Wales leads the way in tackling liver disease, but UK death rates remain high

New research highlights Wales’ success in early detection pathways while exposing a “postcode lottery” in liver disease care across the UK.

Wales is setting an example for the UK in tackling liver disease, according to new research published in the British Journal of General Practice.

The study shows Wales has achieved 100% coverage of comprehensive care pathways for liver disease across all seven health boards, compared to just 36% in the rest of the UK.

 

The findings have been hailed by the British Liver Trust as a model for addressing the growing challenge of liver disease, which causes more than 12,000 deaths annually across the UK.

In 2021, Wales became the first UK nation to implement the All-Wales Liver Blood Test Pathway, an initiative aimed at improving the early detection and management of liver disease.

This proactive approach allows healthcare professionals to identify and manage risk factors, such as alcohol consumption and diabetes, more effectively.

However, the study also revealed stark disparities elsewhere in the UK. In England, only 52% of regions have access to critical fibrosis or liver scarring assessments, which are essential for early detection.

Northern Ireland also lags behind, while Scotland has a relatively high rate of pathway coverage, though it still falls short of Wales.

Call for Urgent Action

The British Liver Trust is calling for nationwide improvements to combat the 27% rise in liver disease deaths seen between 2019 and 2023. These changes include:

• Universal implementation of early detection pathways to identify at-risk individuals before symptoms develop.
• Routine fibrosis assessments for patients with abnormal liver blood tests, ensuring timely referrals to specialist care.
• Inclusion of liver disease risk factors in routine health checks for conditions like diabetes and obesity.

Pamela Healy OBE, Chief Executive of the British Liver Trust, emphasised the need for equity in care across the UK:

“Our research shows that when it comes to the early detection of liver disease, there is a postcode lottery. While there have been pockets of good practice, widespread preventative measures remain woefully inadequate. The work in Wales is an excellent example of what can be achieved. We need the rest of the UK to follow suit with a national liver disease delivery plan to prevent avoidable deaths and reduce pressure on the NHS.”

The Importance of Early Diagnosis

Liver disease is often symptomless in its early stages, meaning three-quarters of patients are diagnosed only after the condition has progressed to an advanced stage, where treatment options are limited. Experts believe early detection is key to reversing this trend.

Professor Stephen Ryder, Consultant Hepatologist, said:

“If we are to tackle the huge increases in the numbers of people dying from liver disease, then prevention and early diagnosis are key. We need joined-up, effective pathways that link primary and secondary care to ensure more people are diagnosed early and treated promptly.”

Dr Helen Jarvis, Clinical Advisor for the British Liver Trust and lead author of the research, added:

“GPs and primary care professionals are working tirelessly, but many feel they lack the confidence and resources to diagnose and manage liver disease effectively. This has resulted in thousands of avoidable deaths. It is vital that we establish a central directive to ensure consistent pathways for early detection across the UK.”

The Case for National Reform

With 90% of liver disease being preventable, the British Liver Trust argues that immediate investment in preventative measures could save thousands of lives and reduce NHS costs.

The Welsh model, with its focus on early detection and coordinated care, is being championed as a blueprint for other nations to adopt.

The survey, conducted by the British Liver Trust, compared healthcare provision across the UK, examining commissioned care pathways, diagnostic practices, and processes for monitoring at-risk populations.

While the findings highlighted progress in Wales and Scotland, they exposed significant gaps in England and Northern Ireland, underscoring the need for urgent nationwide reform.

As liver disease continues to claim more lives, experts warn that without concerted action, the burden on the NHS will only grow.

With the example set by Wales, the UK has a clear path forward to improve outcomes and prevent countless unnecessary deaths.