Tackling increasing alcohol harm: Fibroscan pilot in Turning Point’s Leicester City Service

Alcoholic liver disease accounts for the majority of alcohol-specific deaths. A FibroScan is a simple and non-invasive procedure used to accurately assess the health of the liver and gives the opportunity to identify poor liver health at an early stage. Fibro scanning can also be used in outreach activities and can extend service reach people who have not previously engaged in treatment but who are at higher risk (for instance; rough sleepers, military personnel, those with poor mental health).

The use of FibroScan technology by the Turning Point Leicester City service was initially funded by Leicester City Council with the aim to increase the number of Leicester City residents accessing alcohol treatment and to support positive behaviour change to reduce harmful drinking behaviour. Funding was initially agreed as part of an 8 month pilot for use of a FibroScan with 2 specific cohorts:

• Offered as part of Turning Point’s alcohol dependent treatment pathway to Leicester City residents who are identified to have potential alcohol dependence and in structured treatment with Turning Point.
• Offered to registered patients within a pilot primary care GP site (Saffron Group Health) who are identified to have potential alcohol dependence but ambivalent/reluctant to engage in treatment.

1. Offered as part of Turning Point’s alcohol dependent treatment pathway to Leicester City residents who are identified to have potential alcohol dependence and in structured treatment with Turning Point. Between August 2021 and July 2022, 123 structured treatment service users were offered FibroScan exams. 31 (32%) people who had the scan were referred to Hepatology, 28 had a liver stiffness higher than normal, five had a score indicating advanced Fibrosis and 16 had scores indicating cirrhosis of the liver.

1. Offered to registered patients within a pilot primary care GP site (Saffron Group Health) who are identified to have potential alcohol dependence but are ambivalent/reluctant to engage in treatment. During the same period, 55 patients from this group were offered FibroScan exams. 11 (29%) had a liver stiffness higher than normal and were referred to Hepatology, five had a score indicating advanced Fibrosis and one service user had a score indicating cirrhosis. Approximately 30% of patients subsequently accepted a referral and entered structured treatment with Turning Point.

Our ambition is to offer FibroScan to all new alcohol treatment presentations and to existing service users within the next 12 months. The use of FibroScan has been recognised by Turning Point and resulted in our national alcohol pathway being updated to include the offer of a FibroScan exam at the earliest opportunity.