Our Services

Our Ward

Hepatology inpatient care is provided on ward F21 at QMC. This is a combined gastroenterology and hepatology ward with 28 beds including 4 side rooms. Our consultant hepatologists provide ward cover on a rotational basis with a separate gastroenterology consultant rota for the gastroenterology patients on the ward. 

Our patients are admitted from a variety of settings including: medical admissions units, critical care areas, and outpatient clinics. We frequently take transfers from other hospitals for specialised procedures and care

 

Acute Gastrointestinal Service

Emergency care for patients with gastrointestinal diseases is provided by the Acute Gastrointestinal Service (acute GI). This rotational team consists of a consultant, a specialist registrar, and a specialist nurse. Their responsibilities include the review of patients in the emergency department and other admission areas as well as patients in critical care. The acute GI team will see referrals from other wards and prioritise the transfer of appropriate patients to specialist gastroenterology and hepatology beds. Emergency endoscopy for inpatients is provided by the acute GI team including the endoscopic treatment of gastrointestinal bleeding both in and out of hours. 

 

Hepatology Hot Clinic

The Hepatology Hot Clinic is a twice-weekly clinic for patients referred via the ‘2-week wait’ pathway and any patient in need of urgent hepatology review. The clinic aims to provide urgent access to a specialist in order to avoid admission and facilitate early discharge. 

A range of consultant and specialist nurse-led clinics are provided within our network, in partnership with other NHS Trusts, at locations in Nottingham, Grantham, Mansfield and Newark. These include general clinics and a range of sub-speciality clinics covering a broad range of conditions. Our service is supported by specialist diagnostic modalities, including fibroscan, liver ultrasound, advanced endoscopy and liver biopsy. Further information on locations and contact details can be found on the our clinics page. 

Monitoring

Cirrhosis monitoring and surveillance is delivered by our team of consultants and specialist nurses. Clinics provide long-term care for patients with chronic liver disease including management of portal hypertension, surveillance for complications of cirrhosis, monitoring of blood tests, and brief interventions for lifestyle-related liver diseases.

Elective Paracentesis

Our paracentesis service is a dedicated service, delivered by our paracentesis team, for patients accumulating fluid in the tummy, termed ascites. This is one of the complications of cirrhosis caused by elevated pressures around the liver, termed portal hypertension. When the fluid cannot be treated by medications our paracentesis team can arrange an abdominal drain (paracentesis) to remove the fluid for our patients on an elective basis. This care is delivered on the Queen’s Day Case Unit and avoids the need for admission to hospital. Our paracentesis team builds strong relationships with our patients and are always accessible to provide information and advice.

Transjugular Intrahepatic Portosystemic Shunt (TIPSS)

TIPSS is a technique performed by interventional radiology specialists. It involves passing a metal tube across the liver to allow blood to flow from the portal vein to the hepatic vein. The aim of this is to bypass the liver to reduce the effects of raised pressures around the liver.

Nottingham is the regional referral centre for all aspects of the treatment of HCC. Treatments offered include, transplant assessment, surgical resection, microwave ablation, transarterial choembolisation (TACE), and systemic therapies. There is a dedicated consultant-led HCC clinic supported by our liver specialist nursing team.

Further information on HCC can be found on the British Liver Trust website.

Hepatitis C

The Nottinghamshire, Derbyshire and Lincolnshire Hepatitis C Operational Delivery Network involves partnership working between Nottingham University Hospitals, University Hospitals of Derby and Burton, and United Lincolnshire Hospitals. The hospitals work closely with partners in community settings to improve testing and access to treatment. Effective treatments are offered for hepatitis C. Further information is available on The Hepatitis C Trust and British Liver Trust websites. 

If you have any questions regarding our service including testing, treatment or referrals then please email: nuhnt.nottinghamhepatology@nhs.net  or Tel: 0115 924 9924 Ext: 82814

 

Hepatitis B and other viral hepatitis

Our consultants and viral hepatology specialist nurses provide outpatient diagnosis, monitoring and surveillance appointments for individuals diagnosed with viral hepatitis. The hepatitis service works with the infectious diseases team to provide a multidisciplinary joint clinic for individuals co-infected with hepatitis and HIV (human immunodeficiency virus). 

 

 

Nottingham has developed a close relationship with the Cambridge Liver Unit at Addenbrookes to run the joint liver clinic to provide better access to liver transplant services for patients right across Nottinghamshire and Lincolnshire. All pre and post-transplant care is provided in Nottingham meaning patients only need to travel to Cambridge to undergo the transplant procedure. 

