Fylde coast bucks the trend in Lancashire liver disease diagnosis 'postcode lottery'

A study undertaken by charity the British Liver Trust (BLT) found much of the county, including Greater Preston and East Lancashire clinical commissioning groups, have little or no formal structures in place for detecting and managing liver disease and liver cancer.

However, figures obtained by the charity from UK CCGs identified that Blackpool, Wyre and Fylde did have "partial or in development pathways" in place.

The BLT said three quarters of people with liver disease are diagnosed at a stage when it is often too late for treatment or intervention, and called on healthcare commissioners to ensure earlier detection of liver disease and better patient care across all regions of the UK.

Timely diagnosis and treatment of liver disease and liver cancer "should not be a postcode lottery," it said.

Dr Helen Jarvis, clinical advisor for the BLT and lead author of the research, said: “Anyone who has liver disease, or is at risk of getting it, should get the medical care and advice they need no matter where in the country they live. There are pockets of good practice, but there are also many areas that do not have a consistent approach to testing for and diagnosing liver disease. It shouldn’t be a postcode lottery.

“GPs and other healthcare professionals in primary care are doing a fantastic job under a lot of pressure, but in many areas, they’re working within a system that doesn’t allow them to detect and treat liver disease effectively. Unfortunately, many GPs also report a lack confidence and knowledge when it comes to managing the condition.

"Symptoms of liver disease often only appear once damage has progressed and the liver is starting to fail. However, 90 per cent of liver disease is preventable and, in many cases, it’s reversible if caught in time. That’s why early detection and prevention are key."

But Mike Davis, 73, from Bispham, praised his GP and medics at Blackpool Victoria Hospital for his diagnosis and treatment of Hemochromatosis - a genetic liver disease - in 2002.

The regular monitoring he received as part of his ongoing healthcare at the Vic identified a tumour in his liver, which resulted in a diagnosis of liver cancer in April 2011.

Mike was referred to St James's hospital in Leeds for a transplant, which he received just five months after his diagnosis.

He now remains under yearly monitoring but is cancer free, and said he felt the responsibility of detecting liver disease lies not only with GPs, but with patients themselves.

Mike said: "After I was diagnosed with Hemochromatosis I was receiving monitoring from the gastroenterology department at the Vic, so I saw consultants annually for MRI scans.

"I was different to a lot of people who are diagnosed with liver disease in that I already had a monitorable condition, whereas many people tend to be asymptomatic until relatively further down the line.

"Late diagnoses are an issue, but GPs may not necessarily be alert to potential problems because so many people don't show any symptoms. However, issues associated with alcohol, diet and lifestyle can lead to liver cancer or liver disease and those are all things which should alert GPs.

"Even when I had a tumour in my liver I was otherwise in good health, it was only picked up by one of the routine MRI scans I had. It is important that there is some sort of effort that goes into making sure an appropriate response happens when people turn up to their GP, but there are so many other possibilities GPs have to rule out.

"It's about being alerted the the lifestyle choices patients make. The fact is liver disease and cancer are potentially life-threatening illnesses, so it's about encouraging people to be more proactive in managing their own health and symptoms as well."

Pamela Healy OBE, chief executive of the British Liver Trust, said deaths due to liver disease have "more than doubled in the last 20 years," and the condition is expected to overtake heart disease as the biggest cause of premature death in the UK in the next few years.

Obesity, alcohol and viral hepatitis are the three main risk factors for preventable liver disease, she added.

Fylde Coast CCGs were contacted for comment.