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Environmentally Sustainable Hepatology - It’s time to make a start.
The Covid-19 Pandemic has precipitated a rapid re-think of how medical services should be provided in the UK and around the world. This reconfiguring of services is happening in parallel to the run up to the G7 conference in Carbis Bay, Cornwall where Climate is a key item on the agenda. As well as this the UK is hosting the COP26 climate conference later this year, this pivotal meeting taking place at a time when key decisions and investments are being made as part of the recovery from the pandemic. There have been many pleas to place Climate, Planetary and Human Health at the centre of the pandemic recovery.
Over the last few years the majority of us will have noticed gradual steps towards a more sustainable future, in what we eat, how we travel and almost every other aspect of our lives. These changes include a move to a more environmentally sustainable future for healthcare. The NHS is leading this change internationally with plans underway to deliver the world’s first net zero healthcare system . This transformation requires a rethink of every aspect of NHS practice from heating and lighting to changes to the NHS constitution. This transformation delivers the potential to maintain or improve quality of care whilst lessening our impact on the planetary systems and natural world on which we all rely.
"It is not enough for the NHS to treat the problems caused by air pollution and climate change - from asthma to heart attacks and strokes - we need to play our part in tackling them at source."
NHS Chief Executive Simon Stevens
A number of specialities including Anaesthetics, Surgery and Nephrology are making progress with a move to more sustainable healthcare models, with help from organisation such as https://sustainablehealthcare.org.uk . Our Gastroenterology colleagues are also making progress with the recent appointment of a Fellow in Sustainable Endoscopy and an expanding international coalition: ‘The Green Endoscopy Network’ (Twitter @GreenEndoscopy).
It is overdue for Hepatology to start a journey towards a more sustainable future rather than be left on the sidelines at this time.
What is Sustainable Healthcare?
A sustainable healthcare system is achieved by delivery high-quality care and improved public health without exhausting natural resources and living within the ecological boundaries of our planet.
The 4 main domains of sustainable healthcare are set out below adapted from Mortimer et al.
How do we make a start on Sustainable Hepatology?
Maybe the best way to start is by recognising that some current practices already fit within the sphere of sustainable hepatology within one of the domains above. For instance non-invasive assessment of hepatic fibrosis whether it be by ELF test or FibroScan represent low carbon modalities of assessing severity of liver disease. Other more sustainable practices underway, such as telephone and video appointments where appropriate, represent a change to lean services delivery and such practices should be embedded where appropriate and feasible. These may sound like small steps, however with an increasing burden of liver disease they are significant and represent a beginning.
Where else might Sustainable Hepatology lead and what might be the next steps?
The next step may be to consider embedding sustainability in quality improvement framework (SusQI) and into the outcomes of a service measured against environmental, economic, and social cost to determine its sustainability value. This framework was developed by the Centre for Sustainable Healthcare with partners including the Royal College of Physicians . This might lead to a new focus on healthcare preventive measures such as minimum unit pricing of alcohol or a greater focus on preventing metabolic liver disease both within childhood and adult services.
We might also consider:
• Form a multi-disciplinary group of interested others to define what Sustainable Hepatology should be.
• Consulting with https://sustainablehealthcare.org.uk at an early stage.
• Educate ourselves, our association, colleagues, departments and others where appropriate on climate, health and liver disease.
• Incorporate talks on climate and sustainability into gastroenterology and hepatology training and relevant meetings.
• The principles of sustainable quality improvement (SusQI) have been developed by a group including the Royal College of Physicians. These principles could be incorporated into guideline development and quality improvement in Hepatology.
• Appoint Fellows in Sustainable Hepatology (as is taking place in Endoscopy, Anaesthetics, Surgery, Dentistry and Psychiatry).
• A move to more sustainable Hepatology conferences.
In our opinion it is time for hepatology to look to a more sustainable future and we welcome the thoughts and opinions of colleagues in the UK around the world as to how to make this happen.
Join BASL’s Sustainable Hepatology Working Group
BASL is committed to being an inclusive organisation, offering equal opportunity for members to be involved in the work of the association. If you are interested in being part of a working group to develop ideas for Sustainable Hepatology and work with others to promote thinking about this is our future research and service developments, please contact our lead, Dr William Stableforth, by emailing firstname.lastname@example.org .
