Just 25% of local authorities are aware of how many people are living with hepatitis C in their areas, a damning new report by the Hepatitis C Trust has revealed.
Huge gaps in the management and care of the disease have come to light through its audit of English commissioners and local authorities, including that a mere 20% have a 'lead' for the disease and even less a strategy for tackling the virus.
According to the Trust, local authorities are simply not ready to take responsibility for hepatitis C with the incoming system next month, given that only 40% of local authorities have arrangements in place with local NHS commissioners coordinate the approach to managing the condition.
Failure to tackle hepatitis C will result in "a significant increase in costs to the NHS and wider society,” warned Charles Gore, Chief Executive of The Hepatitis C Trust. In fact, according to research by RAND, failing to act now will lead to an increase in disease prevalence from 0.44% in 2010 to 0.61% in 2035.
It calculated that associated healthcare costs would increase from £82.7 million in 2012 to £115 million in 2035, while productivity losses would jump from £184 million-367 million to £210 million-£427 million, respectively (depending on whether minimum wage or median income is used).
Despite calls from the Chief Medical Officer and a personal commitment from the Prime Minister for liver diseases to be tackled as a priority no real action has yet been taken, and the Liver Strategy promised by the government is now 15 months overdue, Gore said.
Deaths from liver disease are on the rise, and it is deaths from hepatitis C seeing the fastest growth. Currently around 216,000 people have the disease - which can cause cirrhosis and liver cancer - in the UK.
More than half of those living with the condition are undiagnosed and yet, if caught early enough, the disease can be treated and cured. Astonishingly, just 3% of people with the virus receive treatment each year, highlighting the huge scope for improvement in outcomes.
Unfortunately patients seem to be facing significant barriers to getting the treatment they need. According the report, Opportunity knocks? An audit of hepatitis C services during the transition: just half of NHS commissioners are encouraging tests for the disease at GP surgeries; almost half have no measures in place to increase treatment of the condition; and many have not been effectively monitoring the uptake of treatment.
Recommendations to improve care
To help address this rather bleak picture for many patients, the Trust has made several recommendations. For example, it argues that each local authority should have a hepatitis C lead on their health and wellbeing board, and each clinical commissioning group (CCG) should have a designated person for either liver disease, blood-borne diseases or hepatitis C.
Other measures include: Public Health England should outline plans to establish a national liver intelligence network; CCGs should work with providers to gather data on how many patients with the disease are initiated on treatment and how many achieve a sustained virological response; and the NHS Commissioning Board should consider models that may improve the uptake of treatment.
“We face a real challenge in ensuring that public health and NHS services are commissioned holistically. 2013 is a critical year for the NHS and local authorities", said Gore. “We could eradicate hepatitis C in the UK in a generation. What a tragedy to look back in 20 years and realise that we didn’t eradicate it when we had the opportunity,” he stressed.
