Liver health updates

August 2020 APPG on Liver Health update

APPG on Liver Health news

APPG on Liver Health Co-Chair Baroness Randerson this month tabled two written questions relevant to the APPG’s work, one on increasing provision of low dead space needles in needle and syringe exchanges in England (which are more effective for hepatitis C prevention purposes) and another on hepatitis C testing and treatment in prisons during the Covid-19 pandemic. Both are awaiting answer by a Government minister.

Public Health Minister Jo Churchill published answers to two questions tabled by APPG on Liver Health Vice Chair Virendra Sharma MP on 2019-20 hepatitis C treatment rates by operational delivery network area and including hepatitis C in the Public Health England (PHE) Public Health Outcomes Framework.

The Hepatitis C Trust, as the APPG on Liver Health secretariat, also worked with Mary Glindon MP to table two written questions on increasing needle and syringe provision for injecting drug users and what steps the Department of Health and Social Care is taking to reduce the number of new hepatitis C infections through improved harm reduction approaches. Both questions are awaiting an answer.

Liver news

The Hepatitis C Trust published a round-up of news and activity for World Hepatitis Day, which took place on 28th July. This included NHS Tayside announcing that it had achieved hepatitis C elimination in the area, as covered by the BBC. The Hepatitis C Trust also published statements of support for World Hepatitis Day from a range of political figures including Mayor of London Sadiq Khan, First Minister of Wales Mark Drakeford, Shadow Public Health Minister Alex Norris and Scottish Public Health Minister Joe FitzPatrick. APPG on Liver Health Co-Chair Sir David Amess also showed his support via Twitter.

The Institute of Alcohol Studies released a new briefing on alcohol consumption during the Covid-19 lockdown, which summarises the emerging evidence base on changes in UK alcohol consumption during the lockdown.

A study by King’s College London found an association between increases in alcohol-related hospital admissions and decreases in alcohol services, with the authors concluding that spending cuts to alcohol services represent a false economy since decreases in expenditure are linked to increased hospital admissions which inevitably are costly to society and the economy.

A University of Manchester-led project seeking to improve early diagnosis of liver disease has been awarded £4.5m in government and industry funding.

The Alcohol Health Alliance UK hosted a roundtable discussion with members of the Labour Shadow Health team in July, with the meeting including discussion of concerns over the predicted surge in demand for treatment following Covid-19 after treatment services reported a substantial drop in referrals since the start of lockdown.

British Liver Trust wrote twice to the Prime Minister this month, calling for improved labelling on alcohol products as part of the Government’s plans to reduce levels of obesity in the UK and calling for the implementation of measures in the Government’s Childhood Obesity Plan. 

A new study published in Nature Communications investigating the effectiveness of liver perfusion as a technique to improve the function of donor livers that would have otherwise been rejected has shown that up to 7 in every 10 could be used after just 4-6 hours of the assessment. A summary is available here.

The Telegraph published an obituary of Professor Roger Williams, who helped to create the UK’s first liver transplant programme and led The Lancet Commission on Liver Disease.

Relevant parliamentary activity

Parliamentary debates

A number of peers spoke in favour of an amendment in the House of Lords seeking to limit the relaxation of alcohol licensing in certain areas. During the debate, Baroness Meacher referred to the liver health implications of excessive alcohol use, noting that alcohol kills 7,000 to 8,000 people each year and is one of the leading preventable causes of death in the UK.

Parliamentary Questions

Fiona Bruce MP asked when the Government plans to publish an alcohol strategy. The minister’s response states that the Government does not believe a specific alcohol strategy to be necessary.

Lloyd Russell-Moyle MP asked what steps are being taken to ensure homeless people diagnosed with HIV and hepatitis C during the Covid-19 outbreak are retained in clinical care.

Jim Shannon MP asked about steps being taken to reduce alcohol-related hospital admissions.

July 2020 APPG on Liver Health update

APPG on Liver Health news

APPG on Liver Health Vice Chair Virendra Sharma MP this month tabled two Parliamentary Questions regarding hepatitis C, one asking for 2019-20 hepatitis C treatment rates by operational delivery network area and the other asking whether the Health and Social Care Secretary has made an assessment of the potential merits of including hepatitis C in the Public Health England (PHE) Public Health Outcomes Framework.

For both questions, the Department of Health and Social Care has indicated that it will not be possible to answer the question within the usual time period, saying an answer is being prepared and will be provided as soon as it is available.

Liver news

Guidance for those advised to ‘shield’ during the Covid-19 outbreak will change on 6th July and end on 31st July. British Liver Trust has updated its FAQs on shielding in all four nations of the UK here.

Outreach projects by NHS Trusts, The Hepatitis C Trust and other partners have been taking place across the country offering screening for hepatitis C and liver damage to previously homeless individuals being accommodated in hotels and hostels during the Covid-19 outbreak. A summary of the outreach work being done in Surrey is available here and in Leeds here.

HCV Action held a webinar on hepatitis C services in England during and beyond the Covid-19 outbreak on 18th June, featuring speakers from NHS England, The Hepatitis C Trust, substance misuse service Change Grow Live and the Nottingham Hepatitis C Operational Delivery Network. The full webinar can be viewed here and a summary report is available here. A webinar on hepatitis C services in Scotland during and beyond the Covid-19 outbreak will be taking place on 4th August at 2.30pm. You can see further details and register here.

The Alcohol Health Alliance is holding a ‘virtual drop-in’ for MPs on alcohol harm and Covid-19, taking place on 15th July. Further details here.

British Liver Trust has warned of a potential future rise in non-alcohol related fatty liver disease (NAFLD) following a new survey which revealed that four out of ten people in the UK have gained weight during lockdown. Read more on the warning here.

The BMJ reported on new analysis by Public Health Scotland the University of Glasgow showing that alcohol sales from supermarkets and off-licences in Scotland fell by 4-5% in the year after minimum unit pricing (MUP) was introduced in May 2018. There has been no further reduction in consumption since, although this means alcohol consumption in Scotland remains at its lowest level since 1994. Read a summary of the report here. The World Health Organization (WHO) praised the “promising” evidence for Scotland’s MUP cutting alcohol consumption in a report, but suggested linking MUP to inflation in order to ensure that the positive impacts will last. Read a summary here.

An editorial in The Lancet Gastroenterology and Hepatology argued that alcohol-related harm may have been exacerbated by the Covid-19 pandemic and that action to address the problem cannot wait until the pandemic is under control. Read the editorial here.

New research published in The Lancet Gastroenterology and Hepatology this month found that people on opioid substitution therapy (OST) are twice as likely to clear hepatitis C if they receive medication from their community pharmacist than through conventional care pathways. The APPG on Liver Health has previously lobbied ministers to remove barriers to delivering hepatitis C medication through community pharmacies. A summary of the findings can be accessed here.

The Journal of Viral Hepatitis published new research which identified barriers to uptake of hepatitis C tests among people in prison. The main themes were ‘Fear, Insufficient Knowledge, Stigma, Privacy, Choice and Prison Life’, with the authors concluding that “providing information to people in prison about HCV transmission and treatment may reduce fears and enable the test uptake target to be met.” The paper can be accessed here.

A new blog by substance misuse service provider We Are With You focused on the need to provide support to ‘the hidden generation of drinkers’ – those aged over 50 – noting that the number of alcohol-related deaths among over-50s has increased by 45% since 2001. Read the full piece here.

Relevant parliamentary activity

Parliamentary debates

During a debate on the Finance Bill in the House of Commons on 16th June, Wes Streeting MP pressed Treasury Minister Kemi Badenoch on whether the Government’s forthcoming alcohol duty review will take into account the case for MUP.

Parliamentary Questions

In response to a question from Daisy Cooper MP, Health Minister Helen Whately revealed that an estimated 122 liver transplants have been unable to take place during the Covid-19 outbreak.

Richard Holden MP asked the Department of Health and Social Care to respond to the Lancet Commission on Liver Disease’s latest report. Health Minister Helen Whately said that NHS England’s Hepatobiliary Clinical Reference Group has already taken action in response, such as starting work on the development of liver networks in England, and that the Department is also taking action regarding key liver disease risk factors such as excessive alcohol consumption and obesity, referring to the prevention green paper.

Baroness Bennett asked what steps the Government is taking to increase provision of services to address alcohol-related issues related to any increase in the consumption of alcohol during the Covid-19 pandemic. Health Minister Lord Bethell said that NHS England and NHS Improvement have published a specialty guide for alcohol dependence to support clinicians in acute and mental health trusts treating patients with alcohol dependence. Additionally, a national alcohol clinical expert network has been established to provide advice and support.

Fiona Bruce MP asked a question (yet to be answered) on what assessment DHSC has made of trends in the level of alcohol use during the Covid-19 lockdown and received an answer to a question on steps the DHSC is taking to prevent a rise in alcohol use during the Covid-19 outbreak, which referred to the availability of PHE guidance.