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Jan
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NICE is currently recruiting for additional members to join their Quality Standards Advisory Committee (QSAC) to support delivery of the library quality standards topics.
NICE quality standards are a set of concise, prioritised statements and associated measures that focus on topics relevant to health and/or social care. Quality standards describe high-priority areas for quality improvement in a defined care or service area.
They are looking to appoint a number of standing members with the following backgrounds/expertise:
• Secondary care practitioners - For example doctors, nurses, or allied health professionals, in secondary care.
• Public health practitioner - For example those from local authorities, and PHE regional teams.
• Commissioners of health, public health and social care services - For example those from clinical commissioning groups or local authorities and those with experience of service redesign to improve quality and outcomes for people with care and support needs.
• Safety expert - For example people who take a lead in addressing issues of relating to risk and safety, for example risk managers and safeguarding leads
• Lay member
NICE’s quality standards are central to supporting the Government's vision for a health and social care system focused on delivering the best possible outcomes for people who use services. Derived from NICE guidance and other accredited sources, they are a concise set of prioritised statements designed to drive measurable quality improvements within a particular area of health or care and are becoming the backbone of the new commissioning system for health and social care.
If you have an interest in driving quality improvement in health, public health or social care, experience of working on committees and working groups, and highly developed interpersonal, communication and team working skills, then NICE would like to hear from you.
You will not be representing your organisation but will bring your expertise, experience and knowledge of current practice. The time commitment is one day a month, for a three year period, and your expenses will be reimbursed (if you are a general practitioner, locum cover will be covered).
More information on how to apply can be found at www.nice.org.uk/get-involved/join-a-committee and information on NICE quality standards at www.nice.org.uk/standards-and-indicators
You can also contact Rachel Neary-Jones at NICE on rachel.neary-jones@nice.org.uk .
The closing date for applications is 5pm Monday 15 January 2018.
Kind Regards,
The Quality Standards Team
National Institute for Health and Care Excellence
Dec
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The BASL Annual Meeting 2017 was held between 20th to 22nd September on the Warwick University Campus with a splendid evening of dinner and jousting at Warwick Castle. Here we summarise some clinical highlights from the meeting.
In the Wednesday transplant section, Andrew Holt and Kerry Webb discussed individualisation of transplant assessment for patients with alcohol related liver disease, outlining guidelines which move away from the ‘six month rule’ of pre-transplantation abstinence and aim to provide uniformity of care amongst transplant units to avoid a perceived geographical variation in access to liver transplantation for this indication. The severe alcoholic hepatitis pilot was discussed by Ewen Forrest, who updated the group on the failure to recruit any patients to the pilot, but also stressed the lack of a robust statistical model to predict transplant need in this cohort.
In the field of stem cell transplantation, Fotis Sampaziotis presented his novel study demonstrating applicability of human derived stem cells to successfully populate a bioengineered mouse bile duct in vivo. Peter Friend delivered the Williams-Calne Lecture, which was a state of the art update on the current and future role of organ reperfusion preservation techniques in improving outcomes after liver transplant.
On Thursday morning, Ian Fellows’ erudite lecture highlighted the important role of sarcopenia in prognostication for patients with cirrhosis (perhaps best measured on the L3 slice of a non-contrast abdominal CT). He emphasised that patients with end stage chronic liver disease are invariably malnourished and require nutritional and dietetic support with high protein, high calorie supplementation ‘little and often’.
Tariq Iqbal presented data on a causal association between dysbiosis and liver disease in mouse models, thus highlighting potential novel therapeutic approaches in the field. Sotiris Mastoridis showed that exosomal MiRNA profiles may provide prognostic information in the field of acute liver failure. Gwilym Webb’s study of the epidemiological profile of autoimmune liver disease in the UK identified an interesting association between latitude and prevalence. Julia Verne presented the 2nd atlas of variation in risk factors and healthcare for liver disease in England. This forms an important reference document for all involved in hepatology service provision (https://fingertips.phe.org.uk/profile/atlas-of-variation).
Intrahepatic cholangiocarcinoma continues to confer a poor prognosis. Ali Yousuf presented a systematic review of the application of loco-regional therapies for inoperable disease. The SIRCCA trial is an international study comparing standard therapy versus selective internal radiation therapy (SIRT) for Inoperable disease and is open to recruitment in the UK.
