Evaluation of the Alcohol Improvement Programme: Final Report

BackgroundAlcohol-related harm impacts significantly on health and on costs to the NHS. Regional variation has been identified and research has shown a gap between the need for alcohol treatment and access to treatment. PCTs are responsible for setting local health priorities, but many have been found to fall short in assessment of alcohol problems in their area, and thus cannot know what services they should be providing or gauge whether the services they commission are adequate or cost-effective. Equally, provision of evidenced treatment approaches (e.g. identification and brief advice) is patchy. Encouraging PCTs to assume leadership in addressing alcohol-related harms and embedding supportive systems within NHS structures is key to achieving national and local targets to reduce harm.AimsThis evaluation will assess the effectiveness, cost-effectiveness and appropriateness of the Alcohol Improvement Programme (AIP) to develop a delivery system which prioritises and delivers action to achieve a decrease in alcohol-related hospital admissions. It will explore the value of providing additional support to PCTs in deprived areas in facilitating speedier/ more effective implementation of the delivery system. It will explore the effectiveness and appropriateness of programme components and the extent to which components contribute to the AIP as a whole. It will assess the potential of the AIP model to achieve long-term change. The evaluation aims to reflect the views of different stakeholders and to consider differential effects within different local contexts.Plan of InvestigationUsing a theory driven evaluation framework, the evaluation will employ mixed methods (quantitative and qualitative approaches) to conduct process, outcome and impact evaluation. Data collection will include: available statistics (alcohol attributable hospital admissions) nationally and within selected local areas; a semi-structured interview with all Regional Alcohol Managers; a semi-structured telephone survey with representatives of 40 PCTs; 5 case study PCTs, researched using local documentation, and semi-structured interviews with local stakeholders/ relevant professionals. Two stakeholder meetings and consultation in case study areas will provide 'reality' checks on the design and conduct of the evaluationPotential ImpactThe evaluation will aim to reach a wide target group nationally and locally policy makers, practitioners, academics, through publications in a range of formats, seminars, local feedback sessions and stakeholder meetings. If appropriate, media interest will be encouraged to raise public awareness. Each case study area will generate reports of local interest. The evaluation will also highlight possible inequalities in policy effects on different social groups and on service structures/provision in different local contexts. It will provide a constructive critique of the usefulness of alcohol attributable hospital admissions as an outcome indicator. Process evaluation and a critical theoretical approach will facilitate understanding of the potential of the AIP model to achieve change.