Asked by: Paul Holmes (Conservative - Eastleigh)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to reduce waiting lists for liver transplants.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department works with NHS Blood and Transplant (NHSBT) as it continues to focus on saving the lives of those on the waiting list, and supporting safe organ transplantation from living and deceased donors. NHSBT has made changes to organ offering and allocation to maximise liver transplant opportunities for waiting list patients. They have also developed a United Kingdom wide living donor liver transplant programme to increase opportunities for patients on the waiting list to receive a living donor option. Additionally, NHSBT supports the use of liver perfusion devices across all transplant units to allow livers to be kept alive outside the body, to allow more patients to benefit. NHSBT’s marketing strategy also focuses on increasing transplantation through increased organ donor registrations. The strategy works to change the public’s perception and awareness of organ donation and inform how to register a donation preference.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what criteria were used to determine the cancer types selected for the evaluation of treatment and services by the Royal College of Surgeons and NHS England; and whether an assessment was made of the potential merits of including liver cancer in that study.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The cancer clinical audit review undertaken in 2021 was based on the level of variation apparent, based on proxy indicators and the difference in outcomes we might expect that variation to result in. This led to five new cancer clinical audits being commissioned in 2022, with liver cancer being taken into consideration during the selection process, but not proposed for an audit at that time.
As part of NHS England’s commitment to implementing wider NHS Long Term Plan actions relating to both cancer and liver disease detection and management, there have been discussions as to whether a review of adult liver services should be undertaken in the future. Should such a review take place, the Specialised Commissioning Hepatobiliary Clinical Reference Group will be a key contributor, working in collaboration with colleagues responsible for non-specialised aspects of the liver pathway, including the Hepatitis C and early diagnosis programmes, as well as integrated care boards. The case for a review of liver services will be considered in the context of available resources, taking into account the other priorities to be delivered by the NHS England specialised commissioning team, other related national programmes, and local commissioning teams.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment she has made of the effectiveness of (a) community liver health checks, (b) primary care pilots and (c) surveillance for hepatocellular carcinoma as part of NHS England's early detection of liver cancer programme.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The care of and treatment for patients with cancers, including liver cancer, is a priority for the Government. National Health Service cancer standards have been reformed with the support of clinicians to speed up diagnosis for patients, which means people will receive a diagnosis or have cancer ruled out within 28 days from urgent cancer referral from their general practice. NHS England’s Early diagnosis of Liver Cancer Programme is contributing to deliver the NHS Long Term Plan’s commitment to diagnose 75% of all cancers at stage one or two by 2028. Identifying those at risk and ensuring patients are tested and referred to a surveillance programme, where necessary, will lead to improved patient outcomes.
Asked by: Preet Kaur Gill (Labour (Co-op) - Birmingham, Edgbaston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the letter of 7 March 2023 from the then Minister for Social Care to the Chief Executive of the British Liver Trust, whether it remains his policy that fibroscans will be in use at 100 community diagnostic centres by March 2025; how many fibroscans have been delivered to community diagnostic centres since March 2023; and whether he has made an assessment of the potential merits of setting a new target.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
There is currently no national target specifically relating to the availability of FibroScan equipment, or testing for liver fibrosis, through Community Diagnostic Centres (CDCs) in England by March 2025.
The CDC modality offer is based on the recommendations in the Sir Mike Richards Review, in which Fibroscans were included as a suitable optional additional test for use in CDCs. Decisions on what modalities are offered outside of the core requirements of CDCs will be based on local need and decisions.
I can confirm there are currently plans for 12 CDCs to offer FibroScan testing, of which seven are operational. A further five CDCs plan to offer this service by the end of March 2024.
However, the Government takes very seriously the importance of preventative action, and of identifying patients at risk of liver disease and diagnosing it earlier. It is a fast-growing cause of mortality and morbidity; and one we want to make progress in tackling.
The Government is working with the National Health Service to support earlier diagnosis of liver disease and identifying patients at risk. This includes plans agreed as part of the £2.3 billion diagnostics transformation programme, including upgrading laboratory digital capabilities to ensure that labs across the country have the capability required to offer Intelligent Liver Function Tests. This test is highly effective as a first line diagnostic test to identify patients at higher risk, who may benefit from a FibroScan, or enhanced Liver function test.
The Government is also working with the NHS to deliver and consider the result from the pilot of the community liver health check programme – which in its first year delivered over 17,000 FibroScans to individuals at particular risk of liver disease, through the use of 40 FibroScanners, 12 of which were located in mobile units, across 19 local areas. This is in addition to wider work on health prevention, including vaccination and alcohol awareness programmes.
