Brian Turley Award Winning, Patient-Centred Inflammatory Bowel Disease (IBD) Care Model Team based at St Mark’s Hospital, LNWUH NHS Trust lead on a NIHR CLAHRC NWL funded Research Driven Improvement Project to design a model of care for monitoring Inflammatory Bowel Disease (IBD) through the development of a clinical database.
IBD is a lifelong condition that typically presents in the teens or twenties. Mortality is low but complications can arise from the condition or the drugs used to treat it, so monitoring is needed by means of outpatient appointments four times a year.
The demand on these clinics is growing steadily, says Naila Arebi, consultant gastroenterologist at St Mark’s Hospital in north west London. An audit in Brent and Harrow in 2016 showed 78 new cases diagnosed that year, which if sustained over 10 years would generate 3120 outpatient visits a year, to add to the 7000 a year already taking place. Clinic waiting times were already poor.
“Our plan was to relieve pressure by arranging telephone clinics for patients with stable disease,” Arebi says. Widespread consultations were held with patients, clinicians, and quality improvement scientists before launching. Patients in remission with low risk of complications were offered telephone monitoring, and rapid assessment clinics were created to improve emergency access and decrease emergency department attendance.
“We anticipated that 60% of patients would take up the option,” Arebi says. “Uptake was lower than we expected but improved after patients had direct discussions with clinicians about it. Now the uptake is around 30-40%. Patients who use it, like it. They don’t have to travel to the hospital, pay for car parking, and wait two hours to be seen.”
The capacity of the telephone system is now saturated, so more nurses are needed if it is to expand or, as originally planned, be complemented by an IBD speciality nurse in the community. Recruiting the right person has proved difficult.
(N. Hawkes: 2018)
The Patient-Centred Inflammatory Bowel Disease (IBD) Care Model Team were shortlisted for the BMJ Patient Partnership Award 2018 and are highly commended by BMJ for Patient Partnership. The IBD Care Model Team also won the inaugural London-wide Brian Turley Patient and Carer Involvement Awards.
Editors Note: Content of this post is taken from the BMJ Award article (BMJ 2018;361:k1705) written by Nigel Hawkes, freelance journalist for the The BMJ Awards 2018: Patient Partnership Team of the Year feature. The full article can be read here.