wanted by police - we can say no more - and pictures of cars suspected to be involved in drug dealing. |
| “99.9% of people out tonight are decent people,” Spurgeon tells the volunteers. “Our job is to look after them. 0.1% are not very nice but we still have to look after them and get them home properly.” As uniformed officers file out of the city centre office, next door to the town hall in Albert Square, one says they have already dealt with a group of seven men fighting tonight, one reportedly unconscious. The night is still young, however. | “99.9% of people out tonight are decent people,” Spurgeon tells the volunteers. “Our job is to look after them. 0.1% are not very nice but we still have to look after them and get them home properly.” As uniformed officers file out of the city centre office, next door to the town hall in Albert Square, one says they have already dealt with a group of seven men fighting tonight, one reportedly unconscious. The night is still young, however. |
| Updated | Updated |
| at 11.10pm GMT | at 11.10pm GMT |
| 10.49pm GMT | 10.49pm GMT |
| 22:49 | 22:49 |
| Lisa O'Carroll | Lisa O'Carroll |
| What concerns Tonia Donnelly, emergency medicine consultant who also has an interest in vulnerable children are young parents who get so inebriated they can’t cope with their children on a Saturday morning. | What concerns Tonia Donnelly, emergency medicine consultant who also has an interest in vulnerable children are young parents who get so inebriated they can’t cope with their children on a Saturday morning. |
| “People don’t do this on purpose. People don’t set out to get drunk and end up in emergency departments. It’s about risk assessment. We want people to be safe and safeguard themselves against finding themselves in a vulnerable position collapsed on a street,” said Donnelly. | “People don’t do this on purpose. People don’t set out to get drunk and end up in emergency departments. It’s about risk assessment. We want people to be safe and safeguard themselves against finding themselves in a vulnerable position collapsed on a street,” said Donnelly. |
| I didn’t realise until Donnelly pointed it out that a bottle of wine, which many can easily consume of an evening, is 10 units of alcohol. That’s just four short of the amount advised for women in a full week. | I didn’t realise until Donnelly pointed it out that a bottle of wine, which many can easily consume of an evening, is 10 units of alcohol. That’s just four short of the amount advised for women in a full week. |
| “One unit of wine is 125ml which is like a sherry glass full. A normal wine glass that you might buy in Sainsbury’s and you drink at home can be 250ml easily,” says Donnelly. | “One unit of wine is 125ml which is like a sherry glass full. A normal wine glass that you might buy in Sainsbury’s and you drink at home can be 250ml easily,” says Donnelly. |
| 10.41pm GMT | 10.41pm GMT |
| 22:41 | 22:41 |
| Zoe Williams | Zoe Williams |
| It’s kicking out time in the dry bar. | It’s kicking out time in the dry bar. |
| “Time, ladies and gentlemen,” Ian’s yelling across the braying ferment. “I don’t care that you only just bought it, neck it.” | “Time, ladies and gentlemen,” Ian’s yelling across the braying ferment. “I don’t care that you only just bought it, neck it.” |
| Actually, he said nothing of the sort. It’s all rather genteel. The Frontline Church just left. “Come back and see the Community Spirit food bank next time,” Robbie, 27, calls on his way out. Emma, 41, is hoovering. All the chairs are on the tables except for mine. | Actually, he said nothing of the sort. It’s all rather genteel. The Frontline Church just left. “Come back and see the Community Spirit food bank next time,” Robbie, 27, calls on his way out. Emma, 41, is hoovering. All the chairs are on the tables except for mine. |
| There will be no A&E traffic generated here. | There will be no A&E traffic generated here. |
| Updated | Updated |
| at 11.23pm GMT | at 11.23pm GMT |
| 10.26pm GMT | 10.26pm GMT |
| 22:26 | 22:26 |
| Mark Rice-Oxley | Mark Rice-Oxley |
