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Introduction Acute pancreatitis (AP) often requires complex multidisciplinary care. Historically, multiple hospitals were referring simultaneously to both University College London Hospital (UCLH) and the Royal Free Hospital (RFH), leading to duplicated work and inefficient use of specialist resources. A nurse-led regional referral pathway was introduced to streamline access and improve coordination. We aim to evaluate the one-year performance of a nurse-led, two-centre AP referral pathway, focusing on efficiency, clinical outcomes, and service optimisation.Methods A retrospective review was conducted of all referrals received over 12 months. A specialist HPB nurse operated a single point-of-contact phone line, triaged all referrals, coordinated consultant or senior fellow advice within 24 hours, obtained weekly updates, and presented cases at the joint MDT. Data collected included referral source, disease severity, imaging, interventions, length of stay, adverse events, and mortality, and were compared with internal pre-network data.Results From 2 December 2024 to November 2025, the network received 164 referrals from 19 hospitals across a catchment extending approximately 120 miles. Mean time on the pathway from referral to discharge was 17.6 days (median 13), compared with 23 days before network establishment. 29 patients (18%) required endoscopic intervention: 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.Conclusion A nurse-led referral pathway improves efficiency, reduces duplicated work, and maintains high-quality specialist care. This model demonstrates the central role of specialist nursing leadership in coordinating complex AP management and offers a scalable structure for other tertiary HPB services.