Scottish Hepatology Access Research Partnership

The Scottish Hepatology Access Research Partnership (SHARP) has been formed with funding supported by the National Institute for Health Research (NIHR). It is planned to function for 15 months in the first instance, starting in March 2023. It will address the barriers to accessing liver services and develop research initiatives for geographically isolated and/or socio-economically deprived populations.

SHARP will establish a multidisciplinary network from across Scotland representing extremes of isolation and unmet clinical need in remote/rural and urban populations. This will catalyse specific research projects to identify barriers and novel solutions to accessing liver services.

SHARP intends to report its activities to the NIHR and it is hoped will submit at least one research project proposal to the NIHR early in 2024.

Contacts

Dr Ruairi Lynch (Lead), ruairi.lynch2@nhs.scot

Prof Ewan Forrest (Co-lead), ewan.forrest@ggc.scot.nhs.uk

Clare Dolan (Project Manager), clare.dolan3@ggc.scot.nhs.uk

Background

Chronic liver disease (CLD) is often insidious in onset and progresses with few symptoms until advanced liver injury is established. Thus, prevention, early detection, effective monitoring and intervention are fundamental to altering the course of CLD. CLD disproportionately affects people in the most deprived areas, and whilst more obvious in urban populations, rural deprivation is significant and underappreciated. Scotland has unique geographical and social determinants that limit the provision of equitable access to liver specialists and services. These barriers contribute to Scotland having a higher European Age Standardised Rate (EASR) for CLD when compared to the rest of the UK and other European countires (International comparisons - ScotPHO). Within Scotland, areas of significant social deprivation have even higher EASRs as do remote and rural areas (Mortality - ScotPHO). Alcohol-related liver disease accounts for >80% of CLD deaths.

Structure

The Co-leads of SHARP are Dr Ruairi Lynch, NHS Tayside; and Prof Ewan Forrest, NHS Greater Glasgow and Clyde.

A circular graphic showing the relationship between the Partnership Advisory Group and the Partnership Management Group, as described in the text.

SHARP will be composed of a Partnership Management Group (PMG) and a Partnership Advisory Group (PAG). The PMG will consist of Hepatologists, Nurse Specialists, General Practitioners, Public Health specialists, representatives of regional Alcohol and Drug Partnerships, relevant charities, and patient participation through the British Liver Trust. It will develop research proposals for the Part 2 call and produce a report to NIHR on its activities. The PMG will meet virtually every month. Importantly, regions with historically lower levels of research activity will be actively involved in the PMG.

The PAG will have a similar composition to PMG but with a larger number of partners. The role of the PAG will be to review research proposals from the PMG.

Partners

SHARP will be working with Health Boards and Alcohol Drugs Partnerships throughout Scotland, but in addition there will be close involvement of the following organisations

Workstreams

Four main workstreams are evolving

	Work Stream Title	Lead
Work Stream 1	Current access to liver services in Scotland	Dr R Lynch; Dr R Swann, Dr D Blane
Work Stream 2	Technologies to monitor liver disease	Dr R Lynch; Dr A Mukhapadhya
Work Stream 3	Identifying patients at risk of liver-related events in primary care	Prof J Fallowfield
Work Stream 4	Recognition of factors affecting engagement/disengagement with Liver Services	Dr D Blane

Research Areas