George Mells, speaking on behalf of the UKPBC group, proposed a predictive model for identifying non-responders to ursodeoxycholic acid using pre-treatment parameters. The British Liver Trust Lecture given by Mary Ramsey outlined the economic and political hurdles which were overcome to provide the recently rolled out universal childhood hepatitis B vaccination programme in the UK. Tion Lim presented two cases of steroid resistant AIH which showed treatment response to interleukin-2 therapy that merits further evaluation in larger studies. The afternoon’s highlight was John O’ Grady’s Ralph Wright Lecture in which he emphasized the over-reliance on the p-value in the medical literature. He discussed the syndrome of “acute on chronic liver failure”, the contents of which he lays out in the October 2017 issue of Liver Transplantation.
Friday morning turned to case presentations. Lauren Johansen and Marianne Samyn presented the case of a young boy with juvenile PSC, highlighting the autoimmune element of the disease and the challenges of immune suppression management. Nowlan Selvapatt and Shahid Khan’s case led to a discussion of biomarker development in the field of cholangiocarcinoma and the need for larger studies in the field. Geoff Dusheiko and Shirin Demma expertly interweaved case and case discussion of a patient with active HDV, stressing the importance of universal HDV testing for patients with HBsAg seropositivity. Charlotte Grant and John Iredale discussed fibrosis regression in liver disease, exemplified by a case of recompensation after alcohol cessation and venesection in a patient with haemochromatosis and ARLD cirrhosis. Kris Bennett and Guru Aithal’s case led to a discussion of MRI in assessing for portal venous haemodynamics.
There were a number of noteworthy posters. Amongst these, Jayaswal showed that SVR12 is associated with reduction in liver fibroinflammation as assessed by MRI. Sherman demonstrated the potential value of combining ARFI and a “spleen-platelet/portal vein Doppler score” to predict clinically significant portal hypertension. Verne observed that the rate of cirrhosis related hospital admissions has more than doubled in the last ten years and that there was a high degree of variation in admission rates for paracentesis and oesophageal varices across different CCGs in England. Kamarajah showed that paired liver stiffness measurement compared favourably with paired liver biopsies in determining fibrosis progression for patients with NAFLD in Malaysia. Warburton demonstrated a complex biliary microbiome in “normal” human bile. Srivastava showed comparable liver transplant survival data between patients managed in a non-transplant and transplant liver centres in the UK. Delvincourt highlighted the role of self-expanding metal stents in the management of early post-transplant anastomotic biliary strictures. Campbell described the benefits of a shared palliative care liver pathway for the management of advanced liver disease in a hospice setting. Marra showed that 8-weeks of therapy with sofosbuvir/velpatasvir for patients with G3 HCV and advanced fibrosis achieved a 95% SVR.
Will Gelson
Consultant Hepatologist
Saqib Mumtaz
Hepatology Specialist Trainee
Dec
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On 28 November 2017, the project leads for the Shared Care Liver Project (SCLP) held a showcase event in Basildon to highlight and disseminate the joint work of St Luke’s Hospice and Basildon Hepatology team.
The SCLP has been running since 2015 and is a unique and innovative project which offers early palliative care interventions and support to patients with Advanced Liver Disease (ALD) and their carers.
The award winning project was funded by The Health Foundation and supported by Marie Curie Palliative Care Research Unit (MCPCRU) and has played an important part in informing the national picture on the care of those with ALD.
More than 50 attended from both the Hospice/palliative care and hepatology disciplines. The afternoon included speakers from The Health Foundation and MCPCRU.
The quantative outcome data was presented and highlighted that the project cohort demonstrated improved compliance and often stabilised when offered a multi-disciplinary supportive care approach from the Hospice in addition to their Hepatology services. Significantly, 100% of the cohort had end of life conversations and 68% completed planning documents which included Preferred Priorities for Care documentation and DNACPR documentation.
Qualitative outcome data highlighted themes such as ‘improvement in continuity of care’ and ‘not feeling judged’.
Both the Basildon Hepatology and Hospice teams highlighted the wealth of reciprocal learning gained throughout the project, with enhanced communication being highlighted as key to the success of the project.
