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• W4386886314 abstract "<h3>Introduction</h3> Chronic liver disease (CLD), commonly from alcohol, is often diagnosed for the first time after an acute admission to hospital because of complications from cirrhosis, including variceal bleeding. The outcomes of patients with CLD after an acute hospital admission vary widely across the country, which may partly be linked to regional differences in specialist liver service provision. National surveys of secondary care providers aimed to provide a better understanding of how specialist liver services are delivered in the English NHS. We provide a summary of the surveys’ results. <h3>Methods</h3> We analysed data from 2012 and 2019 of the RCP Consultant Census and the HEE Electronic Staff Record datasets to assess the gastroenterology and hepatology senior clinical specialist (consultant) workforce. Consultants were counted if gastroenterology or hepatology was recorded as their primary specialty. The workforce was measured in terms of fulltime equivalent (FTE) consultant posts (for gastroenterology and hepatology together) and total headcount (for hepatology alone) per 100,000 of the adult (16+) population in 8 regions. The NCEPOD Remeasuring the Units survey, which focused on alcohol-related liver services available in 2019, was analysed to assess whether multi-disciplinary alcohol care teams (ACTs) and 24-hour gastrointestinal bleed services were available on-site. <h3>Results</h3> Considering gastroenterology and hepatology together, the workforce increased across England from 1.8 to 2.6 FTE consultants/100,00 population from 2012 to 2019 respectively. The increase over time varied regionally, from 26% in one region to 73% in another. London showed a large increase (from 2.3 (2012) to 3.3 (2019) FTE consultants/100,000 population), despite it already having the joint largest workforce in 2012. Considering only hepatology, 3 regions doubled their hepatologist workforce (0.14 to 0.28, 0.27 to 0.52 and 0.09 to 0.20 posts/100,000 population from 2012 to 2019), whilst other regions achieved modest increases, varying from 18% (0.25 (2012) to 0.28 (2019) posts/100,000 population) in one region to 33% (0.23 (2012) to 0.30 (2019) posts/100,000 population) in another. The percentage of Trusts that had ACTs in 2019 varied across regions from 50% to 75%. The percentage with a 24-hour gastrointestinal bleeding service available on-site ranged from 79% to 100% by region. <h3>Conclusion</h3> There has been a considerable increase in the gastroenterology and hepatology workforce in the English NHS. However, our summary demonstrates marked regional variation in 2019 in provision of key liver service components. This regional variation may contribute to the differences in outcomes for patients with CLD across England." @default.
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• W4386886314 date "2023-09-01" @default.
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• W4386886314 title "P98 Changes over time and regional variation in specialist services for patients with chronic liver disease: a summary of national organisational surveys in England" @default.
• W4386886314 doi "https://doi.org/10.1136/gutjnl-2023-basl.113" @default.
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