UK IBD audit 3rd round

1. UK IBD audit 3rd round Primary care questionnaire Name of presenter

2. Participation in round 3 • Primary care questionnaire report follows the publication of the: • the National Reports of the Organisational Audit (May 2011) • and the subsequent adult and paediatric reports of the results for the National Clinical Audits of adult and paediatric IBD Inpatient Care in the UK (February 2012) • For each locked audited admission entered to the UK IBD audit web tool, a questionnaire was generated that was sent by the hospital to the patient’s general practitioner (GP) • 1675 completed questionnaires were returned by GPs out of a maximum of 6640 related admissions

3. Key findings • Half of GPs indicated that they did not know who to contact and Less than 10% took up the opportunity to contact an available IBD nurse at their local hospital. • Many GPs may not know of the existence of IBD nurses or where they do, they might not be aware of the type of support that the nurse can provide or how to contact with them directly • No action was taken in a third of consultations preceding admission • There is a disparity between perceived and delivered service. 89% of sites feel that they can see a relapsing patient who has been referred to them within 7 days of their referral to hospital. The overall results show that in the 59% of cases (876/1473) GPs indicated that it would not be possible to arrange an outpatient appointment for relapsing IBD patients within 7 days of their referral to hospital

4. Key findings continued • Around a quarter of patients had not had an outpatient appointment in the 12 months prior to their indicated admission to hospital • ?? when requiring help and advice from secondary care or that even when they did know who to contact the lines of communication were slow • Paediatric patients were: - less likely to be seen by a GP prior to admission - If seen, they were much less likely to have treatment started • There is a hunger for further education in relation to the management of IBD from GPs

5. Key results Less than 10% of GPs took up the opportunity to contact an available IBD nurse

6. Key results A quarter of patients had not had an outpatient appointment in the 12 months prior to their indicated admission

7. Key results There is a hunger for further education in relation to the management of IBD from GPs

8. Key recommendations • Secondary care and the RCN Crohn’s and Colitis Specialist Interest Group should promote and raise awareness of the role of IBD specialist nurses and the support that they can offer to primary care in making treatment choices and preventing admission to hospital • Hospitals should always provide GPs with a copy of a patient’s most up to date care management plan • This plan should clearly indicate named individuals who can be contacted for advice in the event of a relapse, including any details of an IBD nurse specialist where one is in post • The Primary Care Society for Gastroenterology (PCSG) should coordinate educational events with primary and secondary care input to promote the latest knowledge in relation to the treatment of IBD • The PCSG should encourage general practice research into the number of patients who have been diagnosed with IBD but who are not currently being seen either in primary or secondary care • GPs require educational support in relation to understanding the colon cancer surveillance requirements of patients with IBD

9. Acknowledgements • Most importantly thank you to all of the primary care staff that contributed towards organising the collection, and inputting of data and also the secondary care staff that distributed the questionnaire. • All members of the UK IBD Audit Steering Group To access the full report please click here For further information contact: ibd.audit@rcplondon.ac.uk