The project team will now be focusing on publication of their findings and further dissemination. Further funding is also being sort to continue with development and dissemination of the model.
Virginia Campbell – Advanced Nurse Practitioner St Luke’s Hospice Basildon – co-project lead
virginiacampbell@stlukeshospice.co.uk
Sharon Quinn – Assistant Director of Clinical Care & Quality – St Luke’s Hospice, Basildon – co-project lead
sharonquinn@stlukeshospice.co.uk .
Dec
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Due to the current BASL Surgery Representative stepping down BASL are seeking expressions of interest for this position.
The Surgery Representative will serve on the BASL Committee for a maximum term of 3 years and 2 years alternating and may be re-elected once. The representative is expected to attend BASL Committee meetings (face to face or teleconference) as well as the Annual Meeting in September.
Nomination Process
Please send nominations to the BASL Secretariat at judy.hawksworth@execbs.com by the deadline of 17:00 Tuesday 5th December 2017.
Candidates wishing to be considered for election must be a BASL member and will require one BASL member to propose them and a second BASL member to confirm their suitability for the role in writing.
If more than one candidate is nominated, the Secretariat will arrange for an election of all members. He/she will be elected by simple majority of those members voting. A member can be re-elected once to the post of Surgery Representative.
A personal statement, containing no more than approx. 300 words will be required from the candidates should an election need to take place.
The newly elected BASL Surgery Representative will take up their post straight away and will step down at the Annual Business Meeting of the Association during the BASL Annual Meeting in September 2020.
If you require any further information please contact judy.hawksworth@execbs.com .
Nov
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Specialist Clinical Fellow in Hepatology
Job Reference: 304-JSD-B079
Employer: University Hospital Birmingham NHS Foundation Trust - medical and dental
Department: Hepatology
Location: Birmingham
Salary: £50,500 - £68,680
Closing date 7th December 2017
For further information about this vacancy view on NHS Jobs by clicking > here.
Nov
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‘Today’s budget represents a huge missed opportunity for the Government to tackle alcohol harm and protect our most vulnerable.
‘The freezes on alcohol duty the Chancellor has announced represent a real terms cut in duty, and a £1.2 billion tax giveaway to an alcohol industry which has already benefitted from successive duty cuts in previous budgets.
‘The planned increase in duty on some high-strength ciders appears like a small step in the right direction. However, in reality it will have minimal impact. A three-litre bottle of white cider at the newly proposed 6.8% ABV strength will contain more than 20 units of alcohol yet could still be sold for £3.50. This will do very little to protect dependent drinkers and children that consume these damaging products.
‘Furthermore, this measure will not come into effect until 2019 and in the meantime the price of high strength cider will fall because of today’s duty freeze.
‘This strengthens the case for minimum unit pricing of alcohol. With minimum pricing now judged to be legal by the Supreme Court and Scotland and Wales moving to implement the measure, it is important that England does not get left behind in terms of reducing alcohol-related harm.’
About the Alcohol Health Alliance UK
The Alcohol Health Alliance UK (AHA) is a group of over 50 organisations including the Royal College of Physicians, Royal College of GPs, British Medical Association, Alcohol Concern and the Institute of Alcohol Studies. The AHA works together to:
- Highlight the rising levels of alcohol-related health harm
- Propose evidence-based solutions to reduce this harm
- Influence decision makers to take positive action to address the damage caused by alcohol misuse
For further information, please contact Matt Chorley, the AHA’s Policy and Communications Officer, at matt.chorley@rcplondon.ac.uk or on 07748 757376.
Nov
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Responding to the UK Supreme Court judgment that minimum unit pricing is legal, Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK, said:
“We are delighted with the Supreme Court’s judgement that minimum unit pricing is legal and can be implemented in Scotland. The decision today represents a great victory for the health of the public.
“Five years ago the legislation introducing MUP passed through the Scottish Parliament without opposition. It has taken five years to implement for the simple reason that the Scottish Whisky Association and others chose to challenge it in the courts. In that time many families have needlessly suffered the pain and heartache of losing a loved one.
“This decision has implications far beyond Scotland. Wales, Northern Ireland and the Republic of Ireland are now clear to progress their own plans for minimum unit pricing.
