Left undiagnosed and untreated the future burden of hepatitis C on UK health services is estimated to reach £8 billion1
14th January, 2009, London A parliamentary report released today shows vastly inconsistent approaches in how hepatitis C is being tackled across the UK. The report shows Scotland is leading England and Wales in its response to the public health challenge with the most effective multidisciplinary approach in the form of a two-phase Action Plan. Wales is yet to publish its Action Plan, originally due in 2006.2 The report calls for immediate publication by the Welsh Assembly Government and a new liver strategy in England to encompass hepatitis C. Scotland is investing £43 million3 to address the totality of hepatitis C prevention, care, support and treatment.This is a stark contrast to England where there has been only £7 million4 of dedicated funding, confined to disease awareness activities. Although England was first to launch an Action Plan in 2004, it has had a limited effect on tackling the disease – almost two thirds of PCTs5 are failing to implement the Action Plan effectively and only 3%6 of diagnosed patients are receiving treatment each year, GP awareness remains low and infrastructure inadequacy is a major constraint. Lack of targets, benchmarks, timetables or detailed actions has also made it difficult to measure implementation and success of the plan. The Department of Health is, however, launching a new disease awareness campaign in England in the coming month.
“Our report shows there’s so much more that needs to be done to tackle hepatitis C in England. Scotland is leading the way and we must quickly follow otherwise we will continue to see more and more unnecessary deaths from hepatitis C,”statedBob Laxton MP Co-Chair of the All Party Parliamentary Hepatology Group.
Hepatitis C is a cancer-causing infectious virus and a public health time bomb.University of Southampton research estimates there are as many as 466,000 infected people in the UK7. Treatment is available that can eradicate the virus in around half of patients but only a very small proportion of individuals who could benefit from the treatment are receiving it. Deaths, transplants and hospital admissions for HCV-related end stage liver disease are rising and numbers of people with end-stage liver disease and liver cancer have almost trebled over the last 10 years.8 Left undiagnosed and untreated, the future burden of hepatitis C on the NHS is estimated to reach up to £8 billion over the next 30 years.1
“When the Action Plan for England was launched, we said that it wouldn’t work because there were no benchmarks, targets, timetables or monitoring systems set.This report unfortunately confirms our fears and we now have very real health inequalities across the UK. The Welsh Assembly Government cannot be permitted to continue postponing publication of the Welsh Action Plan any longer and the Department of Health must immediately produce a new hepatitis C strategy for England. Years have gone by with very little progress while the death toll just keeps growing,”said Charles Gore,Chief Executive of The Hepatitis C Trust.
The Scottish approach tackles hepatitis C by embracing all relevant services: schools, prisons, the voluntary sector, local authorities (including social and mental health services) and NHS Boards. The plan allows NHS Boards to take different measures according to their local need and epidemiology to target hepatitis C in their local populations. In addition, national guidelines for improvements to all needle/syringe exchanges and a pilot programme of an in-prison needle/syringe exchange have been developed.
For more information please contact:
Jane AllenThe Hepatitis C Trust
Tel: 07779 595609
Email: jane.allen@hepctrust.org.uk
Erika Aalto, Weber Shandwick
Tel: 020 7067 0214
Email: eaalto@webershandwick.com
References
1.University of Southampton and The Hepatitis C Trust, UK Vs. Europe: Losing the fight against hepatitis C (London, May 2006)
2.All Party Parliamentary Hepatology Group (APPHG), 2009: Divided Nations: Tackling the hepatitis C challenge across UK
3.The Scottish Action Plan, Phase 2:http://www.hps.scot.nhs.uk/ewr/article.aspx
4.The House Of Commons Publications and Records, 6 Feb 2008 : Column 1250Whttp://www.publications.parliament.uk/cgi-bin/newhtml_hl?DB=semukparl&STEMMER=en&WORDS=hepat&ALL=hepatitis&ANY=&PHRASE=&CATEGORIES=&SIMPLE=&SPEAKER=&COLOUR=red&STYLE=s&ANCHOR=80206w0027.htm_spnew0&URL=/pa/cm200708/cmhansrd/cm080206/text/80206w0027.htm#80206w0027.htm_spnew0
5.All-Party Parliamentary Hepatology Group, 2008: Location, Location, Location
6.The Health Protection Agency England, 2008 – Hepatitis C In the UK: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1204100441645
7.Parkes J, Bennett-Lloyd B, Rosenberg W, Roderick P. Hepatitis C prevalence in the UK: a pragmatic estimate of the burden 2005. Ref Type: Personal Communication.
