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1274799

registered interest
date	08/01/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce the number of hospital admissions as a result of alcohol-related liver disease.
tabling member constituency	Southend West
tabling member printed	Sir David Amess
uin	134327
answer	answer is ministerial correction date of answer 26/01/2021 answer text <p>As part of the NHS Long Term Plan, NHS England and Improvement, with support from Public Health England (PHE), is helping acute hospitals with the highest rates of alcohol harm to establish or improve specialist alcohol care teams.</p><p> </p><p>PHE is supporting work to increase opportunities for the earlier detection of alcohol-related liver disease in people drinking at or above high-risk levels. This includes a new commissioning for quality and innovation scheme to incentivise increased cirrhosis and fibrosis tests for alcohol dependent patients in acute and mental health services.</p><p> </p> answering member constituency Bury St Edmunds answering member printed Jo Churchill question first answered 26/01/2021 12:02:38 answering member 4380 label Biography information for Jo Churchill
tabling member	44 label Biography information for Sir David Amess

1202844

registered interest
date	11/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, whether his Department plans to respond to the Lancet Standing Commission report entitled Unacceptable failures: the final report of the Lancet Commission into liver disease in the UK, published in November 2019.
tabling member constituency	North West Durham
tabling member printed	Mr Richard Holden
uin	58822
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>NHS England’s Hepatobiliary Clinical Reference Group has already taken action in response to the Lancet Commission report into liver disease in the United Kingdom, such as starting work on the development of liver networks in England.</p><p>More broadly, the Department is also taking action regarding key liver disease risk factors such as excessive alcohol consumption and obesity, and the Prevention Green Paper, ‘Advancing our health: prevention in the 2020s’, recognises the need for a range of actions to address causes of preventable ill health.</p> answering member constituency Faversham and Mid Kent answering member printed Helen Whately question first answered 18/06/2020 10:21:15 answering member 4527 label Biography information for Helen Whately
tabling member	4813 label Biography information for Mr Richard Holden

1202845

registered interest
date	11/06/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many and what proportion of vacancies in the NHS are for hepatologists.
tabling member constituency	North West Durham
tabling member printed	Mr Richard Holden
uin	58823
answer	answer is ministerial correction date of answer 18/06/2020 answer text <p>The Department does not hold the data requested.</p><p> </p> answering member constituency Faversham and Mid Kent answering member printed Helen Whately question first answered 18/06/2020 18:12:23 answering member 4527 label Biography information for Helen Whately
tabling member	4813 label Biography information for Mr Richard Holden

1183699

registered interest
date	09/03/2020
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, when he plans to publish a national strategy for liver disease.
tabling member constituency	Woking
tabling member printed	Mr Jonathan Lord
uin	26921
answer	answer is ministerial correction date of answer 17/03/2020 answer text <p>From April 2020 a new National Health Service CQUIN (Commissioning for Quality and Innovation framework) will be introduced to support early identification of cirrhosis and enhanced fibrosis in alcohol dependent individuals. The CQUIN will incentivise acute and mental health providers to ensure that appropriate tests (transient elastography, enhanced liver fibrosis or STLT blood tests) are carried out on in-patients who have a diagnosis of alcohol dependence.</p><p>The delivery of the national CQUIN to support early identification of cirrhosis and enhanced fibrosis against a standard set of criteria will support tackling regional variation.</p><p>Specialised commissioning is also supporting a programme to identify people with hepatitis C infection at an early stage to avoid subsequent liver disease.</p><p>In 2019/20, Public Health England (PHE) awarded £6 million capital funding to 23 local authorities to support their ambitions to increase access to alcohol treatment. This includes supporting nine areas to purchase fibroscan machines to increase early detection and access to treatment for those with alcohol-related liver disease.</p><p>PHE is also supporting work to increase opportunities for the earlier detection of alcohol-related liver disease in people drinking at or above high-risk levels. This includes new NHS Health Check guidance to encourage referral for liver investigation.</p><p>Additionally, the rollout of optimal Alcohol Care Teams across England in the areas with the highest rates of alcohol dependence-related admissions will improve the care pathway, including the use of appropriate diagnostics, for patients and their families who have issues with alcohol dependence.</p><p> </p><p> </p> answering member constituency Faversham and Mid Kent answering member printed Helen Whately grouped question UIN 26920 26922 26923 26924 question first answered 17/03/2020 12:30:20 answering member 4527 label Biography information for Helen Whately
tabling member	4090 label Biography information for Mr Jonathan Lord