| And before we go back out to the nation at large, herewith a sneak preview of tomorrow’s front page, leading on the aforementioned article about how the booze industry cashes in on problem drinkers. With lots more from our #thisistheNHS series inside. Oh, and a story about Charlotte Rampling, too, by the looks of things. | And before we go back out to the nation at large, herewith a sneak preview of tomorrow’s front page, leading on the aforementioned article about how the booze industry cashes in on problem drinkers. With lots more from our #thisistheNHS series inside. Oh, and a story about Charlotte Rampling, too, by the looks of things. |
| Updated | Updated |
| at 10.33pm GMT | at 10.33pm GMT |
| 10.14pm GMT | 10.14pm GMT |
| 22:14 | 22:14 |
| Mark Rice-Oxley | Mark Rice-Oxley |
| Here’s a nuggety little fact to throw into the debate about tax, alcohol, health, the treasury and the NHS: two thirds of the price of spirits goes straight to the government in tax. Too much? Not enough? | Here’s a nuggety little fact to throw into the debate about tax, alcohol, health, the treasury and the NHS: two thirds of the price of spirits goes straight to the government in tax. Too much? Not enough? |
| 10.00pm GMT | 10.00pm GMT |
| 22:00 | 22:00 |
| "We detox them for a week and they leave - and return to drinking" | "We detox them for a week and they leave - and return to drinking" |
| Jessica Elgot | Jessica Elgot |
| “I’m going to get political about this now,” laughs Dr Stephen Hitchin, surveying the majors section of A&E. The emergency doctor became a councillor at Chesterfield borough council, Tony Benn’s old seat, because of his frustration with how patients are driven into A&E by failing social care, including for alcoholics. He has already treated two inebriated patients, one vomiting blood, another with pancreatic damage. | “I’m going to get political about this now,” laughs Dr Stephen Hitchin, surveying the majors section of A&E. The emergency doctor became a councillor at Chesterfield borough council, Tony Benn’s old seat, because of his frustration with how patients are driven into A&E by failing social care, including for alcoholics. He has already treated two inebriated patients, one vomiting blood, another with pancreatic damage. |
| “I went into politics because I felt like I wanted to help people more. Which sounds silly because I’m a doctor. You see people coming back to A&E because of alcohol constantly and they are not getting proper care in the community. It costs three times as much to treat them here. | “I went into politics because I felt like I wanted to help people more. Which sounds silly because I’m a doctor. You see people coming back to A&E because of alcohol constantly and they are not getting proper care in the community. It costs three times as much to treat them here. |
| “They come here, we detox them for a week in hospital but the support isn’t there for them when they leave, there’s nothing to occupy them, no employment and they return to drinking, and the cycle goes on. It’s a huge strain on the NHS, and the whole system is being set up to fail because of these social care cuts. I think people need to know that.” | “They come here, we detox them for a week in hospital but the support isn’t there for them when they leave, there’s nothing to occupy them, no employment and they return to drinking, and the cycle goes on. It’s a huge strain on the NHS, and the whole system is being set up to fail because of these social care cuts. I think people need to know that.” |
| 9.52pm GMT | 9.52pm GMT |
| 21:52 | 21:52 |
| Lisa O'Carroll | Lisa O'Carroll |
| One hour into the night shift at University Hospital Southampton, and two of the 15 patients in the “majors” treatment area are here because of alcohol.The first, a man in his 30s, was found collapsed in the street. The second, another man in his 30s was “just drunk” says staff nurse Catherine Chipande, but appeared to be having an epileptic fit. She assessed him and thinks he was just pretending because she talked to him during his shaking episode and “he just sat up” and listened.She was the first to see them in the assessment area. They will be further assessed by a doctor because of the risk they may have a head injury. | One hour into the night shift at University Hospital Southampton, and two of the 15 patients in the “majors” treatment area are here because of alcohol.The first, a man in his 30s, was found collapsed in the street. The second, another man in his 30s was “just drunk” says staff nurse Catherine Chipande, but appeared to be having an epileptic fit. She assessed him and thinks he was just pretending because she talked to him during his shaking episode and “he just sat up” and listened.She was the first to see them in the assessment area. They will be further assessed by a doctor because of the risk they may have a head injury. |
