TY - JOUR T1 - The impact of an inflammatory bowel disease nurse-led biologics service JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 283 LP - 288 DO - 10.1136/flgastro-2016-100696 VL - 7 IS - 4 AU - Nicola S Taylor AU - Marion Bettey AU - Julia Wright AU - Caron Underhill AU - Sarah Kerr AU - Kim Perry AU - JR Fraser Cummings Y1 - 2016/10/01 UR - http://fg.bmj.com/content/7/4/283.abstract N2 - Introduction Southampton General Hospital provides inflammatory bowel disease (IBD) services for a population of 650 000. Biological agents have impacted hugely on IBD but are costly drugs requiring careful supervision. These challenges led us to develop a specialist nurse-led biologics service to improve patient care.Method A 2010 case note audit highlighted areas for improvement in monitoring biologics and follow-up. A business case was developed to establish an IBD nurse to ensure identification and appropriate screening, education and review of biologics patients. A gain share was agreed with the local Care Commissioning Group (CCG) and £60 000 invested. Outcomes were reaudited in 2014.Results Biologic use has grown rapidly from 90 patients in 2011 to 330 in 2014. All records are now kept in a centralised database. Infection screening improved from 79% to 100%. In 2014, 96% of patients had follow-up ≤4 months post-induction to assess response, but two patients were seen at 7 months. 80% were followed up again at 9–12 months (100% at 9–14 months), all with treatment decisions. The initial investment was recouped via commissioners funding 368 additional outpatient appointments and 35 colonoscopies. Savings represented 15% total yearly biologic costs.Conclusions The introduction of the IBD biologics nurse-led service resulted in significant gains in care quality and costs. The need for improved follow-up of patients on biologics reflects increased pressures on clinic resources across the country. With continued biologics expansion, the introduction of a biologics nurse has provided invaluable support to patients and the IBD team at Southampton General Hospital. ER -