NCEPOD and alcohol-related liver disease, what are the views of those who deliver the service? A survey of consultants and trainees in North Eastern England

• Main Authors: H, S, M
• Format: Article
• Language: English
• Published: Royal College of Physicians of Edinburgh 2018-12-01
• Series: The Journal of the Royal College of Physicians of Edinburgh
• Subjects: alcohol acute care; gastroenterology on-call rotas; guidance liver failure; ITU provision for severe liver disease; NCEPOD alcohol
• Online Access: https://www.rcpe.ac.uk/sites/default/files/jrcpe_48_4_mitchison.pdf

Background National Confidential Enquiry into Patient Outcome and Death (NCEPOD) ‘Measuring the Units’ (June 2013) identified significant organisational and attitudinal deficits in hospital care of patients with alcohol-related liver disease (ARLD), care being recognised as good in less than 50% of patients. Method We surveyed over 700 consultants and trainees in acute medical and intensive therapy specialties to examine their perceptions of the NCEPOD findings. Results A total of 178 responded. In keeping with the NCEPOD findings, their perception was of lack of 24-hour access to specialty advice for patients with liver disease and inequity of access to high-dependency units. Their explanations include lack of resources, therapeutic nihilism and prejudicial judgements that would not be made of other patient groups. Conclusion There is an urgent need for robust mechanisms to ensure equity of access to specialist liver advice and intensive therapy unit resources, and to counter negative and prejudicial attitudes to these patients.