The joint liver clinic is a monthly clinic attended by the liver transplant team from Addenbrookes (physician, surgeon, and recipient coordinator) and supported by hepatology consultants, specialist nurses, dietitians and pharmacists from Nottingham. Pre-transplant patients are assessed and monitored through the joint liver clinic reducing their need to travel to Cambridge. In the early post-transplant phase patients return to the joint liver clinic for monitoring before future follow up is arranged in the liver transplant follow-up clinic. 

Our liver transplant patients receive their specialist medications via homecare. For homecare enquiries please email: nuhnt.nottinghamhepatology@nhs.net.

Comprehensive information regarding liver transplants can be found on the British Liver Trust website.

Alcohol Care Team

Alcohol services are provided through collaboration between the Framework Housing Association, Nottinghamshire Healthcare NHS Trust and our alcohol nurse specialists. Framework provides a 3-tier alcohol service for Nottingham City residents and delivers a triage and brief intervention service within NUH. The team provides support and advice for those at risk of alcohol-related harm.

 

Edwin House

Our team has close links with Edwin House run by the Framework Housing Association in Nottingham. Edwin House provides care relating to long-term substance misuse. Within the Edwin House site, a 48 bed unit provides residential care, nursing care, and reablement support. A separate 14-bed unit provides a consultant-led, medically assisted inpatient detoxification unit.

We provide care for patients with autoimmune liver conditions, including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Our liver specialist nursing team monitor those on treatment for autoimmune hepatitis. 

For any enquiries relating to PBC please email: nuhnt.nottinghamhepatology@nhs.net or Tel: 0115 9249 924 Ext: 82814.

Haemochromatosis

Patients with haemochromatosis are cared for in a dedicated specialist nurse-led clinic. This clinic accepts referrals from both primary and secondary care with either confirmed or suspected haemochromatosis. Confirmatory testing, risk stratification, family screening, venesection and long term monitoring of patients with confirmed haemochromatosis is arranged through the clinic. For any enquiries relating to haemochromatosis please Tel: 0115 969 1169 Ext: 54139

 

Wilson’s Disease

Our clinics provide care for individuals diagnosed with Wilson’s disease and this includes confirmatory testing, family screening and long-term monitoring. NUH is a national centre for the treatment of Wilson’s disease which means we can provide specialist treatments in Nottingham.

 

Cystic fibrosis related liver disease joint clinic 

Cystic fibrosis can cause blockage of small ducts in the liver leading to complications. The cystic fibrosis joint liver clinic is a specialist clinic for individuals with cystic fibrosis related liver complications, including liver transplant. The joint clinic is delivered by hepatology and respiratory specialists and takes place four times a year at City Hospital in Nottingham.

Neuroendocrine tumours (NET) are rare cancers that affect the digestive system but can occur in other parts of the body. Our team provides multidisciplinary care and treatment options for people with NET. Patients with potential NET are discussed at the specialist NET multidisciplinary team meeting (MDT) which is held monthly.  Referrals for assessment can be made from within NUH or by tertiary referrals directly to the NET MDT. Patients who are suitable for analogue therapy can be managed in the nurse-led neuroendocrine clinic delivered by the liver specialist nursing team.

 

Further information on NET can be found on the Neuroendocrine Cancer UK website.

The transition hepatology clinic is an integrated clinic bridging the gap between paediatric and adult settings for young people with liver conditions to facilitate seamless transition of ongoing care. This clinic is delivered by paediatric gastroenterology and adult hepatology specialists on a rotating basis.

Nottingham is the regional centre for advanced hepatopancreatobiliary endoscopy. Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are provided daily with regular support from anaesthetics. The department provides access to SpyGlass ERCP for the management of both cancerous and biliary stone disease. The endoscopy department is actively involved in research into the endoscopic management of pancreato-biliary disease including EUS guided biliary drainage and radiofrequency ablation of pancreatic cyst neoplasms.

Our team benefits from a specialist pharmacist in hepatology. They provide specialist pharmacy support and supply of medication to our patients in a variety of settings. Responsibilities include medication prescribing and provision of advice to healthcare professionals and patients. They lead our homecare service for liver transplant medication and our viral hepatitis treatment service.

Our network partners with the Nottingham Biomedical Research Centre and Nottingham Clinical Research Facility which were established in April 2017. Our team works to translate research into breakthrough treatments, new technologies and advanced medicines to meet the needs of patients, carers and families locally, nationally and internationally. Research is led by internationally-renowned academics, scientists and clinicians with expertise in innovation and scientific discovery to help develop clinical practice.

Further information can be found at the Nottingham Biomedical Research Centre website.