The Government will continue to look at options to go further. Over the coming year, NHS England are due to pilot a new diagnostic pathway it has developed for liver disease, which will include Fibrosis scanning in CDCs – we look forward to seeing the results of that pilot.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she plans to take steps to (a) roll out intelligent liver function testing nationally and (b) help ensure that Integrated Care systems implement pathways for early detection of liver disease.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is working with the National Health Service to support earlier diagnosis of liver disease and the identification of patients at risk. This includes plans agreed as part of the £2.3 billion of diagnostics transformation programme funding, to upgrade laboratory digital capabilities to ensure that labs across the country have the capability required to offer Intelligent Liver Function Tests.
Over the coming year, NHS England is due to pilot a new diagnostic pathway for liver disease, which will include fibrosis scanning in community diagnostic centres. The Government looks forward to seeing the results of that pilot.
Asked by: Wera Hobhouse (Liberal Democrat - Bath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of hospital admissions were due to liver disease in 2022-23.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Office for Health Improvement and Disparities publishes liver disease profiles. These provide data on the number and rate of hospital admissions for liver disease in England and local areas. The profiles currently include hospital admissions data up to the financial year ending 31 March 2022.
In the financial year ending 2022, there were 82,290 hospital admissions in England due to liver disease. The profiles do not include the proportion of all hospital admissions that are due to liver disease. Data on hospital admissions is updated regularly in the profiles, and data for the financial year ending 2023 will be published this summer.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate she has made of the rate of liver disease in (a) South Holland district, (b) South Kesteven district, and (c) Lincolnshire.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Office for Health Improvement and Disparities (OHID) publishes liver disease profiles that compare local areas within England. Data for the prevalence of liver disease is not collected. The profiles provide liver disease mortality and hospital admissions rates for local authorities to assess their level of disease.
The main findings for the South Holland Non-metropolitan District Council were that during 2022, the rate of mortality from liver disease in people under the age of 75 years old was 18.3, or between 10.8 to 28.9, per 100,000. In the financial year ending 2022 the hospital admission rate due to liver disease in all ages was 109.9, or between 50.8 to 178.0, per 100,000.
The main findings for the South Kesteven Non-metropolitan District Council were that during 2022 the rate of mortality from liver disease in people under the age of 75 years old was 13.3, or between 7.9 to 20.8, per 100,000. In the financial year ending 2022 the hospital admission rate due to liver disease in people of all ages was 80.9, or between 60.8 to 103.9, per 100,000.
The main findings from the profiles for Lincolnshire County were that during 2022 the rate of mortality from liver disease in people under the age of 75 years old was 19.5, or between 16.4 to 22.9, per 100,000. The Lincolnshire County rate was similar to the national mortality rate of 21.4 per 100,000. In the financial year ending 2022, the Lincolnshire County hospital admission rate due to liver disease in people of all ages was 144.3, or between 119.1 to 170.7, per 100,000 population. The Lincolnshire County hospital admission rate was similar to the national rate, of 150.6 per 100,000.
Asked by: Navendu Mishra (Labour - Stockport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 22 January 2024 to Question 8221 on Liver Diseases: Screening, what assessment has been made of the potential impact of the Government's planned measures on geographic variations in the provision of non-invasive liver scans in community diagnostic centres.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is aware that its planned measures will lead to geographic variation in the provision of non-invasive liver scans in community diagnostic centres (CDCs). This is because it is up to individual National Health Service integrated care boards to determine, based on local need and local diagnostic pathways, whether introduction of non-invasive liver scans in CDCs is necessary.
NHS England is reviewing existing liver fibrosis pathways as part of its wider diagnostic transformation work to determine the best approach for identifying patients at an earlier stage of liver disease. This includes looking at developing a pathway starting in primary care, making use of laboratory-based tests, as well as diagnostics in other settings such as CDCs.
Asked by: Theresa Villiers (Conservative - Chipping Barnet)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will take steps to ensure that all general practice clinicians have access to training on the (a) risk factors and (b) symptoms of liver (i) disease and (ii) cancer.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
General practitioners (GP) are responsible for ensuring their own clinical knowledge, including on liver disease and cancer, remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence, to ensure that they can continue to provide high quality care to all patients.
All doctors registered in the United Kingdom are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. In 2012 the GMC introduced revalidation which supports doctors in regularly reflecting on how they can develop or improve their practice, which gives patients confidence that doctors are up to date with their practice, and promotes improved quality of care by driving improvements in clinical governance. The training curricula for postgraduate trainee doctors is set by the Royal College of General Practitioners and must meet the standards set by the GMC.
Asked by: Peter Gibson (Conservative - Darlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 29 January 2024 to Question 10925 on Liver Diseases: Darlington, how much and what proportion of the £30,000 for County Durham and Darlington NHS Foundation Trust will be spent in Darlington.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The breakdown of funding requested is not held by the Department.