| Consultant Diana Hulbert says there are four types of alcohol-related patients typically in A&E. | |
| The first is the drunk who falls over on the street and a passer by calls 999. | The first is the drunk who falls over on the street and a passer by calls 999. |
| “It’s sensible because the worry is always a head injury and the symptoms can be the same – drowsiness.” | “It’s sensible because the worry is always a head injury and the symptoms can be the same – drowsiness.” |
| The second group are those that fall over and break an ankle or a wrist while the third is the worst, the boy racers who end up in a road traffic collision. | The second group are those that fall over and break an ankle or a wrist while the third is the worst, the boy racers who end up in a road traffic collision. |
| There’s lots of bravado fuelled by alcohol: “Quite often they are young men and a passenger may not have their seat belt on. They are a tricky group.” | There’s lots of bravado fuelled by alcohol: “Quite often they are young men and a passenger may not have their seat belt on. They are a tricky group.” |
| The last type presenting at A&E are those mixing drinks and drugs and overdosing. Some of these will be sadly familiar to hospital staff. | The last type presenting at A&E are those mixing drinks and drugs and overdosing. Some of these will be sadly familiar to hospital staff. |
| Updated | |
| at 12.24am GMT | |
| 9.43pm GMT | 9.43pm GMT |
| 21:43 | 21:43 |
| Jessica Elgot | Jessica Elgot |
| Staff nurse Clair Graham has learned exactly the right moment to duck when an aggressive drunk patient might swing. “You learn it over time, obviously you get trained as well. But they can’t help it, they don’t know what they’re doing, they don’t know if you’re trying to help them.” | Staff nurse Clair Graham has learned exactly the right moment to duck when an aggressive drunk patient might swing. “You learn it over time, obviously you get trained as well. But they can’t help it, they don’t know what they’re doing, they don’t know if you’re trying to help them.” |
| Drunks aren’t always aggressive. | Drunks aren’t always aggressive. |
| “We have giggles too, we have a laugh sometimes with the girls, I know I go like that,” she said. Weekends are still the busiest time, but drunks can now come in any time of the night or day, all week long, which never used to be the case, she said. “You can’t predict it, Friday and Saturday are still bad but it can happen any time.” | “We have giggles too, we have a laugh sometimes with the girls, I know I go like that,” she said. Weekends are still the busiest time, but drunks can now come in any time of the night or day, all week long, which never used to be the case, she said. “You can’t predict it, Friday and Saturday are still bad but it can happen any time.” |
| Updated | Updated |
| at 9.53pm GMT | at 9.53pm GMT |
| 9.40pm GMT | 9.40pm GMT |
| 21:40 | 21:40 |
| Zoe Williams | Zoe Williams |
| They’re playing The Drugs Don’t Work in The Brink, but the music doesn’t generally have a temperance theme. Sophie, 22, has been working here for three months, on a Work programme placement. “I love it here,” she says. “The people are really lovely. It’s not busy tonight, it’s really busy for football matches and that. Lots of guys in recovery who would have watched the game in the pub. You really get to know people.” She does over 30 hours a week as a volunteer, which is the condition of her receiving jobseekers allowance. I’ll just leave that there. Now isn’t the time for my thoughts on the Work Programme. | They’re playing The Drugs Don’t Work in The Brink, but the music doesn’t generally have a temperance theme. Sophie, 22, has been working here for three months, on a Work programme placement. “I love it here,” she says. “The people are really lovely. It’s not busy tonight, it’s really busy for football matches and that. Lots of guys in recovery who would have watched the game in the pub. You really get to know people.” She does over 30 hours a week as a volunteer, which is the condition of her receiving jobseekers allowance. I’ll just leave that there. Now isn’t the time for my thoughts on the Work Programme. |
