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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
Mar
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The RCN Foundation NHS Education Fund supports the education and training of nurses, midwives and health care support workers working within the NHS from all corners of the UK.
Any individual working in an NHS nursing or midwifery team can apply.
Grants of up to £1,600 will be awarded to cover the cost of a wide range of educational courses. This might include for example, postgraduate modules, clinically-focused courses and shorter training courses.
Details about how to apply for the grant can be found by clicking here .
The fund opened for applications on Monday 7 March 2022 and will be reviewed on Tuesday 19 April.
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)
Dec
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With the rapid rise in cases of the Omicron variant of COVID-19 in the UK the NHS potentially faces another surge in hospital admissions and we are all facing familiar uncertainty and drawing on our resilience mechanisms again. The uncertainty is compounded by not yet knowing the severity or otherwise compared to the Delta variant, the moderating effect of vaccination and whether enough of the population are either vaccinated or boosted to exert this effect, and how the new monoclonal antibody drugs for symptomatic mild to moderate disease in the community will impact on admissions. Below is a summary from the relevant policies, with links, for your information.
These new monocolonals now have conditional marketing authorisation for use in non-hospitalised patients in the UK (read the cas.mhra.gov.uk website alert by clicking > here ).
- Sotrovimab is given by single intravenous infusion and is reported to reduce the relative risk of hospitalisation or death by 85%.
- Molnupiravir is given orally by capsules for 5 days and is reported to reduce the relative risk of hospitalisation or death by 30%.
Patients must meet all of the eligibility criteria and none of the exclusion criteria. Prehospitalised patients are eligible for treatment if:
• SARS-CoV-2 infection is confirmed by polymerase chain reaction (PCR) testing within the last 5 days
AND
• Onset of symptoms of COVID-193 4 within the last 5 days
AND
• A member of a ‘highest’ risk group (as defined in Appendix 1).
Symptoms listed are: feverish, chills, sore throat, cough, shortness of breath or difficulty breathing, nausea, vomiting, diarrhoea, headache, red or watery eyes, body aches, loss of taste or smell, fatigue, loss of appetite, confusion, dizziness, pressure or tight chest, chest pain, stomach ache, rash, sneezing, sputum or phlegm, runny nose.
Appendix 1 includes liver disease in the following categories:
• Patients with cirrhosis Child’s-Pugh class B and C (decompensated liver disease).
• Patients with a liver transplant
• Liver patients on immune suppressive therapy (including patients with and without liver cirrhosis)
• Patients with cirrhosis Child’s-Pugh class A who are not on immune suppressive therapy (compensated liver disease)
Patients will be anxious, and as clinicians we may be contacted for advice. How the delivery of these drugs is to be organised is being worked out at local operational levels. Members are advised to make enquiries within their Trusts for local arrangements. The Liverpool COVID-19 interactions checker is a useful resource (click > here ). We checked these drugs against the more commonly used immunosuppressants and, for those not familiar with this tool, it is easy to use (no expected interactions for tacrolimus, ciclosprin, azathioprine, mycophenolate, prednisolone).
Members will no doubt be aware that casirivumab and imdevimab (Ronapreve®) has authorisation in hospitalised patients admitted with acute COVID-19. This seems to be less effective in patients with the Omicron variant. Thus where Omicron accounts for more than 50% of the local hospital prevalence, Ronapreve is only recommended where genotyping results are available and confirm infection with a non-Omicron variant. Where genotyping is not available or genotyping confirms infection with the Omicron variant, the December 2021 rapid policy statement advises nMABs can only be offered as part of a formal trial.
Nosocomial acquisition is a bit different. Ronapreve can be used in non-Omicron cases where known, meeting high risk criteria and Sotrovimab has also now been authorised for hospitalised patients who acquire Omicron variant COVID-19 during their hospital stay and meet high risk criteria - for our patients with liver disease, these are the same as those listed above. (read the cas.mhra.gov.uk website alert by clicking > here ).
Again, members are advised to check their local Trust policies, but nosocomial acquisition of COVID-19 in patients with liver disease may well meet criteria for the use of these drugs so we thought we would draw your attention to this.
Hepatologists and gastroenterologists have faced very challenging changes to practice over the last two years and rising numbers of patients with liver disease. We know the changing Covid-19 landscape continues to bring new challenges. We hope you all stay safe and well during this period.
Rebecca Jones, President BASL
John Dillon, Vice President Hepatology, BSG
Download Joint BASL_BSG message re monoclonal antibody drugs vs COVID-19.pdf
(Added December 20th 2021)
Nov
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First Call for Applications
The Foundation for Liver Research has set up a new Small Grants Scheme in memory of the late Professor Roger Williams CBE (1931-2020). This scheme is open to any applicant in the UK.
Outline of the Small Grants Scheme
An Application form can be downloaded from the Foundation for Liver Research website > here .
The closing date for the first Call is 1st March 2022.
For details of eligibility and the application process, contact Natalie Day, Chief Executive of the Foundation for Liver Research n.day@researchinliver.org.uk .
Nov
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BASL members are invited to take part in a national survey.
As part of the Early Detection of Liver Disease SIG, we are asking if you could take a moment to complete this short survey of attitudes towards fibrosis assessment and use of non-invasive fibrosis tests.
Gathering this type of information is important to gauge what is current practice and where barriers lie to the use of these tests.
The survey takes only 2 mins, and we’d be hugely grateful for your participation and opinions!
Link to survey: here
Kind Regards,
Kush Abeysekera
Ankur Srivastava
Clinical Research Fellow
Consultant Gastroenterologist and Hepatologist
University of Bristol
Southmead Hospital, North Bristol Trust
Sep
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A survey of HCC surveillance in the UK was last conducted in 2014, which highlighted some weaknesses in service provision nationally. We are repeating the survey to see if things have changed, and extending the survey to include additional questions on surveillance imaging and secondary surveillance. We have worked with the HCC UK Committee in developing this survey, and the project is supported by BASL. We hope that this will generate a valuable contemporary overview of UK HCC surveillance service delivery, and stimulate discussion and innovation.
The link to the survey is found here > https://forms.gle/U46TZq7oeVfJveAs7
This time we are seeking service level responses (one response per organisation or service).We expect the survey will only take 10-15 minutes to complete, although some of the questions might require input from other clinical colleagues e.g. section 3 is about imaging and may require input from a radiologist. We will acknowledge the lead contributor from each organisation in a report of this survey.
Many thanks in advance for your time.
Dr Aloysious Aravinthan, Consultant Hepatologist, Nottingham University Hospitals NHS Trust
Dr James Franklin, Consultant Radiologist, University Hospitals Dorset NHS Foundation Trust
Dr Christopher Clarke, Consultant Radiologist, Nottingham University Hospitals NHS Trust
Professor Steve Ryder, Consultant Hepatologist, Nottingham University Hospitals NHS Trust
Professor Shahid Khan, Professor of Practice (Hepatology), Imperial College London