In October 2023, TPHC began working with colleagues from Harness North and Harness South Primary Care Networks (PCNs) in Brent, north west London, to support their involvement in a 12-month NHS England Liver Case-finding pilot.
Around 6,100 people are diagnosed with liver cancer each year and incidences of liver cancer has increased by 50% over the past decade and is expected to continue to rise. Sadly, over 50% of liver cancers are diagnosed at stage 3 or stage 4.
The NHS England Liver Case-finding Pilot is funding PCNs to identify patients at the highest risk of developing liver disease. Patients are assessed and those with cirrhosis / advanced fibrosis are referred for ultrasound surveillance to identify risk of liver cancer. This enables earlier intervention and should improve their prognosis. The pilot will measure the feasibility and likely impact of rolling out a national case-finding project.
Since the pilot began, patients have already been identified and referred to secondary care for further support, who previously would not have been identified.
What did we do?
The initial ask of TPHC was to bring in PMO expertise, develop governance structures and support stakeholder engagement to strengthen partnerships with local secondary care services and NHS England. TPHC rapidly deployed resources to support Harness Care with TPHC both remotely and on site.
Subsequently, multiple workstreams have been implemented including:
- EMIS templating, data collection and data validation to develop a list of patients at each GP practice to invite for testing and screening.
- Capacity modelling to identify bottlenecks and inform resource allocation.
- Establishing testing, screening, and scanning procedures including identifying clinic sites, procuring laboratory services and clinical pathway development.
- Communication strategies and design of patient materials and assets.
- Reporting of progress and data to NHS England.
The first community fibroscan clinic – a service Harness Care has contracted with local secondary care services to deliver – took place on 21 February 2024 with twice weekly clinics continuing until September 2024, aiming to test over 1500 patients.
This proactive approach will make a real difference to the lives of people at higher risk of liver cancer in Brent and pave the way for effective strategies to combat liver cancer in the future by reporting outcomes to the NHS England Liver Scanning pilot.
Dr MC Patel, Clinical Director of Harness Care and Senior Responsible Officer for the project said:
“The collaboration between Harness PCNs and TPHC has cultivated a remarkably positive relationship, distinguished by the consultancy’s introduction of rigor and a structured methodology essential for the pilot’s success. TPHC’s approach has not only been greatly appreciated for its effectiveness but has also transformed the dynamics of our partnership, evolving from a traditional client-contractor interaction to a collaborative effort. This shift has been pivotal in implementing the programme’s first stage successfully, yielding tangible benefits for patients undergoing fibroscanning or liver disease screening tests.
The responsiveness and adaptability of the TPHC team to refine programme details have been instrumental in fostering a conducive and dynamic working environment. As we anticipate the next phase of our pilot, we are optimistic about strengthening this partnership further, hopeful that it marks the beginning of a long-lasting relationship underpinned by mutual respect, shared goals, and a commitment to excellence.”
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