Gastroenterology
Levelling up care for people living with IBD
In this article, Professor Ailsa Hart highlights the need to tackle unwarranted variation in IBD care as part of Takeda’s ‘500,000 Reasons Why’ campaign. Effective multidisciplinary team-working – to ensure streamlined, consistent care – is vital to driving improvement. She argues that there could also be a role for national targets and greater use of remote monitoring technologies to support patients, in the future.
It is estimated that there are over 500,000 people living with Inflammatory Bowel Disease (IBD) in the UK1
and despite the pockets of
best practice that exist across the country, unwarranted variation in IBD care does exist and will continue to grow along with the prevalence of the disease. Variation was a key finding of the first
audit of IBD services in 2006, which led to the development of the 2009 and 2013 IBD Standards.2 Although these standards outlined a number of recommendations designed to rectify these shortcomings, they were not applied uniformly and inequality in care remains a reality for people living with IBD in the UK.3
Not only can
unwarranted variation in care significantly impact the quality of life for individuals, but it can also prove costly for the NHS.
To address this unwarranted variation for those living with IBD, global biopharmaceutical company, Takeda UK, initiated and funded the report ‘Levelling up care for people living with Inflammatory Bowel Disease(IBD): A spotlight on service exemplars’. The report spotlights seven NHS best-practice case studies from across the UK and explores how learning from best practice can help to end the variation in care faced by people living with IBD across the UK. The best practice case studies identified
in the report represent a diverse range of NHS Trusts, from the size of their population to resource allocations and geographical locations, to ensure that the key learnings resonate with Trusts across the UK. They each demonstrate how Trusts can deliver excellence across different parts of the pathway which
align closely to the themes set out in the IBD Standards. If best practice can be embedded into services across the NHS and beyond, those living with IBD can receive the care they deserve. A recurring theme throughout the case studies is the importance of listening to patients – allowing services to better understand where and why they need improvements through surveys, patient panels, and audits, and illustrating the ways in which communication can drive improvements and reduce the burden on consultants. This is followed by the importance of access to a multidisciplinary team, enabling services to provide a more holistic approach to care, driving better patient experience and supporting them not only physically, but emotionally through their IBD journey.
Underpinning all case studies was the focus
on treating patients by prioritising long-term outcomes and improving their quality of life. This is highlighted through examples of timely access to treatment, enabling early diagnosis or the tailoring of services to ensure patients can be seen by the right person at the right time. While services should be tailored for their population needs, it is critical that the principles identified in the report are implemented to ensure quality care is available to all those living with IBD across the UK – regardless of where they live. One of the challenges that remains in IBD care is irregular adoption of standards, and while good practice should be celebrated, there must be focus on extending the opportunity of receiving best practice in care to all patients across the country.
Case study: St Mark’s Hospital in London The London North West Hospitals NHS Trust benefits from a specialist and world-renowned IBD service, predominately based at St Mark’s Hospital, but also covering Northwick Park,
January 2024 I
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