New blood test reduces liver clinic waiting list at NHS Tayside

A new rapid test is helping NHS Tayside identify priority patients on their liver clinic waiting list.

The introduction of the Enhanced Liver Fibrosis (ELF) blood test has since reduced the waiting list by almost half by allowing clinicians to assess which patients need to be seen by the specialist liver clinic for further treatment. The ELF test is able to identify the amount of scarring (fibrosis) present on the liver.

Tayside has been using Intelligent Liver Function tests (iLFTs) since 2018, when they were first developed and implemented by Professor John Dillon and Dr Ellie Dow. The tests are able to help identify which patients have liver disease, in order to diagnose and treat them at an earlier stage. GPs receive the results as well as 32 potential outcomes, which makes it easier to identify what might be the cause of the liver dysfunction and offer a firm diagnosis.

The iLFTs work to estimate the amount of fibrosis in the liver with a “rule-in, rule-out” threshold; patients who fall in the middle are classed as “indeterminate” and require a referral to the specialist liver clinic for further tests.

The new ELF tests support the iLFTs by introducing an “ELF score” to the iLFT pathway. They are able to more accurately diagnose fibrosis in the liver by measuring three different molecules in the blood. This then allows doctors to assess which “indeterminate” patients need to be seen by a specialist, and which can be safely managed by their GP.

Professor Dillon said, “Since July we have performed ELF tests on over 500 patients, of which 44% had an ELF score which showed they can safely be managed in the community.

“This prevents unnecessary anxiety for these patients and reduces clinic waiting times so that patients with serious liver disease can get specialist care more quickly.”