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Dec
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After the original NCEPOD Report into the care of patients dying with alcohol-related liver disease (ArLD) published in 2013, a survey conducted by NCEPOD has re-evaluated the problems highlighted in the initial Report. This focused on the detection and management of alcohol dependent patients as well as those admitted with alcohol-related liver disease.
The survey Report – ‘Remeasuring the Units’ was published by NCEPOD on 15th December 2022 and highlights where there is further work to be done. It shows that the majority of hospitals still do not have Alcohol Care Teams, that the use of the BASL/BSG Care Bundle needs to be in routine use more widely, and that in over a quarter of Trusts patients with decompensated cirrhosis are not routinely under the care of a gastroenterologist or hepatologist.
For the full Report please click on the link > Here .
Dec
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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.
Nov
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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/
Sep
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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 .
Jul
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Please contact Professor Foster directly by email g.r.foster@qmul.ac.uk if you have any questions.
Apr
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Overview
The BSG/BASL NAFLD special interest group has developed a series of evidence-based quality standard recommendations, with the aim of improving the care of people with NAFLD. It is known that NAFLD is common, affecting 25% of the UK population and management of the condition is variable. Individuals with NAFLD have an increased risk of overall mortality compared with the general population, and common causes of death include cardiovascular disease, malignancy and liver-related complications. A holistic approach is therefore needed to address liver disease, as well as cardio-metabolic risk factors.
The recommendations were developed using a modified Delphi process by a multidisciplinary group of 29 individuals from all disciplines involved in the management of people with NAFLD, and cover: 1. Management of people with, or at risk of, NAFLD before the gastroenterology or liver clinic; 2. Assessment and investigations in secondary care; 3. Management in secondary care. We have also developed 11 auditable key performance indicators (KPIs) to enable service to review the care of their patients and benchmark their practice.
Manuscript and summary documents
The full manuscript can be found here https://www.sciencedirect.com/science/article/pii/S2468125322000619?dgcid=author. (Free access to the manuscript will be available for 50 days from Friday 28 April 2022.)
Click here for the Download Summary of the NAFLD quality standard recommendations for website_l.pdf
Apr
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As a healthcare professional, do you have experiences of the COVID-19 pandemic that you would like the public to hear? As we learn to live with COVID-19, is there anything you think the public needs to know? Are there things about the pandemic that you think should be recorded for posterity?
We can help to get your voice heard.
The Royal College of Physicians (RCP) Archive and Museum are recording the experiences of healthcare workers and of those close to them during the COVID-19 pandemic.
Those working in healthcare have been at the forefront of protecting society throughout the pandemic; help us to document your experiences by completing the survey linked to below.
Your experiences may become part of the 2023 RCP at Regent’s Park exhibition, ‘Sharing doctors’ voices; experiences of the COVID-19 pandemic’. Featuring photos, stories, recorded interviews, and objects, this exhibition will centre the voices of individuals, demonstrating the effects of the pandemic on the people working to combat it, in their own words.
Share your experiences with the RCP > Here
More information can be found on the RCP website > Here
Apr
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Following a systematic audit of the National Nominating Organisations (NNOs) in 2021 and a careful review of the roles of the large numbers of organisations who have historically been involved in nomination and citation processes, the Advisory Committee on Clinical Impact Awards (ACCIA) has reduced the number of recognised NNOs and overall number of ranking places for 2022.
Unfortunately BASL has not been accredited as an NNO by the ACCIA. The full list of accredited NNOs can be found on the ACCIA website > Here
Jan
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The BASL Equality, Diversity and Inclusiveness Strategy 2021-2024 document has been compiled as part of the BASL Inclusiveness Project and has received BASL Committee approval.
This, alongside our updated Equality, Diversity and Inclusiveness Policy and the policies that have been developed to support it can be found in the members area of our website by logging on > here .
Jan
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2021 was a year of significant progress for the IQILS accreditation programme. The programme is in its strongest position since it launched back in 2021. The first few onsite accreditation assessments were conducted in the latter stages of 2021. We would like to congratulate the services at University Hospital Southampton NHS Foundation Trust and North Bristol NHS Trust on being awarded accreditation. Dr James Ferguson, the IQILS clinical lead has commented on the outstanding level of care, compassion and innovation these services have demonstrated. Several assessments will be taking place in the early part of 2022. Currently the programme has 61 registered services, 2 accredited services and 12 services are currently signed off for the level 1 standards.
Introduction to IQILS accreditation programme – Tuesday 15 February 2022, 09:30 – 11:00
If you would like to learn more about the IQILS programme. A virtual introduction to IQILS accreditation session is being ran. This session is designed for services not yet registered to the programme and are interested in finding out more. During the session delegates will learn about:
• What is accreditation and how it can add value to your service
• The process and logistics involved in accreditation
• The overall benefits of registering
The session will be led by the Dr James Ferguson, IQILS clinical lead and Dr Andrew Yeoman, the QA lead of the IQILS programme. The session will take place via MS teams. Once you have registered an invite will be sent to all delegates with the dial in details. Registration for services is open.
Services registered to the programme receive access to the following benefits:
• The full accreditation standards
• Access to the IQILS website and self-assessment webtool
• Regular virtual training session on the accreditation process and standards
• Online repository of best practice templates and documents
• Regular newsletters on the programme with updates
• Support from the IQILS office team
If your service is interested in registering, please visit the IQILS website to sign up; https://www.iqils.org/UserRegistration/ .
Accreditation helps services to:
• independently measure themselves against national standards
• reduce variation in quality standards of their services
• demonstrate dedication to improvement, patient safety and reducing risk
• raise their profile, which can often be used to leverage support in their organisation
• highlight good practice and get targeted advice on where to focus improvement efforts
Please contact the IQILS team at askiqils@rcp.ac.uk or 0203 3075 1508 if you would like to speak to the team about the programme. IQILS has recently joined twitter, follow us @IQILS_Liver .
(Added 5/01/2022)