{
  "abstract": "Introduction Since 1970, liver disease deaths have increased by 400%, in a landscape where deaths from other major health conditions have plateaued or reduced. Research by the British Liver Trust shows that three quarters of people with cirrhosis are diagnosed at crisis point. Liver disease disproportionately affects regions of social deprivation, where access to healthcare can be further compounded by barriers (education, distance to hospital, availability/cost of transport). Northumbria NHS Trust covers a large geographical area with areas of high socioeconomic deprivation. Through collaborative working with Primary Care we highlighted patients at risk of liver disease and invited them to attend a fibroscan locally.Methods Wallsend sits 4 miles east of Newcastle. A focus group comprising of a GP, who was Digital and Transformation Lead and Health Inequalities Lead at Wallsend PCN, Consultant Hepatologist, Consultant Gastroenterologist with a special interest in Liver, Liver Nurse Specialist, Advanced Care Practitioner and Patient Care Advisor Team Lead from Medical Outpatients. 3 GP surgeries contributed. Predetermined criteria were applied to patients within these surgeries. The search was for patients 18–75, not housebound or frail, without pre-existing serious liver disease (cirrhosis, HCC), and a BMI less than 45 – who have a code of >35 units/week or are T2DM with a BMI >30. Patients meeting criteria were invited to attend a fibroscan.Results Data from the Public Health and Information Services Outpatient Inequalities Explorer, covering from 1st December 2023 to 31st May 2025, demonstrated factors related to appointments at Wallsend Health Centre. This did not differentiate between Liver Clinic and Fibroscan appointments. 70% of appointments were allocated to patients within IMD (index of multiple deprivation) Q1 and Q2. Overall, there was a 27.5% non-attendance rate, within the IMD Q1 cohort 40% of patients failed to attend their appointment. Between the 3 surgeries 1726 patients met the criteria and were invited for a fibroscan. Regular focus group meetings discussed issues encountered, particularly patients contacting Primary Care, enquiring about why they had been called for a fibroscan. Frequency of these calls reduced following the introduction of an explanatory text with appointment confirmation, and patient information on the Practice websites.Conclusion Collaborative working with Primary Care, serves to optimise access to healthcare, through minimising specific barriers such as cost and transport to appointments. Overall this increases earlier diagnosis of liver disease and to facilitate engagement with services with a view to reduce late diagnoses and associated complications.",
  "authors": [
    {
      "affiliations": [
        "Northumbria NHS Foundation Trust, UK"
      ],
      "name": "Alice Weidner"
    },
    {
      "affiliations": [
        "Northumbria NHS Foundation Trust, UK"
      ],
      "name": "Tom Manship"
    },
    {
      "affiliations": [
        "Northumbria NHS Foundation Trust, UK"
      ],
      "name": "Bill Evans"
    },
    {
      "affiliations": [
        "Northumbria NHS Foundation Trust, UK"
      ],
      "name": "Linda Irving"
    },
    {
      "affiliations": [
        "Northumbria NHS Foundation Trust, UK"
      ],
      "name": "Amy Johnson"
    },
    {
      "affiliations": [
        "The Village Green Surgery, Wallsend, UK"
      ],
      "name": "Ramsey Ahmed"
    }
  ],
  "title": "P122 Collaborative working between primary and secondary care – optimising access to healthcare and minimising inequality",
  "uid": "f687b9c4-6344-5e17-8cb8-ab34ba511069"
}