722117

registered interest
date	18/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to encourage innovative stem cell and umbilical cord treatments for liver disease.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	71132
answer	answer is ministerial correction date of answer 26/04/2017 answer text <p>The Government continues to support research through a range of funding agencies into the therapeutic use of stem cells. Over 80 patients have been recruited to a clinical trial to test the potential use of stem cells to treat liver disease. The results of this trial will only be available when the follow-up phase of the study has been completed. Before making this type of treatment available through the National Health Service it will be necessary to demonstrate that the treatment is both safe and effective and this is likely to involve further larger clinical trials.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 26/04/2017 09:22:39 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4131 label Biography information for Jim Shannon

675194

registered interest
date	18/01/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what was the incidence of non-alcoholic fatty liver disease in humans in (1) 1990, (2) 1995, (3) 2005, and (4) 2015.
tabling member printed	The Countess of Mar
uin	HL4759
answer	answer is ministerial correction date of answer 27/01/2017 answer text <p>The data is not available in the format requested.</p> answering member printed Lord O'Shaughnessy question first answered 27/01/2017 12:09:25 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

606809

registered interest
date	20/10/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to increase the provision of (a) medical and (b) nursing training in hepatology.
tabling member constituency	Knowsley
tabling member printed	Mr George Howarth
uin	49658
answer	answer is ministerial correction date of answer 26/10/2016 answer text <p>It is the responsibility of the professional regulators such as the General Medical Council or the Nursing and Midwifery Council (NMC) to set the standards and outcomes for education and training and approve training curricula to ensure newly qualified healthcare professionals are equipped with the knowledge, skills and attitudes to provide high quality patient care.</p><p> </p><p>Hepatology is a medical sub-specialty of gastroenterology. In Health Education England’s 2016/17 Workforce Plan for England, there are 450 training commissions proposed for gastroenterology, an increase from 431 in 2015/16.</p><p>Whilst the NMC does not recognise hepatology in its standards for specialist education and practice, the Royal College of Nursing has written a comprehensive competence framework which outlines the training, skills and competence required to develop and maintain a special interest in hepatology:</p><p><a href="https://www2.rcn.org.uk/__data/assets/pdf_file/0004/641425/004-983_WEB.pdf" target="_blank">https://www2.rcn.org.uk/__data/assets/pdf_file/0004/641425/004-983_WEB.pdf</a></p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 26/10/2016 14:56:00 answering member 1542 label Biography information for Philip Dunne
tabling member	481 label Biography information for Sir George Howarth

577540

registered interest
date	07/09/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, when he expects Public Health England to publish the National Liver Strategy Framework.
tabling member constituency	Heywood and Middleton
tabling member printed	Liz McInnes
uin	45448
answer	answer is ministerial correction date of answer 12/09/2016 answer text <p>Public Health England (PHE) has a wide range of work to tackle liver disease. This includes monitoring deaths from liver disease and its risk factors, publishing Local Authority Liver Disease Profiles and updating the Atlas of Variation on Liver Disease. The Atlas of Variation will inform the development of the PHE Liver Disease Framework, therefore publication is likely to take place after the update is completed this winter.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 12/09/2016 13:11:00 answering member 4080 label Biography information for David Mowat
tabling member	4342 label Biography information for Liz McInnes

