Asked by: Sharon Hodgson (Labour - Washington and Sunderland West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she has taken to tackle changes in the level of premature deaths caused by liver disease in women under 75 between 2001 and 2022.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Through the 2021 Drugs Strategy, we are making the largest ever single increase in drug and alcohol treatment and recovery funding, with £780 million of additional investment. Of this, £532 million is being invested to rebuild local authority commissioned drugs and alcohol treatment services in England. This is in addition to the funding invested through the Public Health Grant
By February 2024, the funding had enabled an additional 9,878 people to benefit from treatment for alcohol problems, where alcohol was their only substance misuse problem, and a further 6,258 people where, as well as their alcohol problems, they were also being treated for problems associated with non-opiate drug use.
Local authorities are responsible for understanding the drug and alcohol treatment needs of their local communities, and planning and commissioning services to meet that need, including ensuring women have good access to the most effective treatment. The Department supports them in doing this, with data and guidance.
The National Health Service’s piloting of early diagnosis and prevention through 19 community diagnostic hubs reached over 7000 people in 2022/23, and is identifying undiagnosed liver disease. The Community Liver Health Check pilot provides FibroScans in one-stop community clinics, where patients also have other investigations as required.
Beyond treatment and early diagnosis, we are committed to tackling alcohol harms, including reducing consumption levels, and in 2023 the Government introduced reforms to alcohol duty, meaning products are taxed directly in proportion to their alcohol content.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to ensure there are effective pathways for early detection of liver disease in Shropshire.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Early detection of liver disease is vital to enable interventions, and encourage behavioural changes that can potentially lead to recovery. Liver disease is one of the primary risk factors for liver cancer. Across the Shropshire, Telford, and Wrekin Integrated Care Board (ICB) area, the early detection of liver disease is led by primary care partners, and the ICB encourages general practitioners to follow best practice in the delivery of patient care pathways, to ensure the early detection of liver disease in patients. The Shrewsbury and Telford Hospital NHS Trust is working with primary care partners to increase awareness and provide tools to support this work. The hospital also carries out active outreach into the community for drug and alcohol patients.
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, pursuant to the Answer of 27 February 2024 to Question 381 on Liver Diseases: Screening, where the 12 Community Diagnostic Centres planned to have fibroscans are located; and what further plans she has to roll out fibroscans by March 2025.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
There are currently eight community diagnostic centres (CDCs) offering FibroScan testing, which are:
- Andover CDC in Andover, Hampshire;
- Bexhill CDC in Bexhill-on-Sea, East Sussex;
- Ely CDC in Ely, Cambridgeshire;
- Gloucestershire Quayside CDC in Gloucester, Gloucestershire;
- New QEII Hospital CDC in Welwyn Garden City, Hertfordshire;
- Poole Dorset Health Village CDC in Poole, Dorset;
- St Helens CDC in St Helen’s, Merseyside; and
- Woking Community Hospital CDC in Woking, Surrey.
There are six additional CDCs planning to offer Fibroscan testing in 2024/25, which are:
- Bolton CDC in Bolton, Lancashire;
- Bradford District and Craven CDC in Bradford, West Yorkshire;
- Northern Care Alliance Oldham CDC in Oldham, Greater Manchester;
- Peterborough CDC in Peterborough, Cambridgeshire;
- Wisbech CDC in Wisbech, Cambridgeshire; and
- Wood Green CDC in Haringey, London.
In total, NHS England plans to have rolled out FibroScan testing to 14 CDCs by 2024/25, and continues to explore further rollout of Fibroscans by March 2025.
Asked by: Sharon Hodgson (Labour - Washington and Sunderland West)
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 support the detection of liver disease in Washington and Sunderland West constituency.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Northern Cancer Alliance (NCA) is supporting services to enable the early detection of liver disease across the North East and North Cumbria (NENC) Integrated Care Board (ICB), including in the Washington and Sunderland West Constituency. The focus of work has been to support liver services across NENC to invite more than 80% of patients with cirrhosis, a type of liver disease, to monthly ultrasound surveillance. For 2024/25, the NCA has invested just over £200,000 into trusts across NENC to help improve their monitoring systems for cirrhosis patients.
The NENC ICB is also enrolled in a Community Liver Health Check pilot in Newcastle, being delivered by the system’s Hepatitis C Operational Delivery Networks. This will provide FibroScans in one stop community clinics where patients have relevant blood testing, liver ultrasound, and other investigations, as required. The pilot has expanded into North Tyneside and when resources allow, they intend to develop additional clinics across the area.
Asked by: Alison Thewliss (Scottish National Party - Glasgow Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the implications for her policies of the development of intelligent liver function tests by the University of Dundee; and if she will make it her policy to increase the rollout of these tests in areas with the highest levels of liver disease in England.
