Imperial College London
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Dr Richard J Pinder

Faculty of Medicine, School of Public Health

Director of Undergraduate Public Health Education
 
 
 
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Contact

 

+44 (0)20 7594 0789richard.pinder

 
 
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Location

 

313Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Williams:2021:10.1016/S0140-6736(20)32396-5,
author = {Williams, R and Alessi, C and Alexander, G and Allison, M and Aspinall, R and Batterham, RL and Bhala, N and Day, N and Dhawan, A and Drummond, C and Ferguson, J and Foster, G and Gilmore, I and Goldacre, R and Gordon, H and Henn, C and Kelly, D and MacGilchrist, A and McCorry, R and McDougall, N and Mirza, Z and Moriarty, K and Newsome, P and Pinder, R and Roberts, S and Rutter, H and Ryder, S and Samyn, M and Severi, K and Sheron, N and Thorburn, D and Verne, J and Williams, J and Yeoman, A},
doi = {10.1016/S0140-6736(20)32396-5},
journal = {The Lancet},
pages = {1770--1780},
title = {New dimensions for hospital services and early detection of disease: a Review from the Lancet Commission into liver disease in the UK.},
url = {http://dx.doi.org/10.1016/S0140-6736(20)32396-5},
volume = {397},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - This Review, in addressing the unacceptably high mortality of patients with liver disease admitted to acute hospitals, reinforces the need for integrated clinical services. The masterplan described is based on regional, geographically sited liver centres, each linked to four to six surrounding district general hospitals-a pattern of care similar to that successfully introduced for stroke services. The plan includes the establishment of a lead and deputy lead clinician in each acute hospital, preferably a hepatologist or gastroenterologist with a special interest in liver disease, who will have prime responsibility for organising the care of admitted patients with liver disease on a 24/7 basis. Essential for the plan is greater access to intensive care units and high-dependency units, in line with the reconfiguration of emergency care due to the COVID-19 pandemic. This Review strongly recommends full implementation of alcohol care teams in hospitals and improved working links with acute medical services. We also endorse recommendations from paediatric liver services to improve overall survival figures by diagnosing biliary atresia earlier based on stool colour charts and better caring for patients with impaired cognitive ability and developmental mental health problems. Pilot studies of earlier diagnosis have shown encouraging progress, with 5-6% of previously undiagnosed cases of severe fibrosis or cirrhosis identified through use of a portable FibroScan in primary care. Similar approaches to the detection of early asymptomatic disease are described in accounts from the devolved nations, and the potential of digital technology in improving the value of clinical consultation and screening programmes in primary care is highlighted. The striking contribution of comorbidities, particularly obesity and diabetes (with excess alcohol consumption known to be a major factor in obesity), to mortality in COVID-19 reinforces the need for fiscal and other long delayed regulatory
AU  - Williams,R
AU  - Alessi,C
AU  - Alexander,G
AU  - Allison,M
AU  - Aspinall,R
AU  - Batterham,RL
AU  - Bhala,N
AU  - Day,N
AU  - Dhawan,A
AU  - Drummond,C
AU  - Ferguson,J
AU  - Foster,G
AU  - Gilmore,I
AU  - Goldacre,R
AU  - Gordon,H
AU  - Henn,C
AU  - Kelly,D
AU  - MacGilchrist,A
AU  - McCorry,R
AU  - McDougall,N
AU  - Mirza,Z
AU  - Moriarty,K
AU  - Newsome,P
AU  - Pinder,R
AU  - Roberts,S
AU  - Rutter,H
AU  - Ryder,S
AU  - Samyn,M
AU  - Severi,K
AU  - Sheron,N
AU  - Thorburn,D
AU  - Verne,J
AU  - Williams,J
AU  - Yeoman,A
DO  - 10.1016/S0140-6736(20)32396-5
EP  - 1780
PY  - 2021///
SN  - 0140-6736
SP  - 1770
TI  - New dimensions for hospital services and early detection of disease: a Review from the Lancet Commission into liver disease in the UK.
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(20)32396-5
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33714360
UR  - https://www.sciencedirect.com/science/article/pii/S0140673620323965?via%3Dihub
UR  - http://hdl.handle.net/10044/1/87553
VL  - 397
ER  -
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