577541

registered interest
date	07/09/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what the annual cost of care is for a person with (a) decompensated cirrhosis of the liver and (b) hepatocellular carcinoma.
tabling member constituency	Heywood and Middleton
tabling member printed	Liz McInnes
uin	45449
answer	answer is ministerial correction date of answer 12/09/2016 answer text <p>The information is not available in the format requested. Such information as is available is shown in the table below and is from reference costs, which are the average unit cost to National Health Service trusts and foundation trusts of providing defined services in a given financial year. Reference costs are published annually, with most recently available data being for 2014-15.</p><p> </p><p>Reference costs for acute care are collected by healthcare resource group (HRG), which are standard groupings of clinically similar treatments that consume similar levels of healthcare resource. HRGs are organised by chapters and sub-chapters, representing different body systems, and HRG sub-chapters GC and PG describe hepatobiliary and pancreatic system disorders for adults and children respectively. The average costs in the following table will therefore include the costs to NHS hospitals of treating decompensated cirrhosis of the liver and hepatocellular carcinoma, as well as the costs of other related disorders.</p><p> </p><p>These costs do not include high cost drugs, or treatment in outpatient or other settings outside of hospital. They reflect the costs of a single episode of care under one consultant for a patient admitted to hospital for either elective or non-elective treatment. Patients admitted to hospital may have multiple episodes of care and each one of these episodes will be recorded separately.</p><p> </p><p>Total cost to NHS hospitals of treating hepatobiliary and pancreatic system disorders, 2014-15</p><table><tbody><tr><td><p> </p></td><td><p>Average cost per Finished Consultant Episode (£)</p></td></tr><tr><td><p>Malignant, Hepatobiliary or Pancreatic Disorders<sup>1</sup></p></td><td><p>1,984</p></td></tr><tr><td><p>Non-Malignant, Hepatobiliary or Pancreatic Disorders<sup>2</sup></p></td><td><p>1,751</p></td></tr><tr><td><p>Paediatric, Hepatobiliary or Pancreatic Disorders<sup>3</sup></p></td><td><p>2,344</p></td></tr></tbody></table><p><em>Source: </em>Reference costs, Department of Health</p><p> </p><p><em>Notes:</em></p><p>1. The following HRGs are included in the table:</p><p>GC12C Malignant, Hepatobiliary or Pancreatic Disorders, with Multiple Interventions</p><p>GC12D Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 5+</p><p>GC12E Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 2-4</p><p>GC12F Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 0-1</p><p>GC12G Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 6+</p><p>GC12H Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 3-5</p><p>GC12J Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 1-2</p><p>GC12K Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 0</p><p>2. GC17A Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Multiple Interventions, with CC Score 9+</p><p>GC17B Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Multiple Interventions, with CC Score 4-8</p><p>GC17C Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Multiple Interventions, with CC Score 0-3</p><p>GC17D Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 9+</p><p>GC17E Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 4-8</p><p>GC17F Non-Malignant, Hepatobiliary or Pancreatic Disorders, with Single Intervention, with CC Score 0-3</p><p>GC17G Non-Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 8+</p><p>GC17H Non-Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 5-7</p><p>GC17J Non-Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 2-4</p><p>GC17K Non-Malignant, Hepatobiliary or Pancreatic Disorders, without Interventions, with CC Score 0-1</p><p>3. PG71A Paediatric, Hepatobiliary or Pancreatic Disorders, with CC Score 2+</p><p>PG71B Paediatric, Hepatobiliary or Pancreatic Disorders, with CC Score 1</p><p>PG71C Paediatric, Hepatobiliary or Pancreatic Disorders, with CC Score 0</p><p>4. These HRGs are common groupings of the ICD-10 codes used to count the number of finished admission episodes with a primary or secondary diagnosis of hepatocellular carcinoma or decompensated cirrhosis. They also include other ICD-10 codes</p><p>5. For each HRG or other currency in the reference cost collection, NHS hospital trusts submit a unit cost and amount of activity undertaken.</p> answering member constituency Warrington South answering member printed David Mowat question first answered 12/09/2016 13:18:01 answering member 4080 label Biography information for David Mowat
tabling member	4342 label Biography information for Liz McInnes

541043

registered interest
date	20/07/2016
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Liver Diseases
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department is taking to improve (a) expertise and (b) facilities in primary care to strengthen (i) detection of early liver disease and (ii) treatment for liver disease.
tabling member constituency	Stockton North
tabling member printed	Alex Cunningham
uin	43645
answer	answer is ministerial correction date of answer 05/09/2016 answer text <p>I understand that the British Liver Trust is working in partnership with the Royal College of General Practitioners on a three year programme to make liver disease a clinical priority for primary care. This is aimed at improving awareness and understanding of liver disease as well as treatment amongst those working in primary care.</p><p> </p><p>Public Health England is currently developing a framework to tackle liver disease. This will include the action that needs to be taken across the health and care system, including in primary care, to prevent and better manage liver disease.</p> answering member constituency Warrington South answering member printed David Mowat grouped question UIN 43644 question first answered 05/09/2016 08:53:18 answering member 4080 label Biography information for David Mowat
tabling member	4122 label Biography information for Alex Cunningham