NICE Guidance on Compulsory Alcohol Education

Peter Russell

February 08, 2019

The National Institute for Health and Care Excellence (NICE) issued draft guidance this week on plans for compulsory education in secondary schools in England about the dangers posed by alcohol.

It also produced a final quality standard on sexual health, with a call to offer free condoms in pharmacies and universities.

Meanwhile, Public Health England (PHE) produced an update in its investigation into a rise in cases of acute flaccid paralysis across the UK.

Alcohol Education

A Government plan to make alcohol education a compulsory component of personal, social and health education (PSHE) in all state-funded schools in England from September 2020 was backed by NICE.

It said the draft guidance  supported classroom discussion and wider school policies to embed a 'whole-school approach' as recommended by the Department for Education's plan.

NICE acknowledged that recent evidence suggested a decline in alcohol consumption amongst young people in recent years. 

However, appraisers said 'risky' drinking could still be an issue for some young people and that some children could be more vulnerable to alcohol misuse.

The guideline said some pupils could therefore benefit from targeted intervention, although it was important not to stigmatise individuals.

Prof Gillian Leng, deputy chief executive of NICE, said: "There are many examples of schools that deliver very good alcohol education. The updated NICE guideline reinforces best practice and helps schools provide alcohol education that fits into the new era of PSHE.

"We have also made a number of research recommendations to help develop the evidence base for the future, in an area that is vital in helping young people make informed, healthy decisions."

Joanne Boyd, a member of the guideline committee and a trainer at Humankind, which provides the County Durham Drug and Alcohol Recovery Service, commented: "For young people to leave school with healthy lives ahead of them, they need to be educated so they can make informed choices and be aware of the consequences of alcohol consumption.

"This guideline will help ensure that alcohol education isn't a one-off topic, and that schools provide age-appropriate and accurate information."

A 2018 study by University College London, found that 29% of those aged 16 to 24 in 2015 said they never drank alcohol, up from 18% in 2005. 

The proportion who had not drunk in the last week rose from 35% to 50%.

The proposal was put out for consultation until the 22nd March, with final guidance expected in August 2019.

Sexual Health

A range of schemes to distribute condoms was recommended by NICE in a final quality standard on sexual health.

It also said that people who contact a sexual health service should be given an appointment within 2 working days.

Following diagnosis, individuals with a sexually transmitted infection should be helped to notify their partners, which could be undertaken by the patient or healthcare professional.

Also:

  • People should be asked about their sexual history at key points of contact

  • People identified as being at risk of sexually transmitted infections should have a discussion about prevention and testing

  • Men who have sex with men should be offered repeat testing every three months if they are at increased risk of sexually transmitted infections

The standard called for free condoms and advice to be given in community settings such as pharmacies, universities, and further education colleges.

In 2017, there were 422,147 diagnoses of STIs made in England, which was around the same number reported in 2016.

Acute Flaccid Paralysis Investigation

There were 40 cases of acute flaccid paralysis (AFP) in the UK during 2018, according to updated information from Public Health England (PHE).

Figures were released as part of an investigation by PHE into the rare condition which affects the nervous system, causing one or more limbs to become weak or floppy, and could be confused with symptoms of polio.

PHE said that until August last year, six cases had occurred across the UK. However, this was followed by a rapid rise in incidence, peaking during October.

Dr Mary Ramsay, head of immunisations at PHE, said: "Our investigations into potential causes are ongoing, and we are continuing to build better awareness amongst health care professionals about how to test and manage patients with AFP.

"We are not clear whether all of the apparent increase is real, or whether this represents increased awareness and diagnosis over recent years. The current best theory is that this is a very rare consequence of enterovirus infection, as the increase coincides with increases in infection.

"Enterovirus D68 (EV-D68) has been found in around one quarter of cases. However, as the infection is very common, and most children have been infected by the age of 5 years, there must be other factors involved."

Acute Coughs

NICE updated its guidance on antimicrobial prescribing for patients with an acute cough.

It included a two-page visual summary of the recommendations, including tables to support prescribing decisions.

It repeated advice not to offer antibiotics to treat an acute cough associated with an upper respiratory tract infection in people who are not systemically very unwell or at higher risk of complications.

Canadian Collaboration

NICE announced this week it would collaborate with its counterpart, the Canadian Agency for Drugs and Technology in Health (CADTH), to offer parallel scientific advice to the life sciences industry.

The two health technology assessment (HTA) agencies, which were said to share many common methodologies, planned to find ways of helping pharmaceutical companies that target the English and Canadian markets.

Jeanette Kusel, director of NICE Scientific Advice said: "We recognise the inherent difficulties faced by developers in designing clinical trial programmes that meet the precise requirements of multiple international markets. This new collaboration with CADTH uses the synergies between the English and Canadian systems and provides companies with comprehensive and practical advice from both countries through a single, streamlined process."

Michelle Mujoomdar, acting vice president of evidence standards at CADTH said: "This exciting new international collaboration between two established HTA bodies will help pharmaceutical companies develop relevant evidence for CADTH and NICE while streamlining the process of obtaining advice in two distinct markets."

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