Midlands GI and Liver Transformation and Sustainability Network: Meeting summary

November 2017

Late last year, the Midlands GI and Liver Transformation and Sustainability Network held a meeting at the Holiday Inn, Coventry.

Opened by Richard Gardner, the Chief Executive of the BSG, this meeting brought together consultant gastroenterologists and hepatologists, the GI and Liver nursing community, commissioners, local authority voices, primary care and patient representatives, in the shape of Ms Helen Terry, director of policy at Crohn’s and Colitis UK.

The session took in presentations on transformation and sustainability opportunities in gastroenterology and liver disease across the Midlands, covering patients’, commissioners’ and specialists’ views on opportunities for the network, followed by a feedback session which looked at centralisation of services and new ways of delivery in an environment of financial constraint. Nurse-led, consultant-led and virtual clinics were discussed.

The meeting then moved on to cover best practice initiatives, with examples such as the scarred liver project from Nottingham and the use of faecal calprotectin test for effective triage. This was followed by a lengthy discussion about the successful rollout of fibroscan services to support early diagnosis of liver disease.

Feedback on the meeting was very positive. ‘By hearing what a colleague has come up with in some other part of the Midlands’, said Dr Rupert Ransford, consultant at Wye Valley NHS Trust and BSG Regional Representative for the West Midlands, ‘we can then use that experience they’ve had to improve services at our own trust. It’s made me more optimistic that we are not alone’.

Dr Ajay Verma, Consultant Gastroenterologist at Kettering General NHS Foundation Trust, said: ‘There’s a lot of work that we already do which we can refine and improve on to improve quality, safety and outcomes… at the meeting we can share some of our own successes’.

Dr Yeng Ang, NW Regional Rep covering Greater Manchester and Lancashire, speaking on the importance of collaboration between the liver and GI communities.


North West GI and Liver Transformation and Sustainability Network: Meeting summary

November 2017

The second the North West GI and Liver Transformation and Sustainability Network held a meeting at the Holiday Inn Haydock.

Commissioners, consultants, primary care, nurses and patients from across the North West were represented, including large delegations from Cheshire and Merseyside and Greater Manchester. The meeting was opened by Professor Martin Lombard, President of the BSG

Presentations in the first session on transformation and sustainability opportunities covered: what patients want by Mr David Barker, Chief Executive, Crohn’s & Colitis UK; perspectives on the STP in Cheshire and Merseyside by BSG Regional Representative Dr Paul Richardson; and the “Devo Manc” perspective by Professor Donal O’Donoghue, Medical Director, Greater Manchester AHSN.

A second session took in best practice, with presentations on 7 Day Endoscopy Services by Dr Neil Haslam, Consultant Gastroenterologist, Royal Liverpool and Broadgreen University Hospitals NHS Trust; CQUIN and case identification in HCV by Dr Andrew Ustianowski, Chair of the British Viral Hepatitis Group and Consultant in Infectious Diseases, Pennine Acute Hospitals NHS Trust; and Virtual Services by Dr Imran Patanwala – Consultant Gastroenterologist, Royal Liverpool and Broadgreen University Hospitals NHS Trust.

Discussion around varying sustainability and transformation topics was wide, covering opportunities around HCV elimination programmes, uncovering undiagnosed hepatitis C patients, the ideal make-up of MDTs, agreeing metrics across the system, applying national guidelines equitably, patient records, population profiling, carrying out multiple risk assessment in one interaction, resourcing specialist nurses, optimising tariff, identifying unnecessary work, and using variation to make the case for collaboration.

The debate on virtual services was particularly fruitful, with primary care coming across as a strong stakeholder in that area.

‘The great value in meetings like this is there is a cross-fertilisation of interests across the GI community’, said Professor Donal O’Donaghue from Greater Manchester AHSN. 'You can build alliances, pinch good ideas…talk about your challenges in a safe environment… and you can argue collectively for what is necessary to provide good services for our patient group’.

Presentations can be viewed via the Regional GI and Liver Networks Portal.



Nurse Consultant,  Helen Cadwell, Royal Liverpool and Broadtree University Hospitals NHS Trust

Julie Cunningham, Commissioning Programme Manager, Manachester CCG

Dr Maurice Smith, Rightcare Clinical Lead, Liverpool CCG GP

Dr Yeng Ang, Consultant, Salford Royal NHS Foundation Trust