“The spotlight should now fall on England, where cheap alcohol is also causing considerable damage. Over 23,000 people in England die every year from alcohol-related causes, many of them coming from the poorest and most vulnerable sections of society. We urge the Westminster Government to act now and introduce the measure in England. A failure to do so will needlessly cost more lives.”
Information on the AHA’s campaign for minimum unit pricing, along with facts and figures on the estimated impacts of MUP, is available on the AHA website: http://ahauk.org/campaigning-minimum-unit-price-alcohol/ .
About the Alcohol Health Alliance UK
The Alcohol Health Alliance UK (AHA) is a group of over 50 organisations including the Royal College of Physicians, Royal College of GPs, British Medical Association, Alcohol Concern and the Institute of Alcohol Studies. The AHA works together to:
- Highlight the rising levels of alcohol-related health harm
- Propose evidence-based solutions to reduce this harm
- Influence decision makers to take positive action to address the damage caused by alcohol misuse
For further information, please contact Matt Chorley, the AHA’s Policy and Communications Officer, at matt.chorley@rcplondon.ac.uk or on 0203 075 1726.
Oct
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Commenting on the editorial published in The Lancet Gastroenterology & Hepatology on the new definition of alcohol mortality proposed by Office for National Statistics (ONS), Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK, said:
“We agree entirely with the concerns outlined in The Lancet Gastroenterology & Hepatology about the revised definition for alcohol deaths from the ONS.
“The new definition will mean that a high number of liver disease deaths where we know that alcohol is the cause will no longer be recorded as being linked to alcohol.
“This reduction will give the wrong impression to the public that alcohol deaths are going down, when in fact the burden of alcohol on our nation’s health and health service is growing, with alcohol-related hospital admissions going up, and liver disease rates on the rise.
“Medical experts across the country have warned that it is premature for the ONS to alter the definition in the way it has proposed. The reasons are technical, but it comes down to the fact that more research is needed on the exact link between alcohol and certain categories of liver disease deaths.
“We recommend that the ONS hits the pause button on the work it is doing to alter the definition of alcohol deaths, until the necessary research has been done. This research could be done quickly and cheaply, in a handful of liver centres across the country.”
The editorial is available by clicking > here.
About the Alcohol Health Alliance UK
The Alcohol Health Alliance UK (AHA) is a group of over 50 organisations including the Royal College of Physicians, Royal College of GPs, British Medical Association, Alcohol Concern and the Institute of Alcohol Studies. The AHA works together to:
- Highlight the rising levels of alcohol-related health harm
- Propose evidence-based solutions to reduce this harm
- Influence decision makers to take positive action to address the damage caused by alcohol misuse
For further information, please contact Matt Chorley, the AHA’s Policy and Communications Officer, at matt.chorley@rcplondon.ac.uk or on 0203 075 1726.
Oct
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The Medical Research Foundation have recently launched a funding opportunity focused on Viral Hepatitis research. Due to overwhelming demand the deadline has been extended for applications to Friday 10th November 2017.
This funding is aimed at Mid-Career researchers, who are making the transition to independence, and will support research that will increase the understanding of the disease mechanisms underlying viral hepatitis.
This competition is open to all UK researchers at eligible institutions (UK HEIs, Research Council research institutes, hospitals, and other independent research organisations). Applicants must hold a PhD, DPhil or MD and be in the process of, or be ready for, transition to research independence.
There is up to £1.6 million available in this competition and applicants may apply for up to £300,000 to support their research, over a maximum of a three year period.
The application process is now open and the deadline has been extended to Friday 10th November 2017.
More information can be found on the Medical Research Foundation website > here.
Oct
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Improving Quality in Liver Services (IQILS) is a new scheme based on the work of the LiverQuest project.
The project led by the RCP London and supported by BASL and the BSG supports the national strategy to improve medical liver services for patients.
IQILS is run by the Royal College of Physicians (RCP) working in partnership with the Liver community, the professional bodies, societies and patient groups.
IQILS is open to all liver services across the UK and currently 18 services have signed up and are working towards accreditation. A list of these services can be viewed on the RCP website here; https://www.iqils.org/Default.aspx?PageId=66 .
Should you have any questions about IQILS please contact Madeline Corrigan, IQILS Programme Manager at the RCP at madeline.corrigan@rcplondon.ac.uk .
