Inflammatory bowel disease (IBD) care has evolved markedly in the last decade and recent innovations in both therapeutics and service development should drive further improvements in the coming years. However, the challenges of the global economic downturn combined with more local issues, such as the reform of the National Health Service, will impact upon IBD service provision in the United Kingdom. Marrying the seemingly conflicting goals of ensuring that IBD care is provided by IBD specialists with the drive towards community-based care will require imaginative solutions. Fortunately, improvements in communication and other technologies should help in this regard.
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Competing interests The author has received honoraria from the following companies for lecturing or for advisory services: MSD, Abbott, Shire, Ferring, Warner Chilcott and Falk.
Provenance and peer review Commissioned; internally peer reviewed.