Drunks should be treated in ‘booze buses’ to ease A&E overcrowding, nurses say


They called for alternative schemes to be set up, in city centres, or next to casualty units.

Anthony McGeown, a nurse from Greater Glasgow, said: “It is reported that each year 2 million visits to Accident Emergency in England and Wales are due to alcohol related illness or injury.”

The nurse suggested that Britain should consider introducing “drunk tanks” – holding facilities introduced in many parts of the United States, to accomodate those who are heavily intoxicated – or expand the use of “booze buses” which have been tried in some British cities during the Christmas season.

Mr McGeown said: “With the drunk tank tank concept, those who are intoxicated can sober up – without the need for being arrested or hospital care.”

Dr Peter Carter, RCN chief executive, said pilot schemes should be created to examine alternatives to AE.

He said too many patients were suffering worse care, or being treated in frightening surroundings, because they were surrounded by others who were drunk and sometimes violent.

Dr Carter said: “People that come in inebriated and unconscious they require a lot of nursing care and that detracts from care being given to others, but also there are examples of people coming in an aggressive state, perhaps having been in a fight, blood everywhere, careering around the place – it can make things very difficult.”

He said pilot schemes would need to test whether alternatives were safe, warning that they would need to be able to identify medical emergencies, such as head injuries.

Dr Carter said: “If you can find ways that people can be safely cared for without going to AE then that is good, but this will not be cheap because you will need diagnostic facilities.”

The head of the RCN warned that Britain now has the highest ever levels of alcohol related illness, such as liver disease, with AE units now dealing with high numbers of drunks every night of the week.

He said: “There was a time this was a Friday and Saturday night phenomenon; now it is round the week.”

“Booze buses” have been tried in London, Cardiff, Norwich and York during the Christmas season, with ambulance staff and first aid volunteers helping inebriated party goers.

Uwem Otong, from the south east Northern Ireland branch of the RCN, said: “The truth remains that alcohol intoxication is not an accident. AEs in all countries are under intense pressure. At a time in which the NHS is facing financial burden, it is important that services are channeled properly.

He said it was a “waste of resources” for patients suffering from alcohol-related problems to be sent to AE.

“Somebody takes alcohol knowing exactly what he or she is doing. With that in mind I would suggest a situation in which people who are intoxicated are moved to a different environment to give room to those who are actually having accidents, or those that require emergency care.”

Several nurses raised concerns that creating separate units could mean that medical problems went undetected, with head injuries easily mistaken for intoxication if not examined closely.

Some suggested new services should be set up close to AEs.

Nykoma Hamilton, from the RCN’s Fife branch, said: “Sadly this topic is not new. We have seen a growth in the binge drinking culture across the UK.”

She suggested that locating units next to AE could relieve pressure on units, while ensuring emergency care and tests were close at hand.

“Surely AE being full of drunk people will slow down treatment times – there has to be a better solution. So what about setting up an area adjacent to, but separate from AE at the weekends, when it’s the most busy, staffed by nurses?”

Highlighting research showing that drunk patients are the main cause of violence in hospitals at weekends, increasing staff workload, waiting times and patient anxiety, she said: “This must have a wearing effect on staff morale – they didn’t go to work in AE just to treat a bunch of drunk people every weekend who have fallen over.”

A Department of a Health spokesman said: “Alcohol places a heavy burden on the NHS and costs around £3.5 billion every year.”

He said the local NHS has the freedom to explore how to make improvements to services.

* Nurses should be told to stop waking up patients with noisy chatter or needless interruptions, the conference heard.

Delegates said too many patients were being subjected to “sleep deprivation” because of loud conversations, noisy surroundings and unnecessary wake-up calls – with patients even being woken up to be given sleeping pills.