NHS Fife leading the way in the early detection of liver disease

Posted on: 28th February 2023

NHS Fife is the latest region in Scotland to confirm that it has a new effective pathway for the early detection of liver disease. Scotland is facing a public health emergency with liver disease one of the leading causes of death in those under the age of 75. The implementation of full primary care liver disease pathways, such as the one introduced in NHS Fife, is crucial in turning the tide on preventable deaths.

The British Liver Trust welcomed the news as it has been campaigning for earlier detection of liver disease and better patient care across all regions of the UK to be prioritised.  Supporters of the charity across Scotland have been critical to the ‘Make Early Diagnosis of Liver Disease Routine’ campaign with many writing to MPs at Westminster and Members of the Scottish Parliament.  As a result, 13 Scottish parliamentarians have written to their local Health Board advocating for improved pathways.

Pamela Healy, Chief Executive of the British Liver Trust said, “Shockingly, deaths due to chronic liver disease in Scotland have risen by 60% in the last 30 years with an 11% increase in 2019-20. A major reason for the increase in deaths is late diagnosis, so I am absolutely delighted that NHS Fife are leading the way and have an effective pathway in place.”

Three quarters of people in Scotland are currently diagnosed with cirrhosis when it is too late for effective intervention or treatment. In 2021, the British Liver Trust published the results of its survey that found that only 5 of the 14 Health Boards in Scotland had an effective early detection pathway in place.  The results and subsequent changes across Scotland can be seen on this map.

The survey results were published in the British Journal of General Practice in August 2021. Both NHS Fife and NHS Lothian have turned ‘green’ and NHS Dumfries now has a pathway in development since the original survey. 7 of the 14 Scottish Health Boards now have an effective pathway in place and the British Liver Trust is calling for the others to follow their lead.

The charity has been working to influence healthcare Boards across Scotland and is delighted that NHS Fife has now confirmed that it has a process in place that will:

  • pro-actively look for patients who are most at risk.
  • interpret abnormal liver blood tests in line with national guidelines.
  • assess those with high readings for liver scarring and refer those with more. advanced disease to secondary care.

Pamela Healy OBE, Chief Executive of the British Liver Trust, added: “The liver is an incredibly resilient organ, but only up to a point. Symptoms of liver disease often only appear once damage has progressed, and the liver is starting to fail. However, 90% of liver disease is preventable and, in many cases, it’s reversible if caught in time. That’s why early detection and prevention are key.”

NHS Fife implemented the innovative practice of intelligent Liver Function Testing (iLFTs) in April last year (the second Health Board in Scotland to do so) and the introduction of a FibroScan service last Summer. The British Liver Trust is calling for the adoption of iLFTs and fibrosis assessment by all Scottish Health Boards.

Alcohol, excess bodyweight, and viral hepatitis are behind 9 in 10 cases of liver disease. You can find out if you are at risk and check your liver health online by doing the online screening test at https://www.britishlivertrust.org.uk/screener