| Along a table on the back wall sit ten younglings; they could be the students that Ian Wilson described earlier: “It’s got quite trendy, not to drink. Freshers are much more likely to come in here than people in their 30s”. But these are no students. | Along a table on the back wall sit ten younglings; they could be the students that Ian Wilson described earlier: “It’s got quite trendy, not to drink. Freshers are much more likely to come in here than people in their 30s”. But these are no students. |
| “Why’re you here, then?” | “Why’re you here, then?” |
| “There’s no exciting reason, I’m afraid,” said Mark, 28. “There’s no recovering alcoholics.” | “There’s no exciting reason, I’m afraid,” said Mark, 28. “There’s no recovering alcoholics.” |
| “Mmm… but you’re in a bar, that doesn’t serve alcohol.” “I don’t know why we chose it,” Sam, 27, reiterates mildly, smiling. “Ruth, do you know?’ Finally, they put me out of my misery. They’re from the Frontline Church. “I think a lot of people drink because of isolation,” said Mark, “If you could build good communities, you wouldn’t need it.” “But there’s a lot of judgment, people saying ‘no, no, no, no, no,’ there has to be a ‘yes’ to go to”, Sam adds. “Whether it’s faith or meaning or just meeting another person’s need.” | “Mmm… but you’re in a bar, that doesn’t serve alcohol.” “I don’t know why we chose it,” Sam, 27, reiterates mildly, smiling. “Ruth, do you know?’ Finally, they put me out of my misery. They’re from the Frontline Church. “I think a lot of people drink because of isolation,” said Mark, “If you could build good communities, you wouldn’t need it.” “But there’s a lot of judgment, people saying ‘no, no, no, no, no,’ there has to be a ‘yes’ to go to”, Sam adds. “Whether it’s faith or meaning or just meeting another person’s need.” |
| Updated | Updated |
| at 10.32pm GMT | at 10.32pm GMT |
| 9.34pm GMT | 9.34pm GMT |
| 21:34 | 21:34 |
| The view from Manchester | The view from Manchester |
| Josh Halliday | Josh Halliday |
| Manchester paramedic Dan Smith has been talking to me about what a typical Friday night here looks like. The key surprise - it’s not all about closing time and pubs turning people out. The pressure on the emergency services goes on all night. | Manchester paramedic Dan Smith has been talking to me about what a typical Friday night here looks like. The key surprise - it’s not all about closing time and pubs turning people out. The pressure on the emergency services goes on all night. |
| Updated | Updated |
| at 9.59pm GMT | at 9.59pm GMT |
| 9.26pm GMT | 9.26pm GMT |
| 21:26 | 21:26 |
| Mark Rice-Oxley | Mark Rice-Oxley |
| Interesting that some of our sources talk about young people and drink. It’s my impression that the younger generation DOESN’T drink as much as their forebears. Data bears that out: this may be the only UK alcohol graphic that actually goes down... | Interesting that some of our sources talk about young people and drink. It’s my impression that the younger generation DOESN’T drink as much as their forebears. Data bears that out: this may be the only UK alcohol graphic that actually goes down... |
| And in an attempt to keep things in perspective and deflect accusations below the line of being “sanctimonious” “self-righteous” and a bit of a party pooper, let’s set a bit of international context. Yes, the UK has a problem. But it is by no means as soaked as some of its continental peers. | And in an attempt to keep things in perspective and deflect accusations below the line of being “sanctimonious” “self-righteous” and a bit of a party pooper, let’s set a bit of international context. Yes, the UK has a problem. But it is by no means as soaked as some of its continental peers. |
| Updated | Updated |
| at 9.41pm GMT | at 9.41pm GMT |
| 9.15pm GMT | 9.15pm GMT |
| 21:15 | 21:15 |
| Jessica Elgot | Jessica Elgot |
| Dr Anthony Taylor was born in the Royal Stoke. As a medical student, he worked with the consultant who delivered him. “He didn’t like me reminding him of that,” he laughed. | Dr Anthony Taylor was born in the Royal Stoke. As a medical student, he worked with the consultant who delivered him. “He didn’t like me reminding him of that,” he laughed. |
