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Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses.Two postal surveys of all NHS general hospital Trusts in England, the first in 2000 (n=138; 54% response rate) and the second in 2003 after the publication of the Royal College of Physicians (RCP) report on alcohol in secondary care (n=164; 75% response rate).Between the two surveys, there was a significant increase (P=0.005) in the number of dedicated alcohol nurses employed by general hospital trusts; however, the numbers remain low (n=21). Additionally, the availability of prescribing guidelines for the management of alcohol withdrawal increased significantly (P=0.0001).The survey indicates that most general hospitals do not have appropriate services in place to deal with such patients. Although there is a need and willingness to develop alcohol services in general hospitals, which is one of the key recommendations of the RCP report, the lack of funding is going to act as a major barrier.