We know how important it is to diagnose liver disease as early as possible so it can be treated before it’s too late. Current diagnosis methods make it very hard to do this.

The Scarred Liver Project team have developed a new and simple pathway to diagnose chronic liver disease at a critical early stage often when there are no apparent symptoms. This early detection means lives can be saved.

How it works

We have combined two diagnosis methods to detect liver disease earlier:

1. Actively seeking out patients at risk of chronic liver disease
   
2. Non-invasive diagnostic tests (including Fibroscan^®).
   

GPs are invited to refer patients with risk factors for liver disease (excess alcohol intake/diabetes/obesity) to the pathway where they undergo a non invasive test called a Fibroscan^® to determine whether they have any liver scarring. Every patient who attends the pathway is offered information into maintaining good liver health whilst those with abnormal scans are referred to a liver doctor for a specialist opinion.

This aims to provide an integrated pathway between the GP and the hospital.

The pathway means we are picking up patients with liver disease much earlier, with the ultimate aim of halting the condition or dramatically improving patient health..

Why it works

• Identification of patients earlier than the use of current tests available to the GP
• The non-invasive test is acceptable to patients
• All patients who attend receive information about their liver health
• The pathway has been shown to be an efficient use of health care funds
• Satisfaction with the pathway from patients is consistently high (greater than 90%)
  

Our methods have undergone a full health economic evaluation and we have demonstrated success in 5 different primary care sites across the East Midlands.

The pathway has also attracted interest from regional clinical commissioning groups (CCGs) and has recently been commissioned across south Nottinghamshire making our pathway accessible to more than 100 GP practices serving a population of approximately 700,000 people.

Following an algorithm GPs are able to refer patients at risk of liver disease directly for a specialist test (Fibroscan) before thinking about a referral to hospital.