Unacceptable failures: the final report of the Lancet Commission into liver disease in the UK

Posted on: 29th November 2019

Unacceptable failures: the sixth report of the Lancet Standing Commission on liver disease in the UK, published today, stresses the continuing increase in burden of liver disease from excess alcohol consumption and obesity, with high levels of hospital admissions which are worsening in deprived areas.

Vanessa Hebditch, Director of Policy and Communications at the British Liver Trust, says: “This latest report highlights the unacceptable burden of liver disease in the UK. 90% of liver disease is preventable, yet it is expected to overtake heart disease as the biggest cause of premature death in the UK in the next few years. Too many patients are diagnosed at late stage when there are very limited options for treatment.

"The next Government needs to take urgent action to address this crisis, including introducing fiscal measures to reduce alcohol consumption and obesity and improving legislation on marketing and labelling. We also need much more effective pathways to diagnose patients early so that effective treatments and lifestyle intervention advice can be given."

The report highlights how:

  • Only with comprehensive food and alcohol strategies based on fiscal and regulatory measures (including a minimum unit price for alcohol, the alcohol duty escalator, and an extension of the sugar levy on food content) can the disease burden be curtailed.
  • Following introduction of minimum unit pricing in Scotland, alcohol sales fell by 3%, with the greatest effect on heavy drinkers of low-cost alcohol products.
  • The major contribution of obesity and alcohol to the ten most common cancers as well as measures outlined by the departing Chief Medical Officer to combat rising levels of obesity - the highest of any country in the west.
  • The mortality of severely ill patients with liver disease in district general hospitals is unacceptably high, indicating the need to develop a masterplan for improving hospital care.
  • The lack of awareness about liver disease in the general population

Specialist hospital centres

The Lancet Commission proposes a plan based around specialist hospital centres that are linked to district general hospitals by operational delivery networks. The authors claim this plan has received strong backing from the British Association for Study of the Liver and British Society of Gastroenterology, but is held up at NHS England.

The Lancet Commission has serious doubts about whether the initiatives described in the Government’s Prevention Green Paper, with the onus placed on the individual based on the use of information technology and the latest in behavioural science, will be effective.

It calls for greater coordination between official and non-official bodies that have highlighted the unacceptable disease burden from liver disease in England in order to present a single, strong voice to the higher echelons of government.

The Lancet Commission into Liver Disease in the UK is supported by key health care organisations and charities including the British Liver Trust.

 

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