RT Journal Article
SR Electronic
T1 Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP 343
OP 350
DO 10.1136/flgastro-2020-101520
VO 11
IS 5
A1 Nicholas A Kennedy
A1 Richard Hansen
A1 Lisa Younge
A1 Joel Mawdsley
A1 R Mark Beattie
A1 Shahida Din
A1 Christopher A Lamb
A1 Philip J Smith
A1 Christian Selinger
A1 Jimmy Limdi
A1 Tariq H Iqbal
A1 Alan Lobo
A1 Rachel Cooney
A1 Oliver Brain
A1 Daniel R Gaya
A1 Charles Murray
A1 Richard Pollok
A1 Alexandra Kent
A1 Tim Raine
A1 Neeraj Bhala
A1 James O Lindsay
A1 Peter M Irving
A1 Charlie W Lees
A1 Shaji Sebastian
YR 2020
UL http://fg.bmj.com/content/11/5/343.abstract
AB Objective To determine the challenges in diagnosis, monitoring, support provision in the management of inflammatory bowel disease (IBD) patients and explore the adaptations of IBD services.Methods Internet-based survey by invitation of IBD services across the UK from 8 to 14 April 2020.Results Respondents from 125 IBD services completed the survey. The number of whole-time equivalent gastroenterologists and IBD nurses providing elective outpatient care decreased significantly between baseline (median 4, IQR 4–7.5 and median 3, IQR 2–4) to the point of survey (median 2, IQR 1–4.8 and median 2, IQR 1–3) in the 6-week period following the onset of the COVID-19 pandemic (p<0.001 for both comparisons). Almost all (94%; 112/119) services reported an increase in IBD helpline activity. Face-to-face clinics were substituted for telephone consultation by 86% and video consultation by 11% of services. A variation in the provision of laboratory faecal calprotectin testing was noted with 27% of services reporting no access to faecal calprotectin, and a further 32% reduced access. There was also significant curtailment of IBD-specific endoscopy and elective surgery.Conclusions IBD services in the UK have implemented several adaptive strategies in order to continue to provide safe and high-quality care for patients. National Health Service organisations will need to consider the impact of these changes in current service delivery models and staffing levels when planning exit strategies for post-pandemic IBD care. Careful planning to manage the increased workload and to maintain IBD services is essential to ensure patient safety.