New research demonstrates that a large majority (70%) of Strategic Health Authorities (SHAs) in England are failing to oversee the Government's strategy to tackle hepatitis C1, leaving infection rates of this deadly virus to increase and causing the disease to spiral out of control - putting thousands of lives at risk. A further study shows SHAs ignoring NICE guidance with only 29% of diagnosed patients2 being treated across the country, less than half of the 60% that NICE recommends.3

"We have to act now to stop this. It is not acceptable that people are dying when there are treatments available to save lives. The strategies that have been developed are simply not being implemented and there is no more time for excuses, we must act to ensure that the strategy is delivered. The time for paperwork is over, we need action not documents." says Graham Foster, Professor of Hepatology, Queen Mary, University of London.

Click here to download interactive map of SHA regions and view soundbites from key spokespeople: hepcoutofcontrol

Five years wasted since Hepatitis C Action Plan for England launched

In 2004 the Department of Health published the Hepatitis C Action Plan for England, which outlines specific actions to improve research, monitoring, awareness and prevention efforts and overall patient care. However, an audit in 2008 found that half of PCTs were only partially implementing the Action Plan and in 15% of PCTs there was minimal implementation or none at all.4 One year on, it is apparent that SHAs, which manage the NHS locally and are a key link between the Department of Health and the NHS, have not intervened to improve PCT implementation of the Action Plan, despite the fact that responsibility for oversight is placed with them. As the latest research shows, one SHA (South East) is not aware of any local arrangements in place to deliver the Plan, and in most areas of the country there is no plan in place to ensure improvements to hepatitis C services and treatment for patients.

Charles Gore, CEO of The Hepatitis C Trust, the charity that has published the research, says "Patients are dying and that is the Trust's concern. There is failure at every level in addressing hepatitis C. SHAs, PCTs and all relevant NHS bodies must be held accountable to avoid dire consequences. Time has run out and the Government need to show leadership and take control now. It is time to prioritise liver disease; it is time for a liver strategy; and it is time for a liver czar."

Liver deaths and new infections increasing in England compared to the rest of Europe

Overall, mortality from liver disease is declining in Europe5, in sharp contrast to the situation in England where deaths attributable to hepatitis C have doubled in the past decade.6 Furthermore, the number of people with hepatitis C cirrhosis is expected to double to 8,280 by 2015.7 Unless the Government responds now, poor treatment rates, coupled with an increase in incidence of around 12,995 infections per year (more than 1,000 per month)8 mean that the hepatitis C epidemic will continue to soar in the UK.

Treating and curing so few patients means that deaths will continue to escalate, the demand for last ditch interventions such as liver transplants will rise and more people will become infected with the disease. This imminent crisis can be effectively managed and people's lives can be saved. It is time to prioritise liver disease; it is time for a liver strategy; and it is time for a liver czar.

The Hepatitis C Trust calls for:

1.A national liver czar responsible for driving forward improvements in liver services, particularly hepatitis C.

2.A national liver strategy to address the growing crisis of liver disease, with clearly defined actions for addressing hepatitis C.

3.A robust governance structure for hepatitis C to oversee the monitoring, benchmarking and evaluation of actions by all levels of the NHS. These should be reported annually in the HPA report on hepatitis C.

4.A review of the implementation of NICE treatment and an audit of the barriers to achieving recommended treatment uptake levels.

About hepatitis C in the UK

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). Hepatitis C, one of the most common chronic blood-borne infections, is transmitted primarily through blood or blood products. Hepatitis C can be passed by piercing, tattoos, transfusion, injection, razors, sharing toothbrushes, dental work9 and by sharing snorting equipment e.g. rolled bank notes or straws10 Patients can live for many years without experiencing symptoms, and as a consequence, a large number of patients remain undiagnosed.

There are estimated to be around 201,054 people infected with hepatitis C in England11 with a further 50,00012 in Scotland (Health Protection Scotland) and 12,00013 in Wales (National Public Health Service Wales). University of Southampton research estimates there are as many as 466,000 infected people in the UK.14 Hepatitis C can remain undetected for 20 years without showing symptoms but it can still be causing liver damage.

Day to day symptoms vary from general fatigue, to flu-like feelings through to digestive issues, joint pains, mood swings and depression. There is no vaccine against hepatitis C, but treatment can achieve a cure in over half of patients. Pamela Anderson, Keith Richards, Natalie Cole, Anthony Kiedis, Marianne Faithfull and the late Dame Anita Roddick, have all been diagnosed with hepatitis C.

About The Hepatitis C Trust

The Hepatitis C Trust is the national patient-run charity that provides a range of services offering support, information and representation for people with hepatitis C. The Trust is also committed to raising awareness and highlighting the importance of getting tested.

If you are at all concerned that you may have been exposed to hepatitis C or have symptoms that may be attributed to hepatitis C - please call The Hepatitis C Trust HELPLINE on 0845 223 4424 for more information.

References

1. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 5

2. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 12

3. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 12

4. The All-Party Parliamentary Hepatology Group. Location, Location, Location: An Audit of Hepatitis C Healthcare in England, February 2008, Page 3

5. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 6

6. Health Protection Agency. Hepatitis C in the UK: The Health Protection Agency Annual Report 2008. Page 58, Figure 19

7. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 12

8. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 13

9. NHS, Hepatitis C Essential information for professionals and guidance on testing, 2004, Page 7

10. The Hep C Trust website. Risk Factors. hepctrust/hepatitis-c/Risk+factors.htm. Accessed 7 July 2009

11. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 13, Figure 3

12. Health Protection Agency (Scotland), Hepatitis C action plan for Scotland. Phase I: September 2006 - August 2008, Page 6

13. National Public Health Service Wales. Hepatitis C. wales.nhs/sites3/page.cfm?orgId=719&pid=23121 Accessed 30 June 2009

14. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance, July 2009, Page 6

Source
The Hepatitis C Trust