NHS Tayside reduces liver clinic waiting list by almost half with new testing during COVID-19

Ellie & John at Tayside

[From left to right:] NHS Tayside Consultant Hepatologist and Professor of Hepatology and Gastroenterology at the University of Dundee, Professor John Dillon, alongside Dr Ellie Dow, Consultant in Biochemical Medicine at NHS Tayside – pioneers in the use of the Enhanced Liver Fibrosis Test from Siemens Healthineers at NHS Tayside 

  • NHS Tayside reduces liver clinic waiting list by 43% with Enhanced Liver Fibrosis (ELF) test
  • Rapid, minimally invasive blood test identifies priority patients for liver clinic
  • Automated laboratory equipment from Siemens Healthineers and an intelligent liver function pathway developed by NHS Tayside, work in conjunction with the ELF test to enable earlier diagnosis of advanced liver disease

NHS Tayside has implemented a blood test from Siemens Healthineers to rapidly provide an indication of liver fibrosis severity, enabling prioritisation of clinical treatment for patients at risk of severe liver disease. The Enhanced Liver Fibrosis (ELF) test, included in guidelines recommended by the National Institute for Health and Care Excellence (NICE), has enabled the Scottish Health Board to reduce the liver clinic waiting list by 43% and more easily route patients to the correct intervention1.

Decreased demand for laboratory testing enabled the introduction of the ELF test for patients on the liver clinic waiting list, using stored samples. In addition, the new community phlebotomy hubs set up by NHS Tayside (responsible for deploying blood testing for patients outside of the traditional hospital or GP practice settings) meant that GPs could ensure patient samples could be analysed in the new updated iLFT (intelligent liver function testing) pathway, incorporating the ELF test. Overall, this resulted in a reduction of the liver clinic waiting list for patients who would otherwise have required alternative hospital-based liver testing, such as a liver stiffness measurement or biopsy.

The introduction of the ELF test follows the implementation of an intelligent liver function (iLFT) pathway developed at NHS Tayside, providing real-time, automated analysis of blood tests. Facilitated by advanced laboratory equipment and Aptio® Automation from Siemens Healthineers, the iLFT pathway provides more detailed results – enabling improved risk stratification, earlier diagnosis and effective referral to secondary care.

“The use of ELF testing has added value to our clinical pathways – helping to separate the more severe liver disease cases from those which can be safely managed in Primary Care, and routing these patients to the correct intervention,” states Ellie Dow, Consultant in Biochemical Medicine at NHS Tayside. “During the pandemic, many of our appointments have moved to NearMe solutions, with COVID-19 accelerating the use of this new way of working. With the ELF test now incorporated into the iLFT algorithm, this enables our consultants to see only the patients who need to be seen, reducing waiting times and streamlining the patient pathway.”

“ELF testing is established for use in viral hepatitis, NAFLD and alcoholic patient groups – offering a minimally invasive alternative to a biopsy or liver stiffness measurement, without compromising diagnostic accuracy,” states Catherine Spurgeon, Marketing Lead for Laboratory Diagnostics at Siemens Healthineers GB&I. “The integration of ELF testing to the existing iLFT pathway at NHS Tayside is key to enabling more effective risk stratification for improved patient management, with the long term goal of reducing liver disease morbidity and mortality.”