Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will introduce (a) liver and (b) blood tests for (i) young and (ii) any other people with high alcohol use.

Decisions on the use of diagnostic tests for individual patients both under and over 16 years old, are the responsibility of a referring clinician or a healthcare professional, where delegated, taking into account local priorities and clinical guidance.

Alcohol-related liver disease is relatively uncommon in patients under 16 years old as it usually results from several years of heavy drinking. There are no National Institute for Health and Care Excellence (NICE) guidelines and guidance, recommending the use of liver and blood tests for young people.

NICE has made the following recommendations about the use of liver and blood tests for patients over 16 years old: for adults referred to specialist alcohol services, it recommends considering blood tests to help identify physical health needs, but to not use blood tests routinely for the identification and diagnosis of alcohol use disorders; and it recommends liver testing for all men who regularly drink more than 50 units of alcohol per week or women who drink more than 35 units per week. However, routine liver blood tests should not be used to rule out liver fibrosis and cirrhosis.

NHS England is currently reviewing existing liver diagnosis pathways as part of its wider diagnostic transformation work, to determine what the best approach should be to identify patients at an earlier stage of liver disease, through a liver pathway starting in primary care and involving pathology labs and community diagnostic centres. This will likely include a combination of blood tests and transient elastography.