| Now he’s the senior doctor overseeing the accident and emergency department at Royal Stoke. Stoke A&E is already busy tonight - 113 people in, and possibly the same number again expected by midnight. The department currently has a fairly large overflow - which means beds in corridors - of around 14 people. Many of the patients are also waiting in the ambulatory medicine queue - people who need attention but don’t need to lie in a bed. | Now he’s the senior doctor overseeing the accident and emergency department at Royal Stoke. Stoke A&E is already busy tonight - 113 people in, and possibly the same number again expected by midnight. The department currently has a fairly large overflow - which means beds in corridors - of around 14 people. Many of the patients are also waiting in the ambulatory medicine queue - people who need attention but don’t need to lie in a bed. |
| Alcohol just makes everything worse, says Taylor. | Alcohol just makes everything worse, says Taylor. |
| “If someone is whacked on the head and passing in and out of consciousness, that could be because of alcohol or the head injury,” he says. “And then you have to assume it’s the injury and then we may have to over treat the injury.” | “If someone is whacked on the head and passing in and out of consciousness, that could be because of alcohol or the head injury,” he says. “And then you have to assume it’s the injury and then we may have to over treat the injury.” |
| The department had what it calls frequent flyers, one of the patients in the ambulance queues is on his 155th visit to the A&E and he is only 39 years old. “He’s not the most frequent by any means. The guidelines state that 200mg of alcohol in your blood leaves you unconscious, 300mg should be fatal. We’ve had patients with 500mg in their blood.” | The department had what it calls frequent flyers, one of the patients in the ambulance queues is on his 155th visit to the A&E and he is only 39 years old. “He’s not the most frequent by any means. The guidelines state that 200mg of alcohol in your blood leaves you unconscious, 300mg should be fatal. We’ve had patients with 500mg in their blood.” |
| Updated | Updated |
| at 10.31pm GMT | at 10.31pm GMT |
| 9.09pm GMT | 9.09pm GMT |
| 21:09 | 21:09 |
| Lisa O'Carroll | Lisa O'Carroll |
| The emergency department at University Hospital Southampton already has a busy air with nurses, paramedics, consultants and a few police busy around the “majors” treatment area during handover between shifts. | The emergency department at University Hospital Southampton already has a busy air with nurses, paramedics, consultants and a few police busy around the “majors” treatment area during handover between shifts. |
| Emergency consultant Diana Hulbert, who is in charge tonight, explains that not all alcohol-related attendances happen after a night on the town. | Emergency consultant Diana Hulbert, who is in charge tonight, explains that not all alcohol-related attendances happen after a night on the town. |
| “A classic one is people waking up the next day and finding their wrist turned the wrong way,” says Hulbert. So people are just as likely to present on the morning after. | “A classic one is people waking up the next day and finding their wrist turned the wrong way,” says Hulbert. So people are just as likely to present on the morning after. |
| She doesn’t judge people who turn up in the department because of alcohol-related injuries or accidents, but says over the past 20 years she had noticed changes that are concerning. | She doesn’t judge people who turn up in the department because of alcohol-related injuries or accidents, but says over the past 20 years she had noticed changes that are concerning. |
| “People drink differently. Spirits is more a young person’s drink and they can make people profoundly drunk very quickly. A beer is two units and you can’t drink that many, maybe 10 pints. But if you’re drinking shots, you can down five in five minutes. That’s what young people do.” | “People drink differently. Spirits is more a young person’s drink and they can make people profoundly drunk very quickly. A beer is two units and you can’t drink that many, maybe 10 pints. But if you’re drinking shots, you can down five in five minutes. That’s what young people do.” |
| Updated | Updated |
| at 10.31pm GMT | at 10.31pm GMT |