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Alcohol-related risk reduction GMS contract requirements

It is a contractual requirement for practices to identify newly-registered patients who are drinking at increased or high-risk levels. Patients identified as at risk should also be screened for depression

Patients identified as at risk should also be screened for depression (Picture: iStock)
Patients identified as at risk should also be screened for depression (Picture: iStock)

Practices are required to identify newly-registered patients aged 16 or over drinking at increased or higher levels using either the FAST or AUDIT-C tools.

Once identified patients should receive simple brief advice and referred to specialist services where appropriate. These patients should also be assessed for anxiety and/or depression and provided with treatment or advice.

Initial screening

  • Screening applies to all patients registered within the financial year who are aged 16 or over at the time the short case finding test is applied.
  • Practices are required to screen patients using either the FAST or AUDIT-C tools which each take about one minute to complete. A score of 3 or more with FAST and 5 or more with AUDIT-C is regarded as positive.

Full screening

  • All patients with a positive score should be screened using the remaining questions in the 10-question AUDIT questionnaire to establish if increasing, higher risk or likely dependent drinking
    • 0-7 indicates sensible or lower risk drinking
    • 8-15 is increasing risk drinking
    • 16-19 is higher risk drinking
    • 20 and over indicates possible alcohol dependence
  • Practices should add a value to the field associated with the code in the patient’s record.
  • Patients scoring between 8 and 15 should be offered brief intervention, those with a score of 16 to 19 should be offered brief intervention or brief lifestyle counselling (20-30 minutes), or be referred to a community-based counselling service.
  • The recommended brief advice should take around 5 minutes. Click here for details and see ‘other resources’ below for patient literature to support this.
  • Patients with a score of over 20 should be considered for referral to specialist services.
  • Those identified as drinking at increasing or higher levels (scoring 8 or more) should be offered an assessment  for anxiety and/or depression using  questionnaires such as the Generalised Anxiety Disorder Scale-7 (GADS-7) and/or Patient Health Questionnaire (PHQ-9).
  • Patients found suffering from anxiety and/or depression should be provided with treatment and support as appropriate, which may include therapy, counseling and medication.
  • In severe cases referral to specialist mental health services may be appropriate.

Read codes

  Read v2 Read CTV3
Alcohol – initial screening
FAST alcohol screening test 388u. XaNO9
Alcohol use disorder identification test consumption questionnaire 38D4. XaORP
Alcohol assessment declined - enhanced services administration 9k19. XaPKl
Alcohol consumption screening test declined
8IA7. XaNOA

There are no codes available which indicate a positive FAST or AUDIT-C test result. Practices should add a value to a field associated with the code. A value of three or more is regarded as positive for FAST and a value of five or more is regarded as positive for AUDIT-C.

Alcohol – Full screening
Alcohol use disorders identification test 38D3. XM0aD
Alcohol use disorders identification test declined 8IH4.   
XabYP

Practices are required to add a value to a field associated with the code to record the score. The score are as follows:

  • 0–7 indicates sensible or lower risk drinking
  • 8–15 indicates increasing risk drinking
  • 16–19 indicates higher risk drinking
  • 20 and over indicates possible alcohol dependence.
Alcohol - intervention
Brief intervention for excessive alcohol consumption completed 9k1A. XaPPv
Extended intervention for excessive alcohol consumption completed 9k1B. XaPPy
Referral to specialist alcohol treatment service 8HkG. XaORR
Brief intervention for excessive alcohol consumption declined 8IAF. XaPty
Extended intervention for excessive alcohol consumption declined 8IAt. XaX4s
Declined referral to specialist alcohol treatment service 8IAJ. XaPwp
Anxiety and depression
Anxiety screening 6897. Xab9E
Anxiety screening using questions 68970 Xab9F
Depression screening using questions 6896. XaLIc
Generalised anxiety disorder 2 scale 38QN. XaZJQ
Generalised anxiety disorder 7 item score 388w. XaNkT
Patient health questionnaire (PHQ-9) score 388f. XaLDN
HAD scale: depression score 388P. XaIwf
Beck depression inventory second edition score 388g. XaLLG
Patient given advice about management of anxiety Xab9Gpneumoc 8CAZ0
Patient given advice about management of depression 8CAa. XaKEz

Other resources

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