22. In Schedule 5 to the PMS Agreements Regulations (other contractual terms), after paragraph 13 (list of patients) insert—
13ZA.—(1) Where under paragraph 13 a patient has been—
(a)accepted onto the contractor’s list of patients; or
(b)assigned to that list by the Board,
the contractor must take action to identify any such patient over the age of 16 who is drinking alcohol at increasing or higher risk levels with a view to seeking to reduce the alcohol related health risks to that patient.
(2) The contractor must comply with the requirement in sub-paragraph (1) by screening the patient using either one of the two shortened versions of the World Health Organisation Alcohol Use Disorders Identification (“AUDIT”) questionnaire(1) which are known as—
(a)FAST (which has four questions); or
(b)AUDIT-C (which has three questions).
(3) Where, under sub-paragraph (2), the contractor identifies a patient as positive using either of the shortened versions of the AUDIT questionnaire specified in sub-paragraph (2), the remaining questions of the full ten question AUDIT questionnaire are to be used by the contractor to determine increasing risk, higher risk or likely dependent drinking.
(4) Where a patient is identified as drinking at increasing or higher risk levels, the contractor must—
(a)offer the patient appropriate advice and lifestyle counselling;
(b)respond to any other need identified in the patient which relates to the patient’s levels of drinking, including by providing any additional support or treatment required for people with mental health issues; and
(c)in any case where the patient is identified as a dependent drinker, offer the patient a referral to such specialist services as are considered clinically appropriate to meet the needs of the patient.
(5) Where a patient is identified as drinking at increasing or higher risk levels or as a dependent drinker, the contractor must ensure that the patient is—
(a)assessed for anxiety and depression;
(b)offered screening for anxiety or depression; and
(c)where anxiety or depression is diagnosed, provided with any treatment and support which may be required under the agreement, including referral for specialist mental health treatment.
(6) The contractor must make relevant entries, including the results of the completed questionnaire referred to in sub-paragraph (2), in the patient’s record that the contractor is required to keep under paragraph 70.”.
The World Health Organisation Alcohol Use Disorders Identification Test (AUDIT) questionnaire can be accessed at http://www.who.int/substance_abuse/activities/sbi/en/. Further information about the test, and the questionnaires themselves, are available in hard copy from NHS England, PO Box 16738, Redditch, B97 7PT.