HSJ Value Awards 2019: Improving the value of diagnostic services award

Winner

University of Nottingham and Nottingham University Hospitals Trust: The scarred liver project

The University of Nottingham and Nottingham University Hospitals Trust have developed a new diagnostic pathway to identify patients with chronic liver disease.

Those with risk factors – hazardous alcohol use and/or type 2 diabetes – are invited for a portable liver examination transient elastography in a community setting. They are also given lifestyle advice.

Twenty per cent of the patients who attended had readings consistent with significant liver disease, although around 70 per cent of them had “normal” levels of liver enzymes – the standard primary care diagnostic test used to identify chronic liver disease.  

The pathway was initially used across four GP practices in Nottingham and was then commissioned by four clinical commissioing groups, covering a population of over a million. The project has been widely praised and the British Liver Trust is working on a national commissioning document.  

The test reduces unnecessary appointments and investigations – offering savings for the NHS – and has good patient engagement and support.

Read a detailed case study about this project at HSJ Solutions