News

Call for Applications 2023 – closing date 5pm Friday 14th April 2023

The aim of this translational research programme is to support experimental studies in the following key areas:
(1) Improved understanding of the pathogenesis of liver disease
(2) Development of accurate tests for early diagnosis
(3) Accelerated translation of research discoveries from bench-to-bedside
(4) Prevention of liver disease through early risk identification and promotion of lifestyle and protective measures including vaccination

This pump-priming award is intended to support acquisition of preliminary data leading to an application to a Research Council or similar funding body for a programme grant/fellowship award. The overarching purpose of the scheme is to enable translational research to benefit liver disease patients.

Grants of either £20,000 or £40,000 are available

For further details and the application form visit the Foundation for Liver Research website > Here . 

Closing date 5pm Friday 14th April 2023

Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust is looking to appoint a Consultant Hepatologist some time in 2023.

The Trust is on the north-western outskirts of Greater Manchester, and has a catchment population of just over 300,000. The post will have clinic, ward-based, and endoscopy commitments; clinics are purely Hepatology, with no Gastroenterology or General Medicine. Ward-based commitments are at present on a 50/50 on/off ward rota; inpatients are those with Hepatological conditions, plus G(I)M and some Gastroenterology. There is also a Hot Week rota, currently 1 week in 8, reviewing Gastroenterology/Hepatology referrals – all normal scheduled activities are cancelled during this time. ERCP and therapeutic endoscopy skills would be advantageous but are not essential; an interest in EUS can be accommodated.

Early enquiry encouraged; please contact shaun.greer1@wwl.nhs.uk .

This article contains headline information about the recruitment process and timings for posts offering advanced hepatology training starting in 2023. These training opportunities are for 12 months and will form a major part of the hepatology training theme within the 2022 Gastroenterology Curriculum, including experience in a transplant unit. The recruitment process covers posts in England, Scotland and Wales and will enable successful applicants to take up a post in any region.

Eligibility

Only current gastroenterology NTN holders who meet the criteria below can be considered:
• Either at the start of and at least ST6 level of training at post commencement, with evidence of satisfactory progress via ARCP OR
• At the start of ST7 level of training at post commencement, and have completed 12 months of hepatology training, with evidence of satisfactory progress via ARCP. Any outstanding GIM commitment will need to be accommodated by the training centre during ST7.
• CCT date should not be before August 2024

Timeline
• Applications will open from 10am on 1 December until 4pm on 20 December; applications will be made on the Oriel system. Now live:  https://www.oriel.nhs.uk/Web/PermaLink/Vacancy/21EDC26D  
• Shortlisted candidates will be invited to interview in mid-January.
• Interviews take place online on 1 February.
• Offers will be made later in February

Information about the expected posts available and further details about the process are available on the BASL website > Here.

If you are considering applying, it is strongly recommended that you speak to your current training programme director to discuss your plans and the effect it will have on your training.

On 27th October 2022 the British Liver Trust launched Liver Cancer UK in response to rising cases of liver cancer across the country.

Liver cancer is the fastest rising cause of cancer death in the UK. Over the past decade, liver cancer incidence rates have increased by almost half (45%) in the UK and the number of people dying from liver cancer has risen the fastest out of all the twenty most common types of cancer. There are now over 40% more deaths from liver cancer in both men and women than there were a decade ago (1&2).

The disease also has a high mortality rate. Every year over 6,000 people are diagnosed with liver cancer country-wide and just 13% of them will survive for five years or more. (3) Survival rates depend on several factors, including the stage of the disease when it is diagnosed.

Many patients with liver cancer will only be diagnosed after an emergency admission to hospital or an emergency GP referral after symptoms have become severe and the cancer is more advanced. (4) In England, 44.9% of liver cancers are diagnosed in an emergency setting, such as an A&E department (5).

Liver Cancer UK will provide much needed information and support for patients affected by this devastating cancer and provide a focus for action to address this escalating situation. It will aim to improve the lives and outcomes of people affected by liver cancer and, ultimately, reduce cases of the disease.

The British Liver Trust will continue to work towards a world free of all liver diseases in addition, and as part of, its commitment to tackle liver cancer. Liver cancer is most common in people who already have liver disease, especially if they have cirrhosis (damage and scarring) of the liver which is most often caused by viral hepatitis, alcohol or obesity (6).

Pamela Healy OBE, Chief Executive of British Liver Trust, said:
“Liver cancer patients have told us that they didn’t realise that the British Liver Trust was also here for liver cancer patients - they were often confused and worried and did not know where to turn for help. We’ve created new resources and a website with targeted information to make it easier for people to get the help they need. The new programme of activity is in response to the very worrying increase in cases across the UK. We’re also deeply concerned that survival rates for liver cancer remain so low. It’s a situation which needs to urgently change.

