News

The UK NSC has opened the annual call for new screening topics. It provides every individual, group or organisation with the opportunity to submit a proposal for a new screening programme. This window of opportunity closes at midnight on 4th December 2019.

If you wish to propose a new screening topic that is not already on the UK NSC list, the guidance, submission form and an example proposal are all available at the end of this link: https://www.gov.uk/government/publications/uk-nsc-evidence-review-process/appendix-d-how-to-submit-a-proposal-to-the-uk-nsc .

Please ensure you read through the guidance and use the template submission form which will guide you through all the requirements of a proposal.

For more information about the annual call please read our blog:
https://phescreening.blog.gov.uk/2019/09/05/annualcall2019/ 

Evidence Team
UK National Screening Committee
www.screening.nhs.uk 

A new report from the Sheffield Alcohol Research Group, commissioned by the Institute of Alcohol Studies, finds that almost 2,000 people in England, and 250 in Scotland, have died as a result of recent government cuts to alcohol duty.

Tax on alcohol has been reduced in real-terms in five of the last six Budgets, and, as a consequence, there are estimated to have been:
- over 100,000 additional crimes,
- 500,000 additional days of work lost, and
- over 61,000 additional hospital admissions.

This comes at a cost to the NHS of £341 million. The report also finds that reintroducing the duty escalator, which ensured that tax rates rose by 2% above inflation each year, could reverse these trends. A duty escalator in place until 2032 is estimated to save over 4,700 lives. The Independent has the story.

These findings come at a crucial time for the AHA duty campaign and to support the AHA campaign. BASL has sent a letter to the Chancellor, see below, highlighting the need to increase alcohol duty by 2% in the upcoming Budget.  

Download Letter to Chancellor-Duty Campaign October 2019.pdf

Officials at the Treasury have told the AHA that they noticed the increase in letters asking for alcohol tax increases, both from organisations and MPs, so the campaign is having a real impact. 

Press Release -  British Liver Trust

More than a quarter of people who die from liver disease in hospital have no previous admission in the year before their death

New data released today at the largest conference for liver clinicians reveals that around 5,200 people die from liver disease in hospital in England each year. Of these, 30% of those have not had an admission in the year before death. On admission to hospital time is of the essence in saving these seriously ill patients. 1 in 4 of those who die do not survive more than 3 days and 43% do not survive a week.

These are people with advanced liver disease and many of their lives could have been saved if they had been diagnosed earlier in primary or secondary care and had been given advice on risk factors like alcohol and management of their liver disease.

The analysis is being presented at the British Association for the Study of the Liver conference in Glasgow. The data also reveals that these deaths occur in relatively young people. 60% of these patients are under 64 years of age and that one in five are under the age of 50.

Liver disease has increased by 400% since 1970 and it’s the biggest cause of death in those aged between 35-49 years old in the UK (https://britishlivertrust.org.uk/about-us/media-centre/statistics/ ).

This new data highlights the urgent need for improvements in early detection of the disease as most patients are being diagnosed too late in an emergency setting.

Professor Matthew Cramp, president at BASL, says: “Many people with liver disease are unaware that they have it because there are usually have no symptoms in the early stages. Too often the first a patient knows about their liver disease is when they are admitted as an emergency to hospital with life threatening complications. Even with the doctors’ best efforts some patients are so ill that their life cannot be saved.”

“It’s vital that GPs and other healthcare professionals identify those at risk so that more patients are diagnosed at an early stage.”

The research used Office for National Statistics mortality data and Hospital Episode Statistics data supplied by NHS Digital. Other alarming facts highlighted by the research:

• 29.1% of the patients who died in hospital had no previous admission in the year
• 20.8% had only one previous admission in the year before they died
• 25.3% of those who die do not survive more than 3 days in hospital
• 43% of those who die do not survive more than a week in hospital.
• 2,230 liver patients die each year in hospital in a week or less from admission, that is 43 patients per week or 6 patients every day.
• The majority (60%) of those dying from liver disease in hospital are under the age of 64 and 20% are under the age of 50.
• At least two-thirds of the patients who died with no previous admission in the year before death died from alcohol related liver disease
• Patients admitted to hospitals with specialist liver services are more likely to be seen by a specialist in liver disease and be admitted to ITU

Professor Matthew Cramp, president at BASL, says: “Despite being young and very sick, many patients die from the disease without ever being seen or cared for by a specialist. Patients with life-threatening liver disease complications need to be recognised quickly when they arrive at hospital and should be seen by a specialist with knowledge of liver disease quickly and treated according to Guidelines.”

This study found that the chance of these patients being seen by a specialist (Gastroenterologist or hepatologist) and being admitted to ITU was higher if they were admitted to a hospital with specialist liver services.

