Scottish Hepatology Access Research Partnership

The Scottish Hepatology Access Research Partnership (SHARP) was formed with funding supported by the National Institute for Health Research (NIHR). It began in March 2023 and was active for 15 months. It addressed the barriers to accessing liver services and developed research initiatives for geographically isolated and/or socio-economically deprived populations.

SHARP established a multidisciplinary network from across Scotland representing extremes of isolation and unmet clinical need in remote/rural and urban populations.

SHARP reported its activities to the NIHR and this was published in NIHR Open Research in November 2024.

Four main workstreams were established:

Understand current access to liver services

Barriers to accessing liver services were assessed by surveys and audits:

A patient survey evaluated the interactions with primary and secondary care throughout the patient journey (276 respondents). This was developed in conjunction with the British Liver Trust
Two surveys of the perception of local liver services were completed by primary care physicians (199 respondents) and another by Gastroenterologists/Hepatologists (99 respondents)
An audit of the hepatology clinical services in each territorial Health Board in Scotland was completed by service providers

These results are still being analysed and will be informative for the wider UK hepatology community.

Technologies to monitor and diagnose Chronic Liver Disease

To address this unmet need, we have collaborated with Prof. Karen Faulds (University of Strathclyde) and Prof. James Dear (University of Edinburgh). A POU test that quantifies ALT and AST levels using patient finger-prick blood was proposed. This assay will enable the immediate identification of liver inflammation as well as the AST:ALT ratio in a non-clinical setting. The above is being worked into a grant proposal and if successful, the assay will be developed by Prof. Karen Faulds’ research group and trialled clinically in the hepatology clinics in NHS Tayside.

Identification of patients at risk of liver disease

An artificial intelligence tool to predict an individual's risk of being admitted to hospital as an emergency inpatient for chronic liver disease within five years was proposed. This work has been submitted to the Health and Social Care Delivery Research, NIHR.

Barriers to engagement with care for liver disease

A project to explore barriers to care for adults with Chronic Liver Diseases (CLD), and potential ways to overcome these barriers was developed. There were three research objectives:

Explore patient and practitioner views and experiences of referral and attendance
Explore views of people at high risk of CLD who are not currently engaged in services
Co-design a suite of recommendations to improve access to and engagement with care for people living with CLD

This has been submitted for funding to the Chief Scientist Office (CSO) for Scotland, specifically for the Health Improvement, Protection, and Services Research Committee.

Research Areas