Addressing the liver disease crisis in Wales: next steps for a new Government and Senedd Cymru

Posted on: 30th June 2021

The Welsh Government has led the way by being the first UK country to have a specific plan to address liver disease. Their 2015 Together for Health – Liver Disease Delivery Plan; A Delivery Plan for NHS Wales and its Partners to 2020, extended to March 2022, provides a comprehensive plan to manage liver disease in Wales.

Since the launch of the Together for Health – Liver Disease Delivery Plan, there have been early stage signs of improvement across some indicators for those diagnosed with liver disease. However, with the cessation of the Government’s Plan in March 2022, the British Liver Trust is now calling on the new Welsh Government to confirm the next steps in managing liver disease in Wales.

Liver disease remains a significant non-communicable disease. Chronic liver disease has doubled over the past twenty years and is now the biggest cause of death in those aged between 35-49 years. Obesity, alcohol and hepatitis are the most common causes of liver disease. The proportion of children and adults in Wales who are of a healthy weight is dropping and around 60% of adults are overweight or obese[1].  Approximately 330 people die from alcohol-related liver disease in Wales every year[2]. There are also an estimated 8,000 people infected with hepatitis C in Wales[3].

To support awareness around liver disease and to provide tangible proposals, the British Liver Trust has published a policy report, Sound the Alarm on Liver Disease in Wales: A call to action. The Trust has shared this report with Members of the new Senedd and the newly appointed Minister for Health, Baroness Eluned Morgan, following the elections on the 6th of May.

Sound the Alarm on Liver Disease in Wales: A call to action

Sound the Alarm on Liver Disease in Wales is calling for urgent action to improve liver disease awareness, prevention, treatment and outcomes. The Report provides ten clear policy proposals to develop the work and progress already made by the Government’s Together for Health – Liver Disease Delivery Plan.

The ten-point ‘call to action’ provides proposals for improving pathways for the early detection of liver disease, service improvements to weight and alcohol support, the elimination of hepatitis C, improvements in education and support for patients and an increase in hepatologist, specialist nurses and transplant referrals. These ten policy proposals provide a basis to inform future planning and next steps.

The Report and the ten-point action plan is backed by Consultant Hepatologist, Dr Andrew Yeoman, who said; “We have made some progress in improving liver health across Wales. It is vital that we now build on this work. I would urge all Members of the Senedd and policy-makers to turn these recommendations into actions, so we can reduce unnecessary liver disease mortality.”

The ten-point call to action is to;

  1. Include liver disease as part of general health checks, when checking for other non-communicable diseases.
  2. Increase access to tier 3 and 4 weight management services across Wales.
  3. Actively support those suffering the effects of alcohol misuse in Wales, through the statutory backing of 24-7 Alcohol Care Teams in all Health Boards.
  4. Deliver the ‘Healthy Weight: Healthy Wales’ programme to create an environment where healthier choices are the easiest choices for people in Wales.
  5. Ensure that effective testing is offered for viral hepatitis to all ‘at-risk’ groups and that Wales meets the WHO 2030 target to eliminate hepatitis C.
  6. Ensure the successful delivery of the ‘All Wales Liver Disease Pathway’.
  7. Increase the number of hepatologists; ensuring that patients have access to specialist treatment and support regardless of the geographical area in which they live.
  8. Every patient with cirrhosis in Wales to have access to a specialist liver nurse, regardless of the geographical area in which they live.
  9. Improve access to local services and support through better signposting and patient involvement.
  10. Increase the number of referrals for liver transplants in Wales.

Pamela Healy, CEO at The British Liver Trust said: “Wales has led the way with the ‘Liver Disease Delivery Plan’, which is showing some signs of improving outcomes for those diagnosed with liver disease. We now need the Government to confirm plans for the next steps after March 2022, to ensure this momentum is not lost. We are calling on Members of the Senedd to back our proposals and to ensure the Government commits to build on its success.”

Senedd event

To build on the Sound the Alarm on Liver Disease in Wales: A call to action Report and raise awareness around liver disease with Members of the new Senedd, the British Liver Trust plans to hold a virtual event on Tuesday the 19th of October. All Members of the Senedd, families and staff, as well as healthcare professionals, the Liver Disease Implementation Group, third sector organisations, civil servants, clinicians and regional stakeholders will be invited to attend.

Members of the Senedd and guests will join Dr Andrew Yeoman, Consultant Hepatologist, Pamela Healy OBE, CEO of the British Liver Trust, patients and other speakers to discuss the future policy approach to managing liver disease in Wales after March 2022.

Vanessa Hebditch, Director of Communications and Policy at British Liver Trust said: “We have a really exciting policy and awareness programme in Wales, which will keep liver disease front and centre on the new Senedd’s agenda. We have provided a comprehensive set of proposals in our Report Sound the Alarm on Liver Disease in Wales, to provide options for the next steps in Wales. The Government has made some progress addressing liver disease but there is still much more to do. We look forward to working in collaboration with Senedd Members to drive future improvements.”

[1] https://phw.nhs.wales/topics/overweight-and-obesity/

[2] AlcoholAndHealthInWales2014_v2a.pdf

[3] Campaigning in Wales | Hepatitis C Trust (hepctrust.org.uk)