Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK.

Williams, Roger and Alexander, Graeme and Aspinall, Richard and Batterham, Rachel and Bhala, Neeraj and Bosanquet, Nick and Severi, Katherine and Burton, Anya and Burton, Robyn and Cramp, Matthew E and Day, Natalie and Dhawan, Anil and Dillon, John and Drummond, Colin and Dyson, Jessica and Ferguson, James and Foster, Graham R and Gilmore, Ian and Greenberg, Jonny and Henn, Clive and Hudson, Mark and Jarvis, Helen and Kelly, Deirdre and Mann, Jake and McDougall, Neil and McKee, Martin and Moriarty, Kieran and Morling, Joanne and Newsome, Philip and O'Grady, John and Rolfe, Liz and Rice, Peter and Rutter, Harry and Sheron, Nick and Thorburn, Douglas and Verne, Julia and Vohra, Jyotsna and Wass, John and Yeoman, Andrew (2018) Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK. Lancet (London, England), 392 (10162). pp. 2398-2412. ISSN 1474-547X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.thelancet.com/journals/lancet/article/...

Abstract

This report presents further evidence on the escalating alcohol consumption in the UK and the burden of liver disease associated with this major risk factor, as well as the effects on hospital and primary care. We reiterate the need for fiscal regulation by the UK Government if overall alcohol consumption is to be reduced sufficiently to improve health outcomes. We also draw attention to the effects of drastic cuts in public services for alcohol treatment, the repeated failures of voluntary agreements with the drinks industry, and the influence of the industry through its lobbying activities. We continue to press for reintroduction of the alcohol duty escalator, which was highly effective during the 5 years it was in place, and the introduction of minimum unit pricing in England, targeted at the heaviest drinkers. Results from the introduction of minimum unit pricing in Scotland, with results from Wales to follow, are likely to seriously expose the weakness of England's position. The increasing prevalence of obesity-related liver disease, the rising number of people diagnosed with type 2 diabetes and its complications, and increasing number of cases of end-stage liver disease and primary liver cancers from non-alcoholic fatty liver disease make apparent the need for an obesity strategy for adults. We also discuss the important effects of obesity and alcohol on disease progression, and the increased risk of the ten most common cancers (including breast and colon cancers). A new in-depth analysis of the UK National Health Service (NHS) and total societal costs shows the extraordinarily large expenditures that could be saved or redeployed elsewhere in the NHS. Excellent results have been reported for new antiviral drugs for hepatitis C virus infection, making elimination of chronic infection a real possibility ahead of the WHO 2030 target. However, the extent of unidentified cases remains a problem, and will also apply when new curative drugs for hepatitis B virus become available. We also describe efforts to improve standards of hospital care for liver disease with better understanding of current service deficiencies and a new accreditation process for hospitals providing liver services. New commissioning arrangements for primary and community care represent progress, in terms of effective screening of high-risk subjects and the early detection of liver disease.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
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Depositing User: Miss Emily Johnson
Date Deposited: 04 Mar 2019 12:55
Last Modified: 04 Mar 2019 12:55
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1887

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