Introduction The current landscape of service provision for patients with liver disease does not match that of disease burden1. Most hepatologists are based in transplant centres and access to tertiary liver services is not geographically equitable1. In an attempt to improve access, we established a liver transplant outreach clinic from the regional liver unit within a large gastroenterology unit. Here, we describe the benefits of this clinic.
Methods A dedicated monthly joint liver clinic was established in a large gastroenterology unit. Patients with complex liver disease, including pre- and post-transplant are seen by a consultant transplant hepatologist from the regional liver unit (SM) and a local consultant gastroenterologist (AD). Quantitative data was available from the transplant centre. A sample of patients and specialists were asked to complete a written questionnaire on their opinions of the clinic service.
Results Since August 2010, over 400 patients have been seen. In the 4 years prior to the establishment of the clinic, there were a median of 3 (1–4) referrals annually for liver transplant assessment. This increased to 9.5 (9–10) in the subsequent 2 years. Patients were satisfied with the clinical service (Table 1) and the majority (95%) preferred local follow up, citing it as more convenient (100%) with easier travel arrangements (100%). Specialists (n = 16) agreed unanimously that the clinic was more convenient for patients, easy to refer into and improved both accessibility to liver services and communication with the regional liver unit. Most (83%) felt that it reduced waiting times for specialist opinion.
Conclusion Establishing an outreach clinic has increased referrals for transplant assessment. Patients prefer to be seen locally and do not feel this affects their specialist care. They have confidence in the skill and experience of the clinicians they see and rate the quality of care, highly. Referring clinicians are also satisfied with the quality and accessibility of the outreach clinic. Overall, outreach clinics may serve to improve equity of access to transplant services.
Disclosure of Interest None Declared.
Liver Disease Patient Landscape and Care Provision, 2011, http://www.liver.nhs.uk/publications/accessed 14th Jan 2013
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