Future of hepatitis C services and patient care at risk due to changing NHS – ELPA – European Liver Patients Association


2013-05-07 10:50

Future of hepatitis C services and patient care at risk due to changing NHS

 New report suggests innovative service design could help change current state of hepatitis in the UK

Roche,7th May 2013: A report released today, supported by leading hepatitis C patient groups, highlights the poor state of UK hepatitis C services compared to Europe and provides practical steps to service innovation to help reduce the burden of the disease. The Confronting the silent epidemic: a critical review of hepatitis C management in the UKreport, as part of thewider ‘Hepatitis Awareness Leading Outcomes’, initiative comes at a crucial time when research shows not only declining treatment rates, but also significant concerns over the impact the NHS reforms could have on hepatitis treatment services.

Charles Gore, Chief Executive of The Hepatitis C Trust, commented: “The alarming rise in hepatitis C related deaths must be addressed and innovative approaches to service design are essential to improving patient outcomes and saving lives. At a time of reform, it is now more important than ever that hepatitis C is a priority for commissioners and service providers throughout the UK. Through rethinking the design and delivery of services, we can help ensure patients receive early, effective treatment and reduce the significant costs to the health service and society more widely.”

The report funded by Roche and endorsed by The Hepatitis C Trust, British Liver Trust, and the European Liver Patients’ Association highlights that:

  • There has been a 300% rise in hepatitis C deaths from related end-stage liver disease or liver cancer from 1996 to 20101
  • If left untreated, the Health Protection Agency (HPA) estimates that 15,840 people in England (of the projected 216,000 with hepatitis C in the UK) will develop cirrhosis or liver cancer caused by hepatitis C by 20201,2
  • By 2035 the number of people living with hepatitis C in the UK will have increased to 370,000.2
  • To prevent this rise would require a quadrupling of treatment rates, at a cost of £43.8 million per year, but the gains in productivity would far exceed that, at £73.3 million a year2
  • A liver transplant – should a donor be available – costs more than £50,000, and the HPA estimates that if treatment rates for hepatitis C do not increase, 4,200 transplants will be needed by 20203
  • A quarter of health commissioners in the NHS had yet to estimate the numbers diagnosed with hepatitis C,and two thirds had no estimate of the numbers cured by treatment4

In light of these issues and challenges, the report aims to:

  • Improve current diagnosis and treatment rates of hepatitis C in the UK, which are some of the lowest in Europe: the UK is currently ranked 13th out of 14 countries graded5
  • Assist clinicians and commissioners to meet the achievable goal of reducing the burden of disease on health services: associated annual healthcare costs are approximately £83 million, estimated to rise to £115 million by 20352
  • Encourage innovative, localised approaches to service design based on improving patient outcomes through effective, early interventions

Concern over reforms

In addition, new hepatitis specialist qualitative research in the report suggests current challenges in the management of hepatitis C, including service capacity and commissioning, may be exacerbated by the reforms:6

  • “Capacity to treat patients is always an issue, even more so now with triple therapy. Our nurses cannot cope with more patients at any one time”
  • “I think the pressure from commissioners is only going to increase. Although NICE has approved treatments, I’m not sure commissioners will continue to see it as good value for their money”
  • “[Commissioners] don’t really understand what we do, they’re not really in a position to start telling me how to run our service”

“We must learn from the islands of best practice within the UK and apply these learnings wherever they are applicable,” said Professor David Goldberg, Consultant in Public Health Medicine/Consultant Clinical Epidemiologist at Health Protection Scotland and honorary Professor of Public Health, University of Glasgow. “This time of reform has evolved from a seemingly insurmountable challenge into a terrific opportunity.  While there is no ‘one-size-fits-all’ approach, the successful practices outlined in the HALO reportprovide practical examples of optimal services and the steps taken to generate effective care. Maintaining the current level of response is not an option if we want to interrupt the UK’s relentless escalation in serious disease and death caused by hepatitis C. Action plans without muscle has suboptimal impact. There is no time to lose.”

Click here to access the full report as it is presented on the Hepatitis C Trust website


For more information please contact:

Ed Purkis, Virgo HEALTH

020 8939 1261 (office) 07867 456756

[email protected]

Anthony Vaughn, Roche

01707 367 892 (office)

[email protected]

Available for comment/interview:

  • Charles Gore, Chief Executive of The Hepatitis C Trust
  • Andrew Langford, Chief Executive, British Liver Trust
  • Professor David Goldberg, Consultant in Public Health Medicine/Consultant Clinical Epidemiologist at Health Protection Scotland and honorary Professor of Public Health, University of Glasgow
  • Hepatitis specialists representing innovative service design case studies

Notes to the editor

About the HALO report

The report endorsed by The Hepatitis C Trust, British Liver Trust, and the European Liver Patients Association combines an independent literature review representing current thinking in hepatitis C with qualitative research among hepatitis specialists and previously unpublished best practice case studies. The report was funded by Roche and was written by independent medical writer Nigel Hawkes, the former Health Editor of The Times.

About hepatitis C

Hepatitis C is a blood-borne virus that predominantly infects the cells of the liver.  If left untreated, the virus can cause cirrhosis, liver cancer and death.  There is no vaccine but early treatment can successfully clear the virus in around half of patients and ongoing infection can be managed. The Health Protection Agency estimate that less than half of the 216,000 people in the UK estimated to have the disease have been diagnosed.1


1)       Health Protection Agency. Hepatitis C in the UK. 2012. Available at: http://www.hpa.org.uk/Publications/InfectiousDiseases/BloodBorneInfections/HepatitisCInTheUK/1207HepCintheUK2012 [accessed April 2013]

2)       Patruni B, Nolte E, for Rand Europe. Hepatitis C – a projection of the healthcare and economic burden in the UK. January 2013. http://www.rand.org/content/dam/rand/pubs/technical_reports/TR1300/TR1307/RAND_TR1307.pdf [accessed April 2013]

3)       Health Protection Agency. Press release: Four thousand people in England may need liver transplants by 2020 due to hepatitis C, HPA warns. 28 July 2011. http://www.hpa.org.uk/NewsCentre/ NationalPressReleases/2011PressReleases/110728HepCmayleadtotransplantneeds/ [accessed April 2013]

4)       The Hepatitis C Trust. Opportunity Knocks? – an audit of hepatitis C services during the transition. March 2013. http:// www.dsdaily.org.uk/PDF/Opportunityknocksaudit.pdf [accessed April 2013]

5)       Richards M, for Department of Health. Extent and causes of international variations in drug usage.July 2010. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117977.pdf [accessed April 2013]

6)       Market research conducted by The Consortium on behalf of Roche. March 2013. Data on file