Written question WQ85386

The Welsh Government is committed to ensuring that anyone with liver disease in Wales should have access to the best possible care.

The quality statement for liver disease is progressing well and is being co-produced with statutory and voluntary sector stakeholders. This includes the Liver Disease Implementation Group, health boards, third sector organisations and patient representatives. A near final draft will be consulted upon with wider stakeholders over the summer and will be published in the autumn.

Specific liver disease assessments are not routinely included in NHS health checks. However, our Making Every Contact Count (MECC) is an approach to behaviour change that utilises the millions of day to day interactions that organisations and individuals have with other people to support them in making positive changes to their physical and mental health and wellbeing. The MECC approach aims to empower staff working particularly in health services, but also partner organisations, to recognise the role they have in promoting healthy lifestyles, supporting behaviour change and contributing to reducing the risk of chronic disease.

Chronic liver disease is the most significant risk factor for hepatocellular carcinoma, with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of hepatocellular carcinoma through surveillance programs improve prognosis and availability of curative therapies.

We expect the NHS in Wales to deliver care in line with standards from the National Institute for Health and Care Excellence (NICE) which recommend surveillance of patients with liver cirrhosis normally by means of ultrasound every six months. This should be offered to all such patients as part of routine clinical care unless co-morbidity (such as liver failure or severe cardio-respiratory diseases) would preclude active treatment of an identified liver cancer.

The following initiatives are in place to support early diagnosis of liver disease in at-risk populations:

• Emergency Department alcohol screening and the introduction of alcohol care teams in secondary care.

• Public Health Wales and the Hepatitis C network in case finding.

• An all-Wales liver blood test pathway in primary care, underpinned by seminars and the Institute for Clinical Science and Technology. Wales has been shown to be an exemplar in early detection compared to many other parts of the UK.

• Funding of staff to reduce waits for non-invasive detection of chronic liver disease (Transient Elastography) and work on rolling out a blood profile test for those unsuitable for TE.

• Funding of Love your Liver campaigns by the British Liver Trust including roadshows and the offer of immediate TE to those at risk.