Written question WQ88535

In Wales, we are committed to ensuring that our services provide early intervention and prevention so that longer-term harms are prevented before they occur. The Quality Statement for Liver Disease published last November sets out the Welsh Government’s future vision for paediatric and adult liver services in Wales for the next decade.

Reducing the stigma associated with liver disease is crucial in preventing late presentation and diagnosis of liver disease. The Liver Disease Implementation Network works in partnership with the British Liver Trust to destigmatise liver disease through education and improving public understanding of a wide range of different liver conditions.

We also recognise that stigma continues to be an ongoing barrier for many in accessing support, treatment and services for alcohol misuse and reducing this is a key part of our substance misuse agenda. We are working, and will continue to work, with our Area Planning Boards (who commission services) and key partners, such as third sector providers, to ensure that reducing stigma forms part of the ongoing work that is undertaken. An action within our Substance Misuse Delivery Plan 2019-22, published on 23 October 2019 (and refreshed on the 28th January 2021) is to provide funding for Alcohol Change UK to support the delivery of the Plan. Their role includes raising awareness of alcohol misuse issues, looking at behaviour changes and reducing stigma and leading on information campaigns.

To support health professionals to raise and discuss alcohol use in a non-stigmatised way with their patients, Public Health Wales are redeveloping the alcohol brief interventions approach. This will enable health professionals to raise problem drinking and access to treatment services in a sensitive, non-judgemental manner.

In March 2020, we introduced a Minimum Unit Price for alcohol (MUP) which aims to address some of the long-standing and specific health concerns around the effects of excess alcohol consumption in Wales. We also promote awareness of the UK Chief Medical Officers’ low risk drinking guidelines to support people to make healthy choices and informed decisions about their alcohol consumption and keep their risk of cancer and liver disease low.

In relation to obesity, a compassionate, person-centred approach has been central to the development of the All Wales Weight Management Pathway and supporting programmes across community and specialist services. Communications and national messaging, such as the Healthy Weight Healthy You Social Marketing Campaign, and developments for the healthy weight pathway have been created with expert psychological and behavioural science input to ensure the content and language considers and addresses stigma.

Two of the nine standards for the All Wales weight management pathway relate to stigma. For example, standard 3 states; “People with higher body weights are treated with dignity and respect and do not feel stigmatised due to a lack of appropriate equipment or facilities. This includes patient transport and emergency services.” These standards are used as part of the ongoing development and quality assurance of services for the weight management pathway in Wales.

A supporting Primary Care Obesity Prevention Action Plan explicitly recognises the need to support the workforce to confidently manage overweight and obesity to deliver person-centred approaches, free from stigma and bias and to address the education and training needs of different workforce groups. Public Health Wales have been working with partners to develop the Making Every Contact Count Healthy Weight training which is being developed and will be rolled out across Wales.