Liver disease toolkit
The aims of the BLT/RCGP Liver Priority Project are to raise awareness of liver disease as an increasingly important cause of morbidity and mortality in the UK and to provide resources to support its optimal management in primary care.
Innovation and best practice in primary care
Many local teams have led innovative and exciting developments in the prevention and management of liver disease in their areas across the UK, some of these are listed below.
If you've been involved in innovative or best practice in the management of liver disease and you would like to share details of your project, please complete the pro forma and email it to clinicalquality@rcgp.org.uk
- GP-based best practice pro forma [409 KB, DOC]
- Non-GP best practice pro forma [412 KB, DOC]
The Bolton Alcohol Project
Teams in Bolton have developed integrated and collaborative changes that led to:
- the creation of a consultant-led hospital based alcohol care team that has improved the care and reduced admissions for alcohol-related conditions
- a primary care project that has been highly successful in identifying alcohol problems through screening with the AUDIT-C test and signposting patients to early interventions
Liver health screening in Middlesbrough
Middlesbrough has developed a 'Live Well Centre'. The centre is a one-stop shop to support people in changing their lives for the better across a full spectrum of life issues. The project is specifically building in the identification of risk factors for liver disease together with signposting to further interventions as part of an opportunistic screening programme.
End of life care for patients with advanced liver disease
St Luke's Hospice, Basildon, has worked collaboratively with local secondary care hepatology services to create a Shared Care Liver Project designed to meet the unmet needs of patients with advanced liver disease and to improve end of life care.
The Scarred Liver Project Nottingham
The Scarred Liver Project has developed an effective community-based diagnostic pathway for identifying liver disease which stratifies patients using validated non-invasive tests. GPs can refer patients with a defined risk factor for chronic liver disease directly for transient elastography (FibroScan) before considering referral to secondary care. The aims of the project include improving the early detection of liver disease and providing brief lifestyle interventions for those attending for screening.
The St Mary's Surgery Liver Project Southampton
The St Mary's Surgery Southampton recognised that the patients in their large inner city practice were likely to have a high prevalence of liver disease. Having been part of the ‘Locate’ project the practice worked with local liver specialists to improve their identification and management of liver disease through the development of local clinical pathways and through direct GP access to transient elastography (TE).
The West Midlands Liver Health Work
Recognising higher than average liver disease mortality in the region, together with high levels of health inequality, local PHE leads have brought together services and organisations to address the human and financial costs arising from this. Through local workshops and the creation of a local network, the region has put in place strategies to improve the early detection of liver disease and improve the patient experience.
The Liver Matters Project
The 'Liver Matters' project has worked across the Birmingham South Central CCG to enhance the quality of life for people with alcohol related liver disease and their carer(s) and families, providing information and advice, liaising with treatment services, expanding social networks, and supporting end of life care.
The Glasgow Liver Support Service
The Glasgow Ambulatory Liver Support Service was set up with the aim of reducing re-admissions in patients admitted with decompensated cirrhosis by 20%. Focusing on three novel interventions: pre-discharge patient education; post-discharge review; and re-admission prevention strategies; it has been successful in achieving its goals.
Tayside iLFTs
Testing LFTs should be an opportunity to allow early diagnosis, but abnormal LFTs are often incompletely investigated. The Tayside iLFTs project developed an automated investigation algorithm, which maximises diagnosis of liver diseases.