Hepatology Outpatient Services

 A)   Consultant Liver Clinics

All our Gastroenterology consultants review and see General Hepatology patients in their outpatient clinics. Dr Crisan and Dr Osuoha have special interest in Hepatology and support the General Hepatology service.

Dr Shah Lead Hepatologist  and our visiting Hepatologist Dr Agarwal are holding specialist Hepatology clinics at the William Harvey Hospital.

Specialist Hepatology Clinics at William Harvey Hospital:

Dr Jayshri Shah – Monday am  and Thursday am ( Specialist Hepatology Clinic) 2 clinics per week . These are hybrid clinics having F2F and telephone review after careful triage

Dr Kosh Agarwal – Visiting once a  month 2nd Thursday

Monday clinic am will see patients referred with:

  • Viral hepatitis
  • Cirrhosis surveillance
  • General Hepatology such as abnormal LFT’s with unknown cause despite evaluation
  • Metabolic liver disease (Hemochromatosis, Wilsons disease, alpha 1 antitrypsin deficiency )
  • Non alcohol fatty liver disease (NAFLD) with advanced fibrosis
  • Alcohol related liver disease (ALD)
  • Focal liver lesions(indeterminate, hepatic adenomas, etc)
  • Drug induced liver disease

Thursday clinic am sees patients referred with:

  • Complex hepatology such as autoimmune hepatitis not responding to first line immunosuppression, overlap syndrome, Primary Sclerosing Cholangitis(PSC), small duct PSC ,  Primary Biliary cholangitis not responding to ursodeoxycholic acid.
  • Decompensated Liver disease being considered for Pretransplant assessment
  • Patients on waiting list for Liver transplant
  • Patients being considered for TIPS
  • Post liver transplant
  • Vascular conditions such as Portal vein thrombosis, Budd Chiari syndrome 
  • Hepatocellular cancer on treatment

Referrals into these clinics are either via our GP colleagues in the Community; via consultant :consultant referrals within the Trust; following a ward discharge from an acute admission


B)   Nurse led OP Liver Clinics

The Clinical Nurse Specialists hold clinics at the Kent and Canterbury Hospital, Queen Elizabeth the Queen Mother Hospital, William Harvey Hospital and Buckland Hospital.

All patients remain under the consultant and are the point of contact if the Clinical Nurse Specialist (CNS) feels the patient’s condition is changing.

The Hepatology Nurse specialist offer the following clinics:

  • Hepatitis C
  • Hepatitis B
  • Liver cancer Surveillance for cirrhosis of all etiology
  • Autoimmune Hepatitis
  • NAFLD (Non-alcoholic fatty liver disease)
  • Fibroscan


Nurse Outpatient Clinics : Day and Time

  • Tuesday am at the Queen Elizabeth the Queen Mother Hospital – Sandra Pilcher

  • Tuesday pm at the Queen Elizabeth the Queen Mother Hospital – Emma Lloyd

  • Wednesday am at the William Harvey Hospital – Emma Lloyd

  • Wednesday pm, weeks 2, 3, 4 & 5 at Buckland Hospital – Sandra Pilcher

  • Thursday am, weeks 3, 4 & 5 at the William Harvey Hospital – Emma Lloyd

NAFLD (Non-alcoholic fatty liver Disease)

One Stop Clinic :1st Wednesday pm of the month at Buckland Hospital – Sandra Pilcher

Fibroscan Clinics

Emma and Sandra run weekly fibroscan clinics –  fibroscan is a type of ultrasound that can measure the degree of inflammation in your liver.  It is a simple, painless test that uses high frequency sound waves, and helps your doctor to understand the condition of your liver.

Tuesday pm at the Queen Elizabeth the Queen Mother Hospital – Sandra Pilcher Wednesday am at Buckland Hospital – Sandra Pilcher

Tuesday am at the Queen Elizabeth the Queen Mother Hospital – Emma Lloyd

Outreach Community Services

East Kent Hospitals provides a community outreach service supported by the Hepatitis C Trust – www.hepctrust.org.uk -  designed to engage patients who may benefit from screening for blood borne viruses and treatment is required, working in conjunction with local drug and alcohol services, homeless charities and other local care providers. We have 2 hepatology Clinical nurse specialists supporting the outreach service