Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK
Year: 2018
Type: 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.
Source: The Lancet
Authors: Roger Williams, Graeme Alexander, Richard Aspinall, Rachel Batterham, Neeraj Bhala, Nick Bosanquet, Katherine Severi, Anya Burton, Robyn Burton, Matthew E Cramp, Natalie Day, Anil Dhawan, John Dillon, Colin Drummond, Jessica Dyson, James Ferguson, Graham R Foster, Ian Gilmore, Jonny Greenberg, Clive Henn, Mark Hudson, Helen Jarvis, Deirdre Kelly, Jake Mann, Neil McDougall, Martin McKee, Kieran Moriarty, Joanne Morling, Philip Newsome, John O'Grady, Liz Rolfe, Peter Rice, Harry Rutter, Nick Sheron, Douglas Thorburn, Julia Verne, Jyotsna Vohra, John Wass, Andrew Yeoman
Institutions: Foundation for Liver Research, University College London, Portsmouth Hospitals NHS Trust, Queen Elizabeth Hospital Birmingham, University of Birmingham, Imperial College London, Institute of Alcohol Studies, Public Health England, Peninsula College of Medicine and Dentistry, University of Plymouth, King's College Hospital, University of Dundee, King's College London, South London and Maudsley NHS Foundation Trust, Freeman Hospital, University Hospitals Birmingham NHS Foundation Trust, NIHR Birmingham Biomedical Research Centre, Queen Mary University of London, University of Liverpool, Royal College of General Practitioners, Newcastle University, Birmingham Women's Hospital, University of Cambridge, Wellcome/MRC Institute of Metabolic Science, Belfast Health and Social Care Trust, London School of Hygiene & Tropical Medicine, Bolton NHS Foundation Trust, Royal Bolton Hospital, University of Nottingham, University of Bath, National Institute for Health and Care Research, NIHR Southampton Biomedical Research Centre, University of Southampton, The Royal Free Hospital, Cancer Research UK, Churchill Hospital, Aneurin Bevan University Health Board
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $7,890
Funders: London School of Hygiene and Tropical Medicine, King's College Hospital NHS Foundation Trust, Nottingham University Hospitals NHS Trust, National Institute for Health and Care Research, Children's Liver Disease Foundation, King's College London, University College London, Chelsea and Westminster Hospital NHS Foundation Trust, Rosetrees Trust, University of Nottingham, British Liver Trust, Norgine, Medical Research Council
Awards: G1778884416, NIHR Senior Investigator Award, Diagnosing chronic liver disease in primary care: developing a cost effective care pathway, Developing and evaluating interventions for adolescent alcohol use disorders presenting through emergency departments, The effectiveness of adjunctive Medication Management and Contingency Management to enhance adherence to medications for relapse prevention in alcohol dependence, G6305209212, Maximising the health benefits gained from bariatric surgery, In-Practice Fellowship 2018, G8774195036
OpenAlex ID: W2901599804