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APPHG : Liver Disease – today’s disaster; tomorrow’s catastrophe

MPs and experts call for urgent action to address the catastrophic consequences of ignoring the increasing incidence of liver disease

MPs and experts today joined forces in demanding that the Government, the NHS and Public Health England take urgent action to address the catastrophic consequences of the fast increasing incidence of liver disease.

In 2012, just under 11,000 people died from liver disease in England.  This represents over 30 deaths a day and a 40% increase since 2001.[i] Yet, the vast majority of these, and future deaths from liver disease could be prevented according to the outcomes of an Expert Inquiry into improving outcomes in liver disease, launched today by the All-Party Parliamentary Hepatology Group (APPHG).

David Amess MP, Chair, APPHG, said, “The launch of today’s Inquiry Report is a wakeup call for the nation. Liver disease is the only one of the UK’s top five causes of death where death rates continue to rise and there is no national strategy to tackle this. Unless urgent and co-ordinated action is taken now, in less than a generation, liver disease has the potential to be the UK’s biggest killer”.

“As most liver disease can be prevented, this is a tragic waste of life” he added.

Commenting on the call to action, Andrew Langford, the British Liver Trust Chief Executive, said, “Liver disease is a national scandal and more must be done to prevent, diagnose and treat the condition. We cannot sit by and allow so much needless suffering and death. Liver disease destroys lives and puts a significant financial burden on society. We need decisive action now”.

The APPHG undertook their inquiry following the coalition government’s decision to ditch the planned National Liver Disease Outcomes Strategy that had been three years in the drafting.

Dr Kosh Agarwal, Consultant Hepatologist & Transplant Physician, who works at King’s College Hospital, the UK’s largest liver treatment centre, said, “More has to be done to focus effort and resource in the fight against liver disease.  The current system runs the risk of failing patients and we must all redouble our efforts to better address this largely preventable disease. We see these problems every day in our clinical practice at King’s”.

Liver disease is caused by a wide-range of factors, the most common of which are excess alcohol intake over a period of time, fatty liver disease and viral hepatitis, including the silent killer, hepatitis C. Early identification of those at increased risk of liver disease and its early diagnosis enables appropriate intervention to be taken.

Charles Gore, Chief Executive, The Hepatitis C Trust, added, “There is so much more that could be done to prevent the escalating death toll from liver disease.  For example, only 3% of hepatitis C patients receive potentially life-saving treatment each year.  With the new treatments we could effectively eliminate the virus in the UK within a generation.  The Government, Public Health England and all parts of the NHS urgently needs to prioritise action on the causes of liver disease.”

The Inquiry Report makes 20 recommendations, including:

  • The Government should implement a minimum unit price for alcohol of 50p per unit, as recommended by 70 leading alcohol and health related organisations.
  • The Department of Health, NHS England and Public Health England, as well as local bodies, must act now and recognise liver disease as a priority area for action. They must coordinate a national approach liver disease prevention, early diagnosis, improved service provision and patient care and they must do this now.
  • Data on all aspects of liver disease should be collected, monitored and used effectively on a far more thorough and systematic basis.
  • Public Health England should ensure that all obesity reduction programmes include poor liver health as a significant risk stemming from obesity.
  • Public Health England and NHS England should set a clear goal of eliminating hepatitis C within the next 15 years and should set out joint plans for achieving this goal.

The UK should introduce universal hepatitis B vaccination, as recommended by the World Health Organisation, which could result in the near elimination of this killer disease.

Read the full report:  THE APPHG LIVER INQUIRY REPORT 2014



  • Full details of the Inquiry and all of the written and oral evidence submissions are available at
  • The APPHG Expert Inquiry into improving outcomes in liver disease sought evidence from a range of expert witnesses including charities, medical bodies, leading physicians, pharmaceutical companies and NHS representative (including the Department of Health, Public Health England, NHS England and the Deputy Chief Medical Officer).
  • In the past 10 years there has been a five-fold increase incirrhosis for people between the ages of 35 and 55.[i]
  • Alcohol health problems cost the NHS £3.5 billion a year.[ii]
  • Around a quarter of adults in England are obese and at serious risk of developing liver disease.[iii]
  • Annual deaths from hepatitis C have almost quadrupled since 1996.[iv]

[i] British Society of Gastroenterology (BSG) ‘Chronic management: Management of patients with Chronic liver disease’, 2009. Available at:

[ii] Home Office, ‘Next steps following the consultation on delivering the Government’s alcohol strategy’, July 2013, p.5. Available at:

[iii] Public Health England, ‘Slide sets for adult and child obesity’. Available at:

–           Health & Social Care Information Centre (hscic) ‘Health Survey for England – 2012, Trend tables (NS)’, December 18th 2013. Available at:

[iv]   The Hepatitis C Trust, ‘The Uncomfortable Truth: Hepatitis C in England. The State of the Nation’, p.5, October 2013. Available at:

[i] The National End of Life Care Intelligence Network, Public Health England
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