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 to identify patients at risk. This includes plans agreed as part of the £2.3 billion diagnostics transformation programme, to upgrade the digital capabilities of laboratories across the country and ensure that they have the capability required to offer Intelligent Liver Function Tests (iLFTs).
NHS England is reviewing the liver fibrosis pathways, and looking at developing a diagnosis pathway starting in primary care that will make use of both laboratory-based tests, such as iLFTs, and community diagnostic centres. The Government will make a further assessment of this work once it is complete, including the benefits of an increased rollout of iLFTs across England.
Asked by: Baroness Finlay of Llandaff (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of new data from the Office for National Statistics showing that alcohol-specific deaths are now 32.8 per cent higher than in 2019 and at an all-time high; and what steps they plan to take to tackle rising alcohol harm.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government keeps all official health data related to alcohol consumption and alcohol related harms under regular review. The 2021 Public Health England publication, Monitoring alcohol consumption and harm during the COVID-19 pandemic, found that increases in alcohol consumption since the beginning of the pandemic tended to be among people who were already heavy drinkers before this period, which may be a factor in the increase.
The most effective way to prevent alcohol specific deaths, is drinking within the United Kingdom Chief Medical Officers’ low-risk drinking guidelines, namely under 14 units per week. The Government is supporting people who drink above low-risk levels to reduce their alcohol consumption. As part of the NHS Health Check, questions are asked about alcohol consumption, and appropriate advice given to support people to make healthier choices. Those identified to be drinking at higher-risk levels are referred for liver investigation. The Department is also supporting people with alcohol dependency through the Drug Strategy and NHS Long Term Plan, by facilitating more people in need of treatment into local authority commissioned alcohol treatment services.
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, what steps her Department is taking to reduce levels of liver disease in Darlington constituency.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Through the 2021 Drugs Strategy we are making the largest ever single increase in drug and alcohol treatment and recovery funding, with £780 million of additional investment. Of this, £532 million is being invested to rebuild local authority commissioned substance misuse treatment services in England. As alcohol and drug services are commissioned together, this will benefit people seeking treatment for alcohol use.
In the financial years 2022/23 to 2024/25, Darlington has been allocated just over £1.9 million through the Supplementary Substance Misuse Treatment and Recovery Grant and Inpatient Detoxification Grant, to increase the number of people benefiting from alcohol and drug treatment and recovery services, and the outcomes they achieve. This is additional to the amounts invested through the Public Health Grant.
Work in the National Health Service, specifically piloting early diagnosis and prevention through 19 community diagnostic hubs, is identifying undiagnosed liver disease. The North East and North Cumbria Integrated Care Board is enrolled in a Community Liver Health Check pilot in Newcastle, being delivered by the system’s Hepatitis C Operational Delivery Networks. This will provide FibroScans in one-stop community clinics, where patients also have other investigations, as required. The pilot has expanded into North Tyneside, and when resources allow, they intend to develop clinics elsewhere.
Beyond treatment, we are committed to tackling alcohol harms including reducing consumption levels, and in 2023 the Government introduced reforms to alcohol duty, meaning products are taxed directly in proportion to their alcohol content.
Asked by: Gregory Campbell (Democratic Unionist Party - East Londonderry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an estimate of expected liver cancer mortality rates by the end of 2025.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
No estimate has been made of expected liver cancer mortality rates by the end of 2025. The care of and treatment for patients with cancer, including liver cancer, is a priority for the Government. Early diagnosis of liver cancer is critical to improving rates of survival. NHS England’s Early Diagnosis of Liver Cancer Programme is contributing to the NHS Long Term Plan’s commitment to diagnose 75% of all cancers at stage one or two by 2028. This programme includes three workstreams: improving liver surveillance programmes; community liver health checks pilots; and primary care pilots. 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: Jim Shannon (Democratic Unionist Party - Strangford)
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 increase public awareness of links between heart disease in women and alcohol consumption.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
The NHS Health Check is England’s cardiovascular disease prevention programme. It aims to prevent heart disease, stroke, diabetes, and kidney disease, and some cases of dementia among adults aged 40 to 74 years old. Each year the programme engages over one million people, including women, and prevents approximately 400 heart attacks or strokes. The provision of an alcohol risk assessment, and brief advice about alcohol harm, is a requirement in the NHS Health Check. The guidance to practitioners sets out that people identified as drinking at higher-risk levels should be referred for a liver check, as recommended by the National Institute for Health and Care Excellence. In addition, the United Kingdom’s Chief Medical Officer’s Low risk drinking guidelines and National Health Service guidance highlight that alcohol use is a risk factor for heart disease.
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.