Matthew Cramp adds: “Smaller hospitals should link with specialist hospitals to consult with experts or transfer patients if appropriate.”
Liver problems develop silently with no obvious symptoms in the early stages yet if caught early, the disease can be reversed through lifestyle changes. More than 90% of liver disease is due to three main risk factors: obesity, alcohol and viral hepatitis.

Pamela Healy, Chief Executive, British Liver Trust said, “This research highlights the liver disease epidemic we are facing in the UK. While the data presented is based on England only, this is likely to reflect the situation with liver disease in Scotland, Wales and Northern Ireland.”

To coincide with the BASL conference, The British Liver Trust’s Love Your Liver roadshow is at the University of Strathclyde today offering free liver health screening and scanning.

Pamela continues: “Helping people understand how to reduce their risk of liver damage is vital to address the increase in deaths from liver disease. Although the liver is remarkably resilient, if left too late damage is often irreversible. I would urge everyone who is unable to attend the roadshow to take our online screener on our website to see if they are at risk.”

ENDS

1. For additional information of please refer to the following:
• The 2nd Atlas of variation in risk factors and healthcare for liver disease in England published by PHE and NHS Rightcare in 2017: https://fingertips.phe.org.uk/profile/atlas-of-variation 
• There is an interactive version of the Atlas at http://tools.england.nhs.uk/images/LiverAtlas17/atlas.html 
2. The Love Your Liver Campaign focuses on three simple steps to Love Your Liver back to health:
i) Drink within recommended limits and have three consecutive days off alcohol every week
ii) Cut down on sugar, carbohydrates and fat, and take more exercise
iii) Know the risk factors for viral hepatitis and get tested or vaccinated if at risk
3. The roadshow comprises a mobile unit where people can take a free online screening test and find out if they are at risk. Free liver health scanning is also offered using a non-invasive device. Expert guidance on how to keep your liver healthy from healthcare profession.

Press Release - British Liver Trust

Minimum unit pricing in Scotland has had biggest impact on drinking patterns in Glasgow

Thursday 19th May 2019 - Evidence released today at the UK’s largest conference for liver experts shows that minimum unit pricing, introduced in Scotland in May 2018, may have had a significant impact amongst Scotland’s heaviest drinkers in Glasgow where there has been a reduction in alcohol-related deaths.

The research being presented at the British Association for the Study of the Liver (BASL) conference in Glasgow has important implications for MUP in England and the rest of the UK. The key findings are:

• Glasgow City has seen a 21.5% reduction in alcohol-related deaths from 2017 to 2018: 186 to 146.
• Almost half (44%) of the alcohol-related deaths in 2018 in Glasgow occurred before May 2018 when MUP was introduced.

Speaking at the BASL event, Dr Ewan Forrest, said when presenting the results:
“Glasgow has always had much higher levels of alcohol-related deaths than other parts of Scotland. This latest information suggests that MUP may be reducing alcohol-related harm in those at highest risk. More time is needed to assess the effect on MUP on the rest of Scotland and to get a clearer idea as to how MUP might affect the rest of the UK.”

Professor Matthew Cramp, President of BASL adds: “This early evidence suggests that implementing MUP does exactly what it is supposed to – it is a highly targeted measure that improves the health of the heaviest drinkers and those experiencing the most harm from alcohol whilst those who drink in moderation continue much as before.”

Scotland was the first country in the world to implement a minimum unit price for alcohol, following a ten-year campaign by health bodies including the British Liver Trust.

The Alcohol (Minimum Pricing) (Scotland) Act 2012 states that all alcohol sold through licensed premises in Scotland cannot be sold below a set minimum unit price (MUP). The MUP depends on the amount of alcohol contained in the product and is currently set at 50p per unit of alcohol.

Pamela Healy, Chief Executive of the British Liver Trust said, “We are facing a liver disease epidemic in the UK and a major reason for this is that as a nation we are drinking too much alcohol.

“There is good evidence that interventions such as minimum unit pricing (MUP), targeted taxes and marketing regulations reduce alcohol harm. Alcohol taxes have been cut repeatedly in real terms. The Government needs to look carefully at the outcomes from Scotland on MUP so that more lives can be saved.

The British Liver Trust is the largest UK charity for all adults with liver disease., which is the third leading cause of premature death. Their Love Your Liver roadshow is in Scotland this week raising awareness of the risk factors of the disease, including alcohol misuse.

The British Liver Trust urges everyone to take their online screening test to find out if they are at risk of liver disease: www.britishlivertrust.org.uk/screener .

The NIHR cross programme broad Liver Disease call has been approved – see https://www.nihr.ac.uk/funding/1993-liver-disease/21585 .

The closing date for outline applications is 13:00 hrs Wednesday 27th November 2019.