Hepatology (The Liver)

Introduction

The Liver (Hepatology) service provides inpatient and outpatient care looking after a range of conditions affecting the liver, pancreas and biliary system. Outpatient clinics and endoscopy procedures are conducted at Central Middlesex, Northwick Park and Ealing Hospitals. There is also a dedicated inpatient hepatology team at Northwick Park, based on the Frederick Salmon South Ward. There is a Hepatology treatment room which provides the following services: the Hot Liver Clinic, Fibroscan and elective paracentesis. Liver inpatients at Ealing are looked after by the Gastroenterology team on Ward 7 South. 

We work closely with Hammersmith Hospital for patients requiring specialised medical care for liver, pancreas or biliary surgeries, both benign and cancer. Liver resections and liver therapy for cancer are conducted at Hammersmith. Patients requiring liver transplantation are referred to the Royal Free Liver Transplant Team.

Our Services

Clinics take place across all three sites and are primarily face-to-face, some may be by telephone if appropriate at the patient’s request. The clinics offered are consultant-led, nurse-led and pharmacy-led. 

General hepatology clinics

General hepatology clinics are offered at Northwick Park Hospital on Monday afternoon, Central Middlesex Hospital on Wednesday and Ealing Hospital on Thursday. The hepatology clinic covers the following:

  • Investigation of abnormal liver function
  • Cirrhosis of any aetiology
  • Surveillance of cirrhotic patients
  • Viral hepatitis
  • Alcohol-related liver disease
  • Non-alcoholic fatty liver disease with severe fibrosis
  • Haemochromatosis
  • Primary biliary cholangitis
  • Primary sclerosing cholangitis
  • Autoimmune hepatitis

Complex hepatology clinics

The complex hepatology clinic is currently only offered at Northwick Park Hospital on Thursday morning. The clinic covers the following:

  • Consideration of transplant or those already on waiting list for transplant
  • Consideration of trans-jugular intrahepatic portosystemic shunt, radiofrequency ablation, or selective internal radiation therapy
  • Palliative long term ascitic drains
  • Post-transplant
  • Vascular liver disease
  • Overlap syndrome
  • Antenatal patients with viral hepatitis B, liver disease in pregnancy, focal liver lesions or liver cancer

Viral hepatitis clinics

The viral hepatitis service is jointly conducted by the liver and infectious diseases team. The clinics are offered across all sites by Hepatology Consultants, Hepatology Clinical Nurse Specialists and Infectious Diseases Consultants and Hepatitis Clinical Nurse Specialists.

Hot liver clinics

The hot liver clinic is run by a registrar under supervision of the ward Hepatology Consultant on a Tuesday and Friday morning on Frederick Salmon South. Recently discharged patients are followed up to adjust their medication, commence immunosuppression for autoimmune hepatitis and early reviews to prevent hospital admission are arranged. 

Inpatients

Northwick Park Hospital: The main Gastroenterology and Hepatology ward is Frederick Salmon South at Northwick Park Hospital with 24 beds on Level 4. The liver inpatients are cared for by a rotation of five Hepatology Consultants who review patients on the Acute Medical Units. In addition, there is a 24-hour gastrointestinal bleed service. 

Ealing Hospital: The Gastroenterology team looks after liver inpatients on Ward 7 South. Out of hours gastrointestinal bleed cover is provided at Northwick Park.

The alcohol liaison team and palliative care teams provide specialised support for inpatients at both sites.

Procedures

You may have a procedure at any one of our hospital sites. These include:

  • Fibroscan 
  • Ultrasound and elastography
  • Upper gastrointestinal endoscopy 
  • Liver biopsy: percutaneous and transjugular
  • ERCP 

Patient Factsheets and Useful Information

You can read more about our services here:

The upper gastrointestinal endoscopy procedure
The ERCP procedure

For further information on your condition, these external websites have some excellent resources:

The British Liver Trust
Alcohol Change UK
The Nutrition and Cirrhosis Wellness Toolbox 
The Hepatitis B Trust
The Hepatitis C Trust
The PBC Foundation
The UK Autoimmune Hepatitis Cohort
PSC Support
Pancreatic Cancer UK
AMMF Cholangiocarcinoma Charity
Liver Cancer UK
Haemochromatosis UK
Wilson’s Disease Support Group

The Hepatology Team

Consultant Hepatologists: Dr Jayshri Shah (Consultant Hepatologist and Clinical Lead), Dr Mohammed El-Naggar, Dr Laurence John, Dr David Sherman, Dr Nina Stafford, Dr Luke Tyson, Dr Gabriel Wallis

Management Team & Matron: Yvonne Deady (Matron), Eimir Bourke (Ward Manager, Frederick Salmon South, Northwick Park), Janette Edwards (Ward Manager, Ward 7 South, Ealing), Jag Samani (Service Manager)

Nurse Specialists: Jobin Antony, Lisa Barnes, May Anne Gamit, Kate Hymes, Tabassum Khan, Milda Reju, Kelcy Salinas, Olakunle Smith-Babalola

Pharmacy: Aya Al-Hasani, Anastasia Lamprou

Hepatology secretary: Shabeena Hamid shabeena.hamid@nhs.net

Alcohol liaison service: Adrian Brown, Bethwell Khumalo

Referral Guidelines

Referral Guidelines for Clinicians