Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

Nicholas A Kennedy; Richard Hansen; Lisa Younge; Joel Mawdsley; R Mark Beattie; Shahida Din; Christopher A Lamb; Philip J Smith; Christian Selinger; Jimmy Limdi; Tariq H Iqbal; Alan Lobo; Rachel Cooney; Oliver Brain; Daniel R Gaya; Charles Murray; Richard Pollok; Alexandra Kent; Tim Raine; Neeraj Bhala; James O Lindsay; Peter M Irving; Charlie W Lees; Shaji Sebastian

doi:10.1136/flgastro-2020-101520

Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

Nicholas A Kennedy, Richard Hansen, Lisa Younge, Joel Mawdsley, R Mark Beattie, Shahida Din, Christopher A Lamb, Philip J Smith, Christian Selinger, Jimmy Limdi, Tariq H Iqbal, Alan Lobo, Rachel Cooney, Oliver Brain, Daniel R Gaya, Charles Murray, Richard Pollok, Alexandra Kent, Tim Raine, Neