From April 2020 a new National Health Service CQUIN (Commissioning for Quality and Innovation framework) will be introduced to support early identification of cirrhosis and enhanced fibrosis in alcohol dependent individuals. The CQUIN will incentivise acute and mental health providers to ensure that appropriate tests (transient elastography, enhanced liver fibrosis or STLT blood tests) are carried out on in-patients who have a diagnosis of alcohol dependence.
The delivery of the national CQUIN to support early identification of cirrhosis and enhanced fibrosis against a standard set of criteria will support tackling regional variation.
Specialised commissioning is also supporting a programme to identify people with hepatitis C infection at an early stage to avoid subsequent liver disease.
In 2019/20, Public Health England (PHE) awarded £6 million capital funding to 23 local authorities to support their ambitions to increase access to alcohol treatment. This includes supporting nine areas to purchase fibroscan machines to increase early detection and access to treatment for those with alcohol-related liver disease.
PHE is also supporting work to increase opportunities for the earlier detection of alcohol-related liver disease in people drinking at or above high-risk levels. This includes new NHS Health Check guidance to encourage referral for liver investigation.
Additionally, the rollout of optimal Alcohol Care Teams across England in the areas with the highest rates of alcohol dependence-related admissions will improve the care pathway, including the use of appropriate diagnostics, for patients and their families who have issues with alcohol dependence.