Each year BASL presents the Dame Sheila Sherlock research prize, one of the highlights of the BASL Annual Meeting. This prize is awarded annually to recognise the enormous contribution of Dame Sheila Sherlock to the development of Hepatology as a discipline in its own right.
Dame Sheila was involved in the foundation of the British Liver Club in 1961, which subsequently evolved into The British Association for the Study of the Liver (BASL). She was one of our past presidents and the first recipient of The BASL Distinguished Service Award. In keeping with Dame Sheila’s enthusiasm for fostering young researchers, this eponymous research prize is awarded to young investigators without substantive posts in either medicine or science for their research contributions in the field of Hepatology.
In keeping with Dame Sheila’s enthusiasm for fostering young researchers, this eponymous research prize is awarded to young investigators without substantive posts in either medicine or science for their contributions in the field of hepatology research.
The winner will receive free registration to the meeting, an award and a prize of £1,000 and an invite to deliver the prize lecture and present their research at the BASL Annual Meeting.
To apply, please send one A4 sheet outlining your research and another A4 sheet listing up to 5 related publications.
Please send submissions to email@example.com before the deadline of 09:00hrs on Monday 2nd August 2021
You must be a BASL member to apply.
The Andy Burroughs Young Investigator Award was set up in honour of the late Professor Andrew Burroughs.
Professor Burroughs was an eminent and world renowned Professor of Hepatology and Consultant Physician/Hepatologist and among his many achievements including his wide area of expertise in cirrhosis and portal hypertension and significant contribution to liver Transplantation.
This prize is awarded to young investigators who have contributed to clinical or translational research related to liver disorders who are in training or within 2 years of taking up consultant positions (or equivalent); this year the winner will receive free registration to the meeting, an award and a prize of £1,000 and an invite to deliver the prize lecture and present their research at the BASL Annual Meeting.
To apply, please send one A4 sheet outlining the research and another A4 sheet listing up to 5 related publications.
Please send submissions to firstname.lastname@example.org before the deadline of 09:00hrs on Monday 2nd August 2021
You must be a BASL member to apply.
Gilead Sciences has announced the launch of a global grant program to support investigator-sponsored research within HDV; HDV DESCRIBE (HDV Epidemiology, Screening and Barriers to Linkage to Care).
The program seeks to better understand HDV patient populations, epidemiology, screening practices and cascades of care.
The program will support individual projects up to $150,000 USD or equivalent sum; projects greater than $150,000 will require approval by Gilead prior to submission.
Successful projects should be able to be completed within 12 months and demonstrate clear objectives, defined timelines, a comprehensive operational plan, and propose data that has relevance to the medical community and policy makers. Priority will be given to studies exploring regional data.
Further information can be read in the program description document available below:
Download Gilead HDV DESCRIBE RFP program description_May2021.pdf
The program will be accepting Letters of Interest between 3rd May and 4th June 2021.
If you have any questions please contact Joyeta.Das@gilead.com .
(Added 4th May 2021)
Guts UK are delighted to announce that Guts UK/BSPGHAN Grants are now open.
Guts UK and the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) are passionate about supporting research into paediatric gastrointestinal, hepatological and nutritional disorders. Since 2010 we have joined forces to co-fund a biennial grant call.
Guts UK and BSPGHAN have just opened a new grant call to provide financial support for the collection of pilot or proof-of-concept data that will enable a high-quality competitive application to be made subsequently to a research council or other large funder.
Clinician and scientific investigators, including academic clinical lecturers, based at a UK university or hospital may apply. The principal applicant must have a contract of sufficient length to cover the duration of the research project and must have their salary guaranteed for the duration.
One grant, worth up to £40,000 is available for up to two years to fund direct costs associated with the project. Click here for further information.
The deadline is 1st June 2021. Please direct any queries to email@example.com
The Guts UK/Dr Falk awards recognise the achievements of those who bring new knowledge and insight to the field of gastroenterology, pancreatology and hepatology. These awards are an opportunity to achieve national recognition as well as the financial support for career progression.
