To ask the Minister of Health (i) whether he plans to create a care pathway for the early detection of liver disease; (ii) whether this pathway could be created via primary care.

The current pathway for people identified in primary care with suspected liver disease is referral to secondary care services in their local Trust.

Some initial discussions have taken place between colleagues in the Belfast Trust Hepatology Service and local primary care representatives around refinement to the local pathway for services provided in Belfast Trust, specifically around non-alcohol fatty liver disease (NAFLD).

A pilot pathway has already been trialled with one GP practice. This involved:

A GP identifying a patient with NAFLD and undertaking initial screening and then sending a referral to the Hepatology Service

The referral is triaged by a consultant and is either forwarded for a consultant clinical appointment or if appropriate to a nurse led clinic

If the appointment is triaged to a nurse led clinic a fibroscan is undertaken and the nurse can provide lifestyle advice regarding NAFLD

If there are any abnormal findings on the scan then the patient is referred on to a consultant clinic, if not then they are discharged back to their GP with appropriate advice.

Due to the success of this pilot the Regional Liver Unit is now applying the criteria to NAFLD referrals from all Belfast Trust practices and is also exploring the implications for similar pathway arrangements in other Trust areas.