Implementation of a pathway for patients with suspected IBD

Stockport CCG and Stockport NHS Foundation Trust

The problem

Suspected Inflammatory Bowel Disease (IBD) patients are waiting up to 38 weeks to be seen and treated in secondary care. During this period, the patient has multiple visits their GP practice and A&E meaning patients had a poor experience and the CCG incurring unnecessary costs during a time when there is increasing pressure to reduce costs.

The Bright Idea

A pathway for patients with suspected IBD referred from primary care to be seen in a Rapid Access Clinic in secondary care was implemented. At the same time, we improved patient care by triaging patients and GP phone calls by an IBD nurse using a telephone advice service for primary care, therefore avoiding unnecessary admissions or clinic appointments. The IBD nurse commenced clinics three weeks after the pathway was rolled out – no training was necessary for the IBD nurse as they already ran clinics, could order treatments and can prescribe. Some new systems were required including a new mobile phone was acquired for the Trust, the telephone advice system was set up, and the nhs.net account took time to arrange but all these incurred minimal costs and time commitment. Education sessions for primary care staff were held using a combination of GP masterclasses and individual practice visits.

The impact

Patients

Patients seen in a timelier manner, from previously 30+ weeks referral to treatment being around in around 8-10 weeks. This meant quality of care, patient satisfaction and experience was improved. Patients were less likely to present at A&E and urgent GP clinics.

Workforce

Primary care staff felt more educated and supported to manage already diagnosed IBD patients and being able to directly call the IBD nurse for advice.

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