Alcohol burden on Scottish ambulances ‘three times higher’ than previously thought, study shows

Ambulances in Scotland attended some 86,780 alcohol-related incidents in 2019, according to new research, which accounts for a whopping average of over 230 callouts per day.

Researchers from the Universities of Glasgow, Stirling and Sheffield, as well as representatives from the Scottish Ambulance Service (SAS), said this is greater than three times the figure previously estimated – and goes a long way to exposing the true burden of alcohol on Scotland’s health providers.

They also calculated that based on the average cost of an ambulance callout at the time, those related to alcohol alone cost SAS around £31.5m for that year.

The study, “Estimating the burden of alcohol on ambulance callouts through development and validation of an algorithm using electronic patient records”, is the first of its kind and comes after paramedics warned about the impact of alcohol on Scotland’s ambulances for years.

In the research, which was led by Francesco Manca and Professor Jim Lewsey at the University of Glasgow, and published in the International Journal of Environmental Research and Public Health, experts used data from SAS to build a highly accurate algorithm that searched paramedic notes in patient records for references to alcohol.

Applying this automated method to records from 2019, Mr Manca and Prof Lewsey found that one in six ambulance callouts (16.2 per cent) was alcohol-related. This rose to over one in four (28.2 per cent) on weekend evenings, categorised as happening between 6pm and 6am.

The data is crucial to understanding the cost of alcohol on Scottish people’s lives and to public services, because ambulances often represent a patient’s first – or even only – contact with professional health providers, the researchers note.

For instance, the algorithm confirmed that age and socioeconomic factors played a major part in determining who might call ambulances due to the effects of alcohol. While a quarter of callouts came from people under the age of 40, less than 7 per cent came from those aged 70 and above.

Meanwhile, of ambulance callouts to addresses in Scotland’s most deprived areas, 20 per cent were deemed to be alcohol-related while just 10 per cent could be identified in more affluent areas.

Prof Lewsey, who teaches medical statistics at the University of Glasgow, said his work proved “there is a high burden of alcohol on ambulance callouts in Scotland”. He also urged the Scottish government to use it when making any fresh alcohol legislation in the future.

“These [figures] can be used to monitor trends over time and inform alcohol policy decision making both at local and national levels,” he said. “Further, our methodological approach can be applied to other contexts for determining the burden of other factors to the ambulance service.”

The newly-created algorithm was found to be 99 per cent accurate at identifying callouts related to alcohol from ambulance notes, and saved experts masses of time compared to previous methods used to identify such incidents.

Prior methods, the study’s authors said, resulted in either large underestimates or used reports from staff surveys, which could not be tested for accuracy or routinely carried out in the same way this automated method can be.

Mr Manca and Prof Lewsey’s work was part of a wider study, led by the University of Stirling’s Prof Niamh Fitzgerald, which measures the impact of minimum unit pricing of alcohol on drink-related ambulance callouts in Scotland.

“As we emerge from the Covid-19 pandemic, we all want to protect NHS services for when they are most needed,” Prof Fitzgerald said.

“It is timely therefore to consider whether it is acceptable that over 230 ambulance callouts every day are linked to alcohol when we have policy solutions that can reduce this burden. We are also conducting further research to understand what types of callouts and drinking locations give rise to these figures and how they are experienced by paramedics.”

Dr Jim Ward, the medical director at SAS, added the study was “very welcome” as it gives the service a chance “to better understand the impact alcohol has on the demand for ambulance response”.

“Our frontline staff consistently see the serious effects unsafe levels of alcohol have on people’s lives and we would urge the public to drink responsibly,” he said.

Scotland has some of the strictest alcohol laws in the UK, with it being made illegal in 2010 for customers to purchase alcoholic drinks from stores and supermarkets after 10pm – seven days a week.

Under the Alcohol etc. (Scotland) Act 2010, Scots can only purchase alcohol between 10am and 10pm.