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Urgent Hepatology Service

Checked: 23-12-2021 by Rob Adams Next Review: 22-12-2023

NBT Triage Service

NBT have a service on eRS to facilitate urgent hepatology outpatient appointments. Once the patient has been referred, and if they fulfil the urgent criteria listed below, they will be offered an appointment within 4 weeks. This service may also be appropriate for some patients who would otherwise be admitted to hospital.

To meet the criteria for this service patients should have one or more of the below:

Decompensated cirrhosis (cirrhosis with ascites +/- encephalopathy +/- coagulopathy)
ALT > 300 U/L (used to be >500 but this has been changed)
Bilirubin > 100 umol/L
Imaging suggestive of hepato-pancreatic-biliary malignancy (see also Upper GI USC)

Please note that patients not meeting the criteria above should be referred routinely to hepatology via eRS or please consider using Hepatology Advice and Guidance.

Referral to NBT

To access the above service please request the Hepatology URGENT Triage Service (excluding Surgery) - Southmead - RVJ via eRS.

This service is available as a Triage service only so that referrals will be triaged in secondary care. Referrals not meeting criteria may be returned with advice.

Patients with active hepatitis C should usually be referred to UHBW who coordinate treatment in BNSSG (1).

UHBW Hepatology Service

UHBW hepatology do not have a Triage service but referrals can be marked urgent and will be seen appropriately if needed.

Fast track referrals (such as acute jaundice) should be discussed directly with the hepatology team or refer via Upper GI 2WW if criteria are met.

Referral to UHBW

Urgent UHBW hepatology referrals can be submitted via eRS to the viral or non-viral services.

You may also like to consider Hepatology Advice and Guidance via eRS (although this is only currently available at NBT).

All patients with active Hepatitis C should be referred to UHBW and not NBT (1).

Resources

(1) The Bristol and Severn Hepatitis C Network (uhbristol.nhs.uk)

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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