8.The Health Protection Agency England , 2007 – Hepatitis C In the UK: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1204100441645
9.NHS, 2004, Hepatitis C Essential information for professionals and guidance on testing
10.The Health Protection Agency (Scotland) -http://www.hps.scot.nhs.uk/Search/pubdetail.aspx?id=32056
11.National Public Health Service Wales, Hepatitis C:http://www.wales.nhs.uk/sites3/page.cfm?orgId=719&pid=23121
BBC - Hepatitis C care 'patchy in UK'
BBC Health News
England and Wales have been urged to follow the lead of Scotland to help tackle a hepatitis C "time-bomb".
It is estimated there may be more than 400,000 people in the UK with the virus, but only about 70,000 have been diagnosed. The Scottish Government has recently launched an action plan to help quadruple the numbers getting help.
But the report by the All-Party Parliamentary Hepatology Group said there was a lack of action elsewhere.
The hepatitis C virus, if untreated, can cause cirrhosis, liver failure or liver cancer.Most people who contract the infection can be successfully treated, but this becomes harder the later the diagnosis. The virus is spread through contact with infected blood. Most people contract it through sharing needles to inject drugs, although some have also caught it via blood transfusions before blood was screened for the virus.
An action plan was published in England in 2004, but the MPs said it had had little impact. The report said many GPs still not fully aware of what to look out for, and two-thirds of local NHS trusts had not put proper infrastructures in place to make sure those diagnosed got access to treatment. It said just £7m has been made available to tackle the condition and called for ministers to publish another strategy to establish new targets and timescales. The MPs also criticised Wales, which has not yet published its strategy. They said the lack of support in place meant hepatitis C was a "public health time-bomb".
Praise
Northern Ireland, which has an action plan, largely escaped criticism, but it was the Scottish Government that was praised for its record. Scotland has a two-stage action plan in place which is promising £43m of funding to help prevent, care and treat hepatitis C.
Over the next three years, officials want to see the numbers in treatment rising four-fold to over 2,000. Bob Laxton, co-chair of the group, said: "Our report shows there's so much more that needs to done to tackle hepatitis C.
"Scotland is leading the way and we must quickly follow otherwise we will continue to see more and more unnecessary deaths."
Charles Gore, chief executive of the Hepatitis C Trust, said: "This report unfortunately confirms our fears and we now have very real health inequalities across the UK."
The Department of Health in England said it would be launching a public awareness campaign later this year. A spokesman said: "We are committed to tackling hepatitis C." "In the past four years, there has been a sustained increase in hepatitis C testing, diagnosis and treatment."
A spokesman for the Welsh Assembly Government said the administration was also fully committed and would be publishing its plan for consultation shortly.
BBC Hepatitis C action plan 'delayed'
BBC News/Wales
An action plan drawn up to tackle the growing threat posed by hepatitis C in Wales is three years behind schedule, according to a group of MPs. A parliamentary report claims the Welsh Assembly Government has drafted the plan, originally due in 2006, but has failed to publish it.
The Hepatitis C Trust accused ministers in Wales of "ignoring" sufferers.
The assembly government said Health Minister Edwina Hart was expected to publish the plan shortly.
Hepatitis is an inflammation of the liver and hepatitis C is one of several viruses that can causes the illness. Research from the University of Southampton estimates there are as many as 466,000 infected people in the UK, with 12,000 in Wales. But the all party parliamentary hepatology group said there were "vastly inconsistent approaches in how hepatitis C is being tackled across the UK". Its report shows Scotland is leading England and Wales in its response to the public health challenge and it has drawn up a two-phase action plan. However, the Blood Borne Viral Hepatitis Action Plan for Wales, tackling both hepatitis B and C, has been drafted but not published or put out for consultation, said the MPs.
"Our report shows there's so much more that needs to be done to tackle hepatitis C in England and Wales," said Bob Laxton MP, co-chair of the all party parliamentary hepatology group.
"Scotland is leading the way and we must quickly follow otherwise we will continue to see more and more unnecessary deaths from hepatitis C."
Charles Gore, chief executive of The Hepatitis C Trust, said assembly government could not be allowed to continue postponing publication of its action plan any longer. "Years have gone by with very little progress while the death toll just keeps growing - why are patients in Wales being ignored?" he added.
The assembly government said it was committed to meeting the challenge of blood-borne viral hepatitis. A spokesman said: "A significant amount of work has been undertaken in the development of an action plan.
"A draft plan, prepared by the National Public Health Service (NPHS), was submitted to assembly government officials for consideration.
"The process for setting budget allocations for 2009-10 and beyond is currently underway and the costs and timetable for implementing the plan is being considered in that process."
There is no vaccine to protect against hepatitis C, which is usually transmitted through blood-to-blood contact, but there is effective treatment available. According to the MPs' report, if left undiagnosed and untreated, the future burden of hepatitis C on the NHS in the UK could reach up to £8bn during the next 30 years.
