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fibroscan which provides concrete evidence of liver damage can sometimes be a catalyst for people who have been drinking at harmful levels for a long time but who were previously reluctant or scared to seek help . This is why Turning Point made the decision to ensure we are able to fibroscan clients in all our services and why we are calling for widespread availability of free liver checks for anyone worried about their drinking .

It ' s one of the recommendations made in our report , A sobering thought : the scale of alcohol harm and what we can do about it , published last month , that urges the government to make alcohol harm a priority to avoid further damage to people ’ s health and reduce the burden of alcoholrelated harm on the NHS , the criminal justice system and the economy . Our analysis indicates alcohol-related admissions cost the NHS £ 1.16bn between 2021 and 2022 .

Official figures show 9,641 people in the UK died in 2021 from causes specifically related to alcohol , the highest number on record and 7.4 per cent higher than in 2020 . Deaths from liver disease alone have increased by 400 per cent since the 1970s , and account for most alcoholrelated deaths .

Professor Sir Ian Gilmore , chair of the Alcohol Health Alliance , has said the recommendations featured in this report would make a ‘ real , tangible improvement to people ’ s everyday lives . As liver health is a known indicator for wider health issues , the report rightly highlights how the broader

commissioning of fibroscan could help reach people who are at higher risk of harm but not yet engaged in treatment ,’ he stated . Turning Point supports more than 14,000 people each year for alcohol-related problems and we ’ re seeing increasing numbers of referrals for those who have end-stage liver disease . Alcohol-related liver disease is a largely hidden epidemic because the warning signs such as yellowing skin take years to develop . Many people are unaware alcohol is affecting their health until they develop advanced cirrhosis .

Fibroscan tests are quick and painless health checks that can detect liver disease before any physical symptoms develop . Turning Point ’ s service in Leicester was initially involved in an eight-month fibroscan trial , which was funded by Leicester City Council .

The scans were offered to two cohorts – clients on Turning Point ’ s alcohol dependent treatment pathway and to registered patients within a pilot primary care GP site ( Saffron Group Health ) – who were identified to have potential alcohol dependence but were ambivalent / reluctant to engage in treatment .

A total of 178 clients were offered a fibroscan , of which 44 were referred to hepatology with 39 showing liver stiffness . A further ten client scans indicated advanced fibrosis , and another 17 showed cirrhosis of the liver .

Fibroscans are now routinely

offered at our Leicester service . Steven Geary , who was drinking heavily for 14 years , said having a fibroscan done at the Leicester service was a ‘ massive ’ wakeup call . ‘ When you ’ re in active addiction , all you think of is the drink , but with the fibroscan I could see the damage I was causing myself ,’ he said . ‘ I just thought “ God this is horrendous ” after I had the fibroscan . I went through detox and a rehab programme at Turning Point . I ’ ve been abstinent for five months .’

Fibroscan equipment is small and portable and can be delivered in outreach settings , reaching people who have not previously engaged in treatment but who are at higher risk . Wider availability of fibroscan would ultimately reduce the burden on acute and primary healthcare services .

The earlier we can identify and stage liver disease , the earlier we can support individuals to reduce their intake . Fibroscan offered alongside psychosocial intervention can support positive behaviour change .

Our ambition is to offer fibroscan to all new alcohol treatment presentations and to

Fibroscan equipment is small and portable and can be delivered in outreach settings .

existing service users within the next 12 months . Our national alcohol pathway has been updated to include the offer of a fibroscan exam at the earliest opportunity .

Other recommendations in A sobering thought include a national alcohol strategy incorporating the introduction of MUP in England and named alcohol leads in every integrated care system ; proper funding of alcohol screening within primary care and A & E , in line with NICE guidance ; and a new evidence based digital self-help tool which is free , available to anyone and publicised as part of an ongoing national public health campaign targeted at harmful and hazardous drinkers .

Gill Campbell is head of nursing at Turning Point