The project

The Somerset Liver Improvement Project was initiated by Dr Tim Jobson (the doctor responsible for the project overall (‘Chief Investigator’)). Dr Jobson works for Somerset NHS Foundation Trust (SFT) and also works for the company that was set up to manage the project. The purpose of the project is to improve the care of patients with liver disease. A key aim was to improve the care of patients with ‘chronic’ (by which we mean long-term) liver disease. It is well known that many patients with chronic liver disease get diagnosed late and therefore miss out on treatment.

Whilst treating patients presenting with liver disease, Dr Jobson and his clinical colleagues noticed that many of these patients had already had blood tests (either with their GP or in hospital) which indicated a need to investigate further for a liver problem. However, these blood tests were not linked together in the right way, or they were not seen by the right people. It is often combinations of blood tests from different clinics or spread out over time that really show an indication of a liver problem.

We therefore set out to design a computer system that would help doctors diagnose liver problems by linking test results together and flagging up patients who are at risk. To enable us to do this, our computer system needs to look at very large numbers of blood tests belonging to a wide range of different people to find those most at risk. This is part of the work we do within the project, working closely with GPs and other doctors who work with us in the hospitals across Somerset.

Predictive Health Intelligence manages all the technical aspects of this project but has no direct access to data. This type of data is under the control of SFT and is processed by approved subcontractors. Secure processing of data is carried out by highly experienced specialists and is regulated under strict confidentiality and information security contractual arrangements.

There are two phases to this project:

Design and testing – this is a new idea, and while it might seem simple, a lot of work is needed to ensure the computer system works correctly, and can identify patients with liver problems.
Treatment phase – once the system works we will start to flag up patients who might need further investigation to see if they have a liver condition. This information will only be available to the hospital and GPs, and patients will be contacted if their doctors think they need some treatment.

To view a video explaining about why Predictive Health Intelligence was set up click here.

Who else is involved in the project?

Predictive Health Intelligence Ltd: This is the company that was set up to manage the project and design the computer system. The company is owned by Somerset NHS FT, Sirius Partners Limited (Director Neil Stevens) and Jobson Medical Services Limited (Director Tim Jobson).

National Institute for Healthcare Research (NIHR) (who funded this project): The NIHR was established in 2006 to “create a health research system in which the NHS supports outstanding individuals, working in world-class facilities, conducting leading-edge research focused on the needs of patients and the public”.

Since that time, the NIHR have transformed research and innovation in and for the NHS and helped to shape the health and social care research and innovation landscape more broadly. This project is funded by the NIHR as part of the ‘Invention for Innovation’ programme.

The NIHR is funded by the Department of Health and Social Care and works in partnership with the NHS, universities, local government, other research funders, patients and the public. They fund, enable and deliver world-leading health and social care research that improves people’s health and wellbeing and promotes economic growth.

How is the project governed?

Dr Tim Jobson is the Chief Investigator and is responsible for ensuring that all the correct approvals are in place. The following people / teams have been involved in authorising or approving this project:

NIHR: As the funding body for the project, they have extensively reviewed it and also commissioned external reviewers to ensure it is worthwhile and likely to be successful. Details of the approved project are here.
Somerset NHS FT Clinical Ethics Committee: the committee was involved early on as one of the likely outcomes is that we will be contacting patients ‘out of the blue’. This committee has advised on how this might best be done.
Patient and public forum: we set up a forum to present our ideas. The patients and public we spoke to were very much in favour of this project, and were in some cases surprised we weren’t doing this already. We will continue to engage with patients, the public and representative groups.
Somerset NHS Research Team: The Clinical Director for Research and the Research Manager have been involved throughout and have approved the approach taken in the project.
Somerset Chief Medical Officer: This is the most senior doctor in Somerset NHS FT and they have agreed that this project is highly important and should go ahead.
Caldicott Guardian: This is the senior doctor at Somerset NHS FT (a consultant) who oversees the use of patient data, and who has approved this project.
Senior Information Risk Owner: this is the executive director of the Trust who approves the use of data and the information security arrangements.
Data Protection Officer: The DPO at Somerset NHS FT has reviewed the project and is satisfied that the correct procedures are being followed.
Clinical Commissioning Group: This is the group responsible overall for healthcare in Somerset. Their Data Protection Officer has reviewed the project and endorsed the approach being taken.
Local Medical Committee: This is the lead group of GPs in Somerset who have reviewed the project and it is following their advice that GPs will release their patient data for this project.

Throughout the set-up of this project, we have been open and transparent about all aspects and have sought approval and advice from as many people as possible.

The project

Who else is involved in the project?

How is the project governed?

Predictive Health Intelligence

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