The National Plan for Liver Services UK 2009
A Time to Act: Improving Liver Health and Outcomes in Liver Disease
Prepared by the:
British Association for the Study of the Liver (BASL)
British Society of Gastroenterology (BSG) (Liver Section)
Liver disease is the 5th largest cause of death in the U.K. The average age of death from liver disease is 59 years, compared to 82-84 years for heart & lung disease or stroke.
Liver disease morbidity and mortality are largely preventable.
The UK is one of few developed nations with an upward trend in mortality.
Patients are presenting and dying with liver disease at an earlier age, with a 5-fold increase in the development of cirrhosis in 35-55 year olds over the last 10 years
The majority of treatable liver disease is undiagnosed and untreated. Early diagnosis and treatment requires engagement of primary care.
Effective prevention strategies or treatments are available for the three main causes of liver disease – alcohol, viral hepatitis and obesity. These decrease the risk of developing cirrhosis, liver cancer and their associated mortality.
The prevalence of chronic hepatitis B in the UK is increasing dramatically as a result of migration. The UK is in a minority by not providing universal vaccination against hepatitis B. Identification of patients with hepatitis B within high prevalence groups is suboptimal.
With appropriate action, the associated disease burden for both hepatitis B and hepatitis C could be largely eliminated by 2030 and 2040 respectively.
Secondary care of liver disease is currently poorly organized and services could be radically improved at relatively little cost.
Liver disease represents one of the few diseases where the inequalities gap is increasing.