The new NICE guidelines for the management of non-alcoholic fatty liver disease (NAFLD) were updated in October 2021, recommending primary care use of the enhanced liver fibrosis (ELF) test to assess the risk of NAFLD progression into liver fibrosis. Is this test available following the transfer of pathology services in Bexley, Greenwich and Lewisham?

Published: 10th November 2021

At this time, the ELF test cannot be offered. However, work has begun to explore the possibility of purchasing the necessary equipment that would enable it to be offered at some point in the future.

For now, it is recommended that GPs in Bexley, Greenwich and Lewisham request platelets (FBC), AST (which will now be part of LFTs) and ALT (which will not be part of LFTs but can be ordered separately) and calculate the patient’s FIB-4 score: Fibrosis-4 (FIB-4) Calculator – Clinical Calculators – Hepatitis C Online (

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