New metrics for the Lancet Standing Commission on Liver Disease in the UK

The eight recommendations are: (1) improving expertise and facilities in primary care to strengthen detection of early disease and its treatment, and screening of high-risk patients in the community; (2) establishment of acute liver services in district general hospitals linked with 30 regional specialist centres for complex investigations and treatment, and increased provision of medical and nursing training in hepatology; (3) a national review of liver transplantation to ensure better access for patients to increase capacity; (4) specialist paediatric services and continuity of care in transition arrangements for children with liver disease reaching adult life; (5) measures to reduce overall alcohol consumption in the country; (6) promotion of healthy lifestyles to reduce obesity and the burden of non-alcoholic fatty liver disease; (7) elimination of viral hepatitis as a major public health threat by 2030 and a major reduction in the burden of disease for hepatitis B; and (8) increasing awareness of liver disease in the general population and within the National Health Service (NHS), including the work of liver patient support groups. The recently published, comprehensive Global Burden of Disease Study 2015 also includes important data on disease burden for alcohol, obesity, and viral hepatitis in relation to other major non-communicable diseases related to lifestyle issues, including smoking. For many of the recommendations the metrics show little progress in terms of reduced disease burden, although together with the efforts of other bodies and agencies, there has been some movement in that direction.