A £1,000 prize for the best essay on gastroenterology or hepatology research personally undertaken by medical students who were on an intercalated BSc/MRes/MSc/MPH/MBPhD* course during the previous academic year (2019-20).
Four £1,500 prizes for medical students taking full-time science degrees (BSc/MRes/MSc/MPH/MBPhD*) focusing on gastrointestinal or liver-related disease in the current academic year (2020-21).
Two £2,500 awards for F1/F2 doctors to facilitate prospective research in an area relevant to gastroenterology or hepatology.
A £1,000 award for primary and secondary care gastrointestinal/liver nurses for initiatives that have improved patient care. (Nominate your colleague today for this award).
A £1,000 award for dietitians working in gastroenterology or hepatology for initiatives that have improved patient care.
Up to £10,000 is available for UK-based gastroenterology / hepatology SpR trainees who would like to conduct an audit or quality improvement project in any area of gastroenterology, liver disease or nutrition.
Applications close at 17:00 on April 12th April 2021
For further information and to apply: https://gutscharity.org.uk/research/grants-and-awards/the-guts-uk-dr-falk-awards/
* PhD students should note that they may apply for the medical student prize only once during their three-year studentship and that they may apply for the essay prize when their PhD has been completed.
The arrival of vaccination for Covid-19 is a very welcome development, particularly after the heavy toll on patients and liver services in 2020. However, the efficacy, or potential for adverse events, of these vaccines in patients with chronic liver disease (CLD) or post-liver transplantation (LT) remains unknown. Sub-optimal immune responses to vaccines are common in CLD and post-LT, and thus additional protective strategies may be necessary.
COBALT is a pan-European, large-scale, prospective observational cohort study designed to determine the real-world effectiveness and safety of vaccines for Covid-19 in CLD and post-LT. We invite centres to participate in this effort, co-ordinated by EF-CLIF: www.efclif.com .
Gilead’s Research Scholars Program supports innovative research from emerging investigators around the world to advance scientific knowledge in areas of unmet medical needs. Each award is funded up to $130,000 for two years, to be paid in annual installments of up to $65,000 per year.
The Research Scholars Program for liver disease is currently accepting applications from early-career scientists to support basic, clinical and translational research in the field of liver disease, including but not limited to:
• Chronic viral hepatitis
• End-stage liver disease and its complications
• Non-viral chronic liver diseases
• Hepatocellular carcinoma (HCC)
• Cholangiocarcinoma (CCC)
The program will be accepting applications until 26th February 2021.
More information on the program, including eligibility criteria and how to submit an application, can be found by visiting the following website: https://researchscholars.gilead.com/en/intl_liver_disease_portal/program-overview
All acute hospital Trusts in England, Wales and Northern Ireland will be contacted on the 18th January 2021 asking them to respond to a Survey asking about a range of aspects of care for patients with alcohol-related liver disease (ARLD).
This Survey is 10 years after the NCEPOD review of patients who died with ARLD, which made up the 2013 NCEPOD report ‘Measuring the Units’. This is an important piece of work looking at where we are with care provision for this patient group, what has improved and where there is work still to be done. For this to have the most impact, it is crucial that there is strong clinician engagement with their Trusts and we very much appreciate your support with this.
Please contact NCEPOD at firstname.lastname@example.org to be put in contact with the person at your Trust/Health board to whom the Survey has been sent.
A joint statement from British Society of Gastroenterology, British Association for the Study of the Liver, NHS Blood & Transplant and British Liver Trust.
Patients with liver disease that are considered to be clinically extremely vulnerable, and are at increased risk if they contract COVID-19. This advice refers to this group and to all other patients with liver disease.
- Whilst the vaccine trials have not looked specifically at safety in patients with liver disease, there is no data to suggest harm.
- Although vaccines may be less effective in patients with chronic liver disease and those post-liver transplant, they still provide protection. As yet there is no data specifically on the Sars-CoV2 vaccines
- We recommend that patients with chronic liver disease, autoimmune hepatitis and those post-liver transplant should consider vaccination for Sars-CoV2 with any of the available vaccines.
First published on 08 Jan 2021