More funding needed for liver disorder treatments

The UK's services to treat patients with liver disorders need more funding and better staffing, a leading expert said today.

Professor Roger Williams, director of the Institute of Hepatology at University College London, said that deaths from liver disease were increasing in the UK.

But he questioned whether there were enough specialist staff and facilities available to cope with the future increases in liver disease.

Writing in the British Medical Journal, Prof Williams pointed out that in 2000 liver disease killed more men than Parkinson's disease and more women than cervical cancer.

He said that deaths from alcoholic liver disease had doubled in the last 10 years.

He also added that less than 10% of an estimated 300,000 cases of hepatitis C infection had been diagnosed, with prevalence of related chronic liver disease expected to treble by 2020. Prof Williams carried out a survey of 28 hospital trusts with liver centres in 2004.

He found that "relatively few" were able to provide a full range of liver services to patients.

"There were serious shortages of staff at all levels: a third of the centres lacked a designated consultant hepatologist, and in 11 of the 28 units general physicians were sharing the workload with gastroenterologists," Prof Williams said.

"Five centres did not have a single specialist nurse for hepatitis, and in four centres the only specialist nurses were for people with alcohol related disorders."

Prof Williams said that the lack of dedicated beds for patients with liver disease was one of the most common limitations to the service.

"Waiting times for outpatient appointments were generally unacceptable too - more than 20 weeks in three hospitals, between 11 and 20 in 14. "Only seven hospitals were able to offer an urgent appointment within two weeks," he said.

Prof Williams said that recent initiatives to improve teaching and specialist training were a step forward.

But he added: "Liver services need better funding as well as better staffing."

Prof Williams said that increasing the number of transplant centres would be one way to provide liver services more widely in the UK, with large parts of the country currently lacking such a centre.

He concluded: "Clearly, specialised services for liver disease and transplantation will have to improve substantially to meet the considerably increased burden of liver disease that is predicted for the next 20 years."
Lyndsay Moss, Press Association, 14 October 2005