Acute pancreatitis (AP) represents a major healthcare burden, with complex cases often requiring coordinated multidisciplinary input. To optimise management and streamline regional referrals, the North Central London Acute Severe Pancreatitis Network was established as a collaboration between the hepaticopancreatobiliary teams at University College London Hospital (UCLH) and the Royal Free Hospital (RFH).

Both centres, located in close proximity, observed that several hospitals across the South of England were referring patients to both sites, leading to duplicated clinical work, conflicting communication, and inefficient use of endoscopy capacity. In response, a unified referral pathway was established to provide timely specialist advice and interventions whilst improving workflow and efficiency. We present a one-year review assessing referral patterns, clinical outcomes, and the impact of this collaborative model on service efficiency. The network operates through a single point-of-contact phone line, alternating weekly between UCLH and RFH, with all referrals and clinical progress are recorded on a shared database. A specialist nurse receives all referrals and responds with consultant or senior fellow advice within 24 hours. Weekly clinical updates are obtained and discussed at a weekly network MDT.

A retrospective review was performed of all acute pancreatitis referrals received by the network over a 12-month period. Data collected included referral source, disease severity, imaging findings, interventions performed (endoscopic, radiological, or surgical), length of stay, adverse events, and mortality. Workload distribution between the two sites was analysed to assess the impact of shared clinical responsibility. Outcomes were compared with internal historical data prior to network implementation.

Between 2 December 2024 and November 2025, the network received 164 referrals from 19 hospitals across a catchment area extending roughly 120 miles. The mean time on the pathway from referral to discharge was 17.6 days (median 13), compared with 23 days before the network was established.

Twenty-nine patients (18%) required endoscopic intervention. Of these, 24 (83%) underwent LAMS placement for walled-off necrosis, 4 (14%) of whom required necrosectomy. 5 patients (17%) received plastic stents for pseudocysts. There were five deaths (3%), all due to complications of severe pancreatitis.

The North Central London Acute Severe Pancreatitis Network demonstrates that a coordinated two-centre model with a single referral pathway can significantly reduce duplicated work, improve resource utilisation, and maintain high-quality specialist care. This model supports efficient management of complex AP across a large regional population and serves as a scalable framework for other tertiary HPB services.