“Liver Cancer UK, as part of the British Liver Trust, will be dedicated to saving and improving the lives of people affected by liver cancer by raising awareness, providing support and campaigning for faster diagnosis and more research into treatments and cures.”

Fiona Bailey (age 48), a liver cancer patient from Hampshire, said:
“When I was diagnosed with liver cancer, aged 45, my husband and I weren’t sure where to turn for support. At the time, I didn’t know anybody who had gone through it apart from my father-in-law who was diagnosed ten years earlier. I was diagnosed in time for surgery although I do continue to live with the ‘worry’ that it could come back. It’s brilliant that the British Liver Trust is launching Liver Cancer UK to provide dedicated information and support to patients like me and to increase awareness of liver cancer to ensure more people are diagnosed earlier. When you’ve been through something like this you just want to help other people.”

As well as the rising cases, late diagnosis of liver cancer continues to be a problem. This is partly due to the population’s low awareness of the symptoms of the disease. In 2021, the Less Survivable Cancers Taskforce released data showing that only 5% of people in the UK were able to correctly identify all symptoms of liver cancer from a list presented to them.

Professor Stephen Ryder, Medical Advisor to the British Liver Trust and Consultant Hepatologist at NHS Nottingham University Hospital, added:

“Lack of awareness of primary liver cancer and its causes is a common problem in the UK.

“The causes of liver disease and HCC, the most common primary liver cancer, are similar and interlinked. The good news is that there are things you can do to reduce the risks. Maintaining a healthy weight, avoiding drinking alcohol excessively and protecting yourself against viral hepatitis are the best defences against both liver disease and liver cancer.

“People can also develop cancer of the liver and gallbladder without the associated risk factors and should be concerned if they have any symptoms that are persistent and not normal for them. If you’re experiencing symptoms such as loss of appetite, nausea, a swollen stomach or yellowing of your skin and/or eyes, please don’t ignore them - make an appointment with your doctor to get them checked out.”

Symptoms of liver cancer include unintentional weight loss, loss of appetite, feeling very full after eating, feeling and being sick, pain or swelling in your abdomen, jaundice (yellowing of your skin and the whites of your eyes), itchy skin, feeling very tired and weak, fever with shivers, vomiting blood, dark black tarry poo or dark urine. However, the majority of these symptoms do not occur until liver cancer is at an advanced stage, so the British Liver Trust is calling for all people who are diagnosed with cirrhosis and who are most at risk to be regularly screened for liver cancer.

Visit Liver Cancer UK to find out more.

1.Over the last decade, liver cancer incidence rates have increased by almost half (45%) in the UK. Rates in females have increased by almost two-fifths (38%), and rates in males have increased by almost half (46%) (2016-2018): https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer#heading-Zero 
2.Liver cancer has shown the fastest increase in mortality (within the current 20 most common UK causes of cancer death) over the past decade in the UK for both females and males. Liver cancer mortality rates have increased by 45% in females and 42% in males over the past decade in the UK. Reference: Cancer Research UK (2019). Cancer mortality for common cancers. [online]. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/common-cancers-compared (last accessed October 2022).
3.https://britishlivertrust.org.uk/liver-cancer-awareness-month/ 
4.The Emergency Presentation Route comprises different emergency pathways into secondary care, including A&E attendance, emergency GP referrals to an inpatient setting (non–two week wait referrals) and emergency admissions to either an inpatient or outpatient setting.
5. https://www.cancerdata.nhs.uk/emergencypresentations . Data compared for 2020 Q3. Percentages differ slightly when compared to the National Cancer Registration Dataset due to diagnostic coding - this data is only currently available for 2006-2016.
6.https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/liver-conditions/liver-cancer-hcc/ 

We are conducting a national retrospective audit to identify practice of outpatient NAFLD management according to national quality standards/international guidelines and explore the changes in NAFLD outpatient services over the last 3 years across the UK. This will require registration as an audit with the local clinical audit department and a search of new patients reviewed in outpatient Gastroenterology and Hepatology clinics with suspected or confirmed diagnosis of NAFLD in March 2019 and March 2022.

No centre or patient-identifiable data will be included in any results disseminated. A nominated Gastroenterology or Hepatology consultant will receive a report of local results, with reference to the national findings at a later date for future auditing purposes.

If you would like to get involved, please access the documents below and follow the necessary steps:

Instruction letter including link to survey:
Download 2 - NAFLD audit_instruction letter for data collection.pdf

Audit registration form:
Download NAFLD audit_audit registration form.pdf

An audit registration form can be obtained by emailing paula@basl.org.uk or wenhao.li@nhs.net .

Please submit all collected data by 30th September 2022 - deadline has been extended from 31st August 2022.

If there are further questions regarding this project, we would be more than happy to answer them and you can contact us by emailing wenhao.li@nhs.net .