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Opportunities for clinicians to shape future liver disease care in North Central London

The North Central London Integrated Care Board is issuing a notice for Expressions of Interest for a Primary Care Lead and a Secondary Care Lead with an interest in Liver Disease to participate in our newly established NCL Liver Disease Clinical Network (to be hosted by Royal Free Hospital).

North Central London

The NHS North Central London Integrated Care Board (NCL ICB) was established in July 2022. The ICB is part of North Central London Integrated Care System (ICS). The ICS is a partnership of organisations that come together to plan and deliver joined up health and care services to improve the lives of people in our five boroughs: Barnet, Camden, Enfield, Haringey and Islington.

ICBs are statutory NHS bodies responsible for planning and allocating resources to meet the four core purposes of ICSs:

  • To improve outcomes in population health and healthcare
  • Tackle inequalities in outcomes, experience and access
  • Enhance productivity and value for money
  • Help the NHS support broader social and economic development.

North Central London’s population is incredibly diverse and continues to grow and change. This brings pressures and challenges for the local health and care services that NCL ICB commissions – or buys – on behalf of residents. NCL ICB works closely with Councils, providers, general practices, voluntary, community organisations, and unions, to achieve our shared aims. NCL ICB values our staff, our partners and their expertise to deliver the best health and care possible for the patients and residents of North Central London.

The delegation of specialised services

Specialised services comprise a diverse portfolio of c150 services generally accessed by people living with rare or complex conditions. The NHS England Board has approved joint commissioning of specialised services with ICBs and where appropriate is aiming to join up care for patients, improving their experiences and outcomes from treatment. The arrangements in 23/24 represent a stepping-stone towards delegating full commissioning for 59 services from April 24, subject to further NHS England Board approval. Delegation provides us with an opportunity to review end to end pathways with a view to population health improvement therefore focusing on early intervention and prevention.

Liver Disease

Liver Disease is growing at a rate of 20% per year with much of this driven by lifestyle factors (alcohol, smoking, obesity, drugs etc). This is placing increased pressure on Acute Services (including the need for transplants).

Liver cancer is a significant chronic care cost resulting from late diagnosis of liver disease with extremely low survival rates and high costs of treatment during both any curative and palliative phases. In addition, NCL, along with other sectors in London, has seen large scale immigration from countries with unusually high prevalence of Hepatitis B and Hepatitis C and both Right Care and Public Health England (PHE) flag that London ICSs have high levels of preventable mortality arising because of Liver Disease (and related Liver Cancer). However, there is no national nor regional plan to address Liver Disease.

Through the NCL Inequalities Fund that the ICS has established we are funding a series of Healthy Living Hubs (HLHs) to start to address the lifestyle factors driving demand growth in Liver Disease. These HLHs are working closely with our Obesity, Alcohol and Smoking groups that work across London Authorities, VCSE and NHS partners to provide a coordinated response to the challenges we face, not only in relation to Liver but many other preventable health conditions.

The NCL Inequalities Fund was established in 2021/22 and funding for the HLHs via this route has been extended to the end of 2024/25 with a view to using this time to develop a longer-term funding plan.

This NCL Liver Disease Clinical Network will coordinate our response and will be overseen by our clinical lead for Liver Disease, Professor Douglas Thorburn at the Royal Free Hospital. The Network also has Engagement sessions with North London representatives to try and share and align good practice service redesign in Liver disease on a wider footprint.

The Role – Primary Care Lead 

This role is integral to support the alignment of liver disease services from primary to tertiary care and will be working with senior clinical and managerial leads across the ICS to focus on integrated commissioning opportunities across liver disease pathways to improve the quality of services, tackle health inequalities and ensure best value.

The successful candidate will be responsible for the following:

  •  Participate in the NCL Liver Disease Clinical Network (expected monthly meetings)
  • Active role in the North London Engagement Sessions (6 weekly)
  • Representing primary care in the systemwide priorities determined by the network and communicating with primary care colleagues via the existing routes
  • Lead on implementing individual elements of any planned change to pathways as agreed via the Network
  • Will report to the clinical lead of the Liver Disease Network
  • Expected 1 session/ ½ day per week (£20k pa)

Candidates are expected to:

  • Have an interest in liver disease detection/ treatment if not experience/qualifications
  • Have experience of leadership in clinical roles
  • Still involved in direct patient care in General Practice
  • Demonstrate the ability to work collaboratively across primary, community and secondary care and between commissioners and providers, including local authorities.
  • Show an understanding of population needs, outcomes and the development of evidence-based clinical pathways is required as well as an understanding of the evidence and the processes needed to drive quality improvement.

Liver Network Primary Care lead Job Specification

For expressions of interest please send cover email and cv to: Nclicb.nclspeccomm@nhs.net

Closing date: Friday 17 November

The Role – Secondary Care Lead

This role is integral to support the alignment of liver disease services from primary to tertiary care and will be working with senior clinical and managerial leads across the ICS to focus on integrated commissioning opportunities across liver disease pathways to improve the quality of services, tackle health inequalities and ensure best value.

The successful candidate will be responsible for the following:

  • Be a Subject Matter Expert in the diagnosis and treatment of Liver Disease in Secondary and Tertiary care
  • Have experience of leadership in clinical roles and preferably Board level experience
  • Demonstrate the ability to work collaboratively across primary, community and secondary care and between commissioners and providers, including local authorities.
  • Show an understanding of population needs, outcomes and the development of evidence-based clinical pathways is required as well as an understanding of the evidence and the processes needed to drive quality improvement.
  • Provide an objective and independent professional expert opinion to inform the direction and improvement activities of the network
  • Responsible to NHS ICB Clinical Lead for Delegated Services
  • Expected 1 session/PA per week; Network management support available

Candidates are expected to:

  • Be a Subject Matter Expert in the diagnosis and treatment of Liver Disease in Secondary and Tertiary care
    Have experience of leadership in clinical roles and preferably Board level experience
  • Demonstrate the ability to work collaboratively across primary, community and secondary care and between commissioners and providers, including local authorities.
  • Show an understanding of population needs, outcomes and the development of evidence-based clinical pathways is required as well as an understanding of the evidence and the processes needed to drive quality improvement.

Liver Network Secondary Care lead Job Specification

For expressions of interest please send cover email and cv to: huw.jones19@nhs.net

Closing date: Friday 10 November