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Nurse-led Hepatology Clinics

Milton Keynes University Hospital is pioneering nurse-led clinics for Hepatology patients, resulting in much shorter waiting times to improve patient experience.

The team help identify patients with liver problems who are at high risk of developing complications and through monitoring and surveillance, the aim is to prevent these complications.

Hepatology clinics offer advice and treatment to patients affected by a range of liver conditions, including hepatitis B and hepatitis C. Patients are also seen by the team for Outpatient Ascitic Drain. Patients are seen at the hospital site or in the community at ARC Drug and Alcohol Service premises in Milton Keynes.

Hepatitis C is a blood borne virus which can now be successfully treated with a 95% chance of cure. The Hepatology Nursing team treat patients and ensure they receive the appropriate Consultant follow up if this is needed at the end of treatment.

Liezel Robinson, Hepatology Nurse Specialist explains: ‘The driver of the service is the effective treatment of Hepatitis C, as there is now a drug that treats the condition. Our nurse-led clinics mean that patients can be seen much quicker and can be given both advice and treatment, which can include a special scan of the liver.

Previously there was a high non-attendance rate for people who were referred from ARC Drug and Alcohol Service, so Community Hepatology Nurse Claire Swadling works at ARC and runs a clinic which screens and treat patients.

‘Patients with Hepatitis C are given a 2-3 month course of treatment which is usually 95% successful. But it doesn’t give the patient immunity from further Hepatitis C transmission, so part of our work involves advising about reducing further transmission risks.

The Hepatology Nursing team also see patients with Hepatitis B and they run a Fibro Scan clinic, which is a specific scan to assess the levels of Fibrosis or scarring of the liver. Having the service at MKUH has helped the service to be more accessible.

‘Our patients are happy to have such easy access to the clinics and we get to know their circumstances quite well. Of course, if we recognize that further input is needed, then we arrange for patient to see Dr Prakash Gupta or Dr Ali Azzam, the Hepatology Consultant Leads, as soon as possible,’ adds Liezel.

MKUH’s Hepatology team works closely with CNWL (Central and North West London) community team and in August, Claire ran a BBV (blood borne virus) screening event at ARC, together with colleagues from the Hep C Trust and ARC Drug and Alcohol Service. Over one day they screened 26 people for BBV and the three who tested positive for Hepatitis C were able to be referred for rapid treatment.

Team member Hepatology CNS Jess Richardson has also contributed to the setup and participates in all aspects of the service. She has also worked with Claire to provide Hepatitis C screening to the homeless population while they were provided hotel accommodation during Covid.


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