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Unlike most other chronic diseases and cancers in Australia, outcomes for cirrhosis and hepatocellular cancer are not improving. Public hospitals are overwhelmed by decompensated cirrhosis and struggling to provide best practice care for the large population of patients with less severe (compensated) cirrhosis. Adding to this dysfunction is a lack of education and support for the primary care workforce. To improve the current care for patients with cirrhosis, we must recognise the current poor outcomes and develop appropriate policy responses, including increasing workforce capacity via training of the primary care workforce and establishment of shared care models.