Evaluating the Diversion of Alcohol-Related Attendances (EDARA)

This project will evaluate the effectiveness, cost-effectiveness, efficiency and acceptability of Alcohol Intoxication Management Services (AIMS) in managing alcohol-related Emergency Departments’ attendances.

AIMS are designed to receive, treat and monitor intoxicated patients who would normally attend Emergency Departments and to lessen the burden that alcohol-misuse places on unscheduled care. They are usually located close to areas characterised by excessive intoxication and are open at times when levels of intoxication peak (eg Friday and Saturday nights).

AIMS therefore offer the potential to mitigate some of the pressures on Emergency Departments as well as ambulance services and the police at times when there is a sustained increase in demand.

Project aims

This project aims to:

• Explore barriers and facilitators of AIMS implementation from the perspective of frontline staff by examining the impact of AIMS on the frontline work setting and on practitioners’ working lives;
• Identify the key ingredients required for successful implementation of AIMS in order to lead on the co-production of guidance on AIMS development and implementation;
• Establish the acceptability of AIMS to users;
• Investigate how the implementation of AIMS affect Emergency Departments users’ experience;
• Determine the effect of AIMS implementation on key performance indicators across health and ambulance services;
• Consider secondary effects of AIMS implementation such as ambulance response times and reduction in violent assaults through increased police presence; and
• Identify set-up and running costs for AIMS, resolve costs by sector (health, ambulance and police), before, during and after AIMS setup, and quantify AIMS benefits in order to establish the cost-effectiveness of AIMS.

Funding

The project is funded by National Institute for Health Research Health Services and Delivery Research Programme. It started in January 2016 and will run for 30 months with £925,000 funding.

Study sites

The project has chosen the AIMS in Cardiff, Swansea, Manchester, Middlesbrough, Newcastle, Norwich and Hereford as intervention sites and Sheffield, Hull, Nottingham, Northampton, Sunderland and Newport as control sites. Ethnographic case studies will be carried out in Cardiff, Swansea and Sheffield.

Investigators

Principal investigator

Professor Simon Moore, School of Dentistry, Cardiff University

Co-Investigators

• Professor Davina Allen, School of Healthcare Sciences, Cardiff University
• Professor Petra Meier, School of Health and Related Research, University of Sheffield
• Professor Steve Goodacre, School of Health and Related Research, University of Sheffield
• Professor Alan Brennan, School of Health and Related Research, University of Sheffield
• Professor Alicia O’Cathain, School of Health and Related Research, University of Sheffield
• Dr Vaseekaran Sivarajasingam, School of Dentistry, Cardiff University
• Professor Jonathan Shepherd, School of Dentistry, Cardiff University
• Dr Tracey Young, School of Health and Related Research, University of Sheffield
• Andy Irving, School of Health and Related Research, University of Sheffield
• Dr Penny F Buykx, School of Health and Related Research, University of Sheffield

Project Managers

• Andy Irving, School of Health and Related Research, University of Sheffield
• Dr Yu-Chiao Wang, School of Dentistry, Cardiff University

EDARA Study Steering Committee

Independent members

• Professor Helen Snooks (Chair, Swansea University)
• Professor David Ford (Swansea University)
• Mr Clive Henn (Public Health England)
• Dr James Nicholls (Alcohol Research UK)
• Dr Richard Mendelsohn (Birmingham South Centre Clinical Commissioning Group)
• Mr Steve Irving (The Association of Ambulance Chief Executives)
• Dr Jon Heron (University of Bristol)
• Mr Henry Yeomans (Wales Involving People PPI)
• Dr Margaret Heslin (Institute of Psychiatry, London)
• Mr Andrew Misell (Alcohol Concern Cymru)
• Mr Colin Shevills (Balance)
• Mr Greg Lloyd (Welsh Ambulance Service)
• Dr Lesley Graham (NHS National Services Scotland)
• Lee Ferguson (Deloitte)
• David MacKintosh (London Drug and Alcohol Policy Forum)
• Ian Graham (Metropolitan Police Service)

Non-independent members

• Mr Wayne Parsons (University Hospital of Wales, Cardiff)
• Professor Shantini Paranjothy (Cardiff University)
• Professor David Fone (Cardiff University)

Research team members

• Professor Simon Moore (Cardiff University)
• Professor Steve Goodacre (University of Sheffield)

Patient and Public Involvement

EDARA project is working with three PPI groups:

• The Involving People Network
  • The Involving People Network covers patients and groups familiar with acute care in Wales and will provide the project with essential perspectives on the reality of drinking culture and related treatment.
• The Sheffield Emergency Care Forum (SECF)
  • The Sheffield Emergency Care Forum (SECF) have an established track record of supporting high quality emergency care research. Members come from diverse backgrounds offering representation from local ambulance service personnel.
• The Sheffield Addiction Recovery Research Panel (ShARRP)
  • The Sheffield Addiction Recovery Research Panel (ShARRP) provides a source of patient experiences from drug and alcohol treatment service users and family/carers.

Project contact

Professor Simon Moore, School of Dentistry, Cardiff University