Asked by: Dan Carden (Labour - Liverpool, Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many alcohol-dependent patients in acute and mental health services were referred for a fibrosis assessment for liver disease in England in 2022.
Answered by Neil O'Brien
NHS England does not routinely collect national data on fibrosis assessment for liver disease. However, as part of the 2022/23 Cirrhosis and Fibrosis Commissioning for Quality and Innovation (CQUIN) indicator (CCG9), data were submitted from 88 acute and mental health trusts indicating 9,462 referrals of alcohol-dependent patients for an appropriate test
Asked by: Dan Carden (Labour - Liverpool, Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent steps he has taken to reduce the effect of stigma on late presentation and delayed diagnosis of alcohol-related liver disease.
Answered by Neil O'Brien
The Department is not currently taking specific steps to reduce the effect of stigma on presentation and diagnosis of alcohol-related liver disease. However, there is an ongoing focus on reducing the stigma attached to alcohol use including promoting public awareness of how to lessen alcohol consumption, a preventable risk factor for liver disease, through the NHS ‘Better Health’ campaign, making training to raise awareness of alcohol stigma freely available to NHS frontline staff via the NHS e-learning for healthcare website and specifying ‘provision of trust-wide education and training in relation to alcohol’ as an explicit responsibility for Alcohol Care Team (ACT) staff in the ACT Core Service Descriptor.
More broadly, through commitments in the Drug Strategy and NHS Long Term Plan, we are facilitating more people in need into local authority commissioned alcohol treatment. Additional treatment and recovery funding, made available through the Drug Strategy, can be used to increase capacity for screening for liver fibrosis in treatment settings and to establish effective referral pathways with hepatology.
Asked by: Virendra Sharma (Labour - Ealing, Southall)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the increased risk of developing (a) cardiovascular disease and (b) cancer among people with non-alcohol-related fatty liver disease.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
No specific assessment has been made.
Asked by: Daisy Cooper (Liberal Democrat - St Albans)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the adequacy of the present system for calculating the Transplant Benefit Score in the context of the potential increase in life expectancy for UK Cystic Fibrosis sufferers following the introduction in the NHS of elexacaftor-tezacaftor-ivacaftor triple combination therapy (Kaftrio).
Answered by Neil O'Brien
NHS Blood and Transplant constantly reviews the data around the National Liver Offering Scheme (NLOS) and Transplant Benefit Score (TBS) through the NLOS monitoring committee which is a sub-group of the Liver Advisory Group (LAG). Changes are made as required to ensure the right patients benefit at the right time. NLOS was updated on 4 October 2022 and the monitoring group will be reviewing the impact of these changes.
The severity of the liver disease, rather than the underlying cause, is what determines whether a patient will be listed for liver transplantation. Minimal listing criteria need to be met, in combination with the patient’s overall fitness and capability to successfully undergo a transplant procedure. Patients with cystic fibrosis (CF) will be assessed for liver transplant in exactly the same way as a patient with another liver disease, with blood and other tests plus clinical assessment by a multidisciplinary team.
Long term data showing Kaftrio therapy leads to reduced liver disease is not yet available. While improved outcomes for CF patients with this new treatment would be very welcome and may lead to more patients being eligible for liver transplant in future, it is not likely to make a significant impact on the existing offering process, which focuses on disease severity and predicted transplant benefit more than the underlying cause.
Asked by: Martyn Day (Scottish National Party - Linlithgow and East Falkirk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress his Department has made on implementing the recommendations made by the Liver Advisory Group in 2020 on liver transplantation for the treatment of perihilar cholangiocarcinoma and intra-hepatic cholangiocarcinoma.
Answered by Neil O'Brien
The Liver Advisory Group, on behalf of NHS Blood and Transplant (NHSBT), are exploring pilot programmes for selected patients with both small intra-hepatic cholangiocarcinoma and perihilar cholangiocarcinoma (pHCCa) with underlying primary sclerosing cholangitis.
The pathway for intrahepatic Cholangiocarcinoma is now live and there is an offering process in place which should ensure they receive a timely named patient offer. The protocol for pHCCa remains in development and will soon be live in the third quarter of this year. Additionally, in collaboration with NHS England, NHSBT are developing the pHCCa as a commissioning evaluation for the neoadjuvant pathway of proton beam therapy which is a ground-breaking intervention that is being evaluated in this clinical transplant pathway.
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 his Department is taking to monitor progress against the target to deliver FibroScan testing for liver fibrosis through Community Diagnostic Centres in England by March 2025.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
There is no national target specifically relating to the delivery of FibroScan testing for liver fibrosis through Community Diagnostic Centres in England by March 2025.
Diagnostic checks are a key part of many elective care pathways. The NHS’ Delivery Plan for tackling the COVID-19 backlog of elective care has an overall ambition that 95% of patients needing a diagnostic check will receive it within six weeks by March 2025.
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 assessment he has made of the potential merits of introducing FibroScans in primary care to improve early diagnosis of non-alcohol related fatty liver disease.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department has not made a specific assessment of the potential merits of introducing FibroScans in primary care to improve early diagnosis of non-alcohol related fatty liver disease. However, a practice has clinical discretion to decide if a FibroScan is necessary and appropriate for a patient and can either provide directly or through a provider, typically a hospital out-patient appointment.
In addition, NHS England have confirmed they have begun to assess the introduction of FibroScans through Community Diagnostic Centres. £2.3 billion is being spent to increase the number of Community Diagnostic Centres by March 2025, these centres will offer a range of services, with some providing services to support liver diagnosis . This will boost capacity to diagnose liver disease and improve earlier diagnosis and health outcomes.
Asked by: Peter Dowd (Labour - Bootle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to include provisions for (a) treatment of liver cancer and (b) tackling hepatitis C as a cause of liver cancer in the forthcoming Major Conditions Strategy.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Major Conditions Strategy will look at the treatment and prevention of cancer in people of all ages, covering the patient pathway. The Strategy will look at a wide range of interventions and enablers to improve outcomes and experience for cancer patients.
This Strategy will draw on previous work on cancer, including over 5,000 submissions provided to the Department as part of our Call for Evidence last year. We will continue to work closely with stakeholders, citizens and the National Health Service in coming weeks to identify actions for the Strategy that will have the most impact.
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, how many people were on the organ donation waiting list in the North West on 10 March 2023.
Answered by Neil O'Brien
NHS Blood and Transplant are responsible for organ donation in the United Kingdom. The following tables shows data transplant waiting list numbers for the North West as of 13 March 2023. Suspended indicates the patient has been temporarily removed from the list. This happens for such reasons as being too ill to undergo the operation or being absent.
Organ | Active | Suspended | Total |
Kidney | 598 | 524 | 1122 |
Kidney/pancreas | 43 | 38 | 81 |
Kidney & pancreas is | 5 | 2 | 7 |
Pancreas | 2 | 10 | 12 |
Pancreas islets | 0 | 1 | 1 |
Heart | 36 | 25 | 61 |
Lung(s) | 33 | 3 | 36 |
Liver | 80 | 14 | 94 |
Intestinal | 2 | 1 | 3 |
Other multi organ | 2 | 0 | 2 |
Total | 801 | 618 | 1419 |
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, what the average waiting time for an organ donation in the North West region was in the latest period for which data is available.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS Blood and Transplant are responsible for organ donation in the United Kingdom. Listing of registrations is by transplant centre rather than by patient address, therefore the following table shows the most recent median waiting times by organ and by centre.
Organ | Manchester Transplant | Liverpool Transplant Centre | Leeds Transplant Centre |
Kidney | 526 days | 425 days | N/A |
Pancreas | 272 days | N/A | N/A |
Lung | 272 days | N/A |
|
Liver | N/A | N/A | 74 days |
Heart non urgent transplant list | 856 days |
|
|
Heart urgent or super urgent transplant list | Super urgent: | N/A | N/A |
Urgent: |