Having originally trained in London at University College Hospital Medical School, I spent my higher specialist training in the South West and Cardiff, where I was awarded an MD after research on an unusual genetic condition affecting the liver called hereditary haemochromatosis. I was appointed as a consultant in Bristol in 2005 and the majority of my clinical time is spent looking after patients with a wide variety of both common and unusual liver diseases.
Within my NHS practice I act departmental lead for gastro/hepatology and clinical lead for alcohol-related and metabolic liver disease. I recently introduced an integrated alcohol service for patients with and without liver disease, improved patient pathways for upper gastrointestinal bleeding and introduced novel therapeutic endoscopy techniques to the trust. Non-invasive measurements of liver fibrosis are now increasingly available to patients with liver disease and this can reduce the need for liver biopsy in some liver diseases. My patients can access my expertise through Liver Health Clinics and elastrography (Fibroscan) where appropriate. Other services include endoscopic investigation (gastroscopy and colonoscopy), general gastroenterology investigations and general medicine.
My practice is holistic and underpinned by clinical effectiveness; the latter being a particular specialist interest. Currently, I am working on a national project with the Royal College of Physicians Accreditation Unit to develop and test an accreditation model for liver services. Public health promotion is also a particular passion and I work with and alongside a number of national and local organisations involved with the care of liver patients, as well as being an executive member of a national charity.
My research interests are broad and thus my patients are given the opportunity to participate in national and local research studies I run. These include studies on treatments for alcohol-related hepatitis, fatty liver disease, primary biliary cirrhosis, autoimmune hepatitis, hepatic encephalopathy and refractory ascites.