The publication of NHS England’s new Cardiovascular Disease Modern Service Framework is an important milestone for people affected by liver disease and a significant step forward in recognising the links between liver, heart, kidney and metabolic health.
For Liver UK, formerly the British Liver Trust, this is particularly welcome because the framework explicitly recognises metabolic dysfunction-associated steatotic liver disease (MASLD) as part of the wider approach to preventing heart disease and stroke. This recognition reflects years of campaigning by Liver UK and our recent work with the NHS England Liver Disease Transformation Programme to ensure liver disease is fully integrated into prevention, early diagnosis and the management of long-term conditions.
For too long, liver disease has been overlooked in national health policy despite being one of the fastest-growing causes of ill health. We have consistently argued that MASLD must be recognised alongside obesity, type 2 diabetes, cardiovascular disease and health inequalities if we are to reduce avoidable illness and save lives. The inclusion of MASLD within this major national framework is an important acknowledgement of that reality.
The challenge now is to turn this vision into action. Liver UK is calling on clinicians, commissioners, policymakers and healthcare leaders to ensure liver disease is fully embedded within local pathways, prevention programmes and integrated models of care. Whenever people are assessed for obesity, diabetes, cardiovascular disease or kidney disease, there should also be opportunities to assess liver health and identify those at risk of MASLD.
MASLD is now one of the most common forms of liver disease and is closely linked to obesity, type 2 diabetes, high blood pressure and raised cholesterol. People living with MASLD are also at a higher risk of developing heart disease and stroke, making cardiovascular disease one of the leading health risks associated with the condition.
Despite these close links, healthcare services have often managed liver disease separately from other metabolic conditions. The new framework recognises that this approach needs to change. By bringing together liver, cardiovascular, kidney and metabolic health, it supports more joined-up care and earlier identification of people at risk.
This matters because liver disease is frequently diagnosed late, when significant and sometimes irreversible damage has already occurred. Many people with MASLD live for years with known risk factors before liver disease is identified. A more integrated approach creates opportunities to find people earlier and intervene before serious complications develop.
The framework sets out a 10-year vision focused on prevention, earlier diagnosis, improving treatment and reducing health inequalities. Many of its priorities align closely with what is needed to tackle MASLD, including earlier identification of people at risk, better management of obesity and diabetes, stronger prevention efforts and more coordinated care across services.
The publication also reflects the progress made through the NHS England Liver Disease Transformation Programme, which has helped drive improvements in awareness, pathway development and early detection. The inclusion of MASLD demonstrates that liver disease is increasingly being recognised as an important part of wider population health and prevention strategies rather than a standalone specialty issue.
The framework’s focus on reducing health inequalities is particularly important. Both liver disease and metabolic ill health disproportionately affect people living in more deprived communities, where access to diagnosis and support can be more challenging. Closer working between primary care, liver services, diabetes teams, cardiovascular specialists and kidney services has the potential to improve access to care and ensure patients receive earlier, more coordinated support.
The inclusion of MASLD within the Cardiovascular Disease Modern Service Framework is a significant step forward. By recognising the close links between liver, heart, kidney and metabolic health, the NHS has an opportunity to diagnose disease earlier, reduce inequalities and improve outcomes for millions of people. Now we must ensure this welcome recognition leads to real and lasting improvements for patients.
