The Centre for Primary Health Care and Equity were engaged to conduct a qualitative and data evaluation of the Integrated Liver Toolkit Education Program to understand the impact, acceptability and feasibility of wider implementation.

Chief investigators

Associate Professor Margo Barr, Ms Margaret Williamson, Dr Cathy O’Callaghan, Ms Kat Meikle, Dr Alamgir Kabir, Associate Professor Fiona Haigh

Project Rationale

The ILTE Program aimed to:

  • Test a model for facilitating early detection of HCC, via timely surveillance of primary care patients with a cirrhosis diagnosis or with pathology results suggesting potential cirrhosis (confirmed via Fibroscan).
  • Strengthen management of patients diagnosed with cirrhosis and HCC via appropriate referrals to specialist hospital-based liver clinics.

Project Aims

The Centre for Primary Health Care and Equity (CPHCE) were engaged to conduct a qualitative and data evaluation of the ILTE Program to understand:

  1. What is the potential of the model presented in the ILTE Program to improve clinical outcomes for patients who are at risk of developing HCC?
  2. How acceptable is the model for those stakeholders involved?
  3. Should broader implementation of the model be supported across general practices in the CESPHN region?

Evalution Project Design and Method

  1. Data reports were reviewed regarding the results of the ILTE Program provided by CESPHN.
  2. Semi-structured interviews were conducted with staff from the participating general practices and hospital-based liver clinics to understand the acceptability of the model.


The evaluation found that although the LTK was seen to be important further development is required before it could be expanded throughout CESPHN, specifically improving specificity and reducing the number of indicators provided.


Williamson M, O’Callaghan C, Meikle K, Kabir A, Haigh F, and Barr M. Integrated Liver Toolkit and Education Program for the Management of Liver Cancer in Primary Care Pilot: Evaluation Report. Centre for Primary Health Care and Equity, Sydney 2023


Margo Barr

Key Partners

Cancer Institute NSW
Hepatitis NSW



Project lead centre


Project stream

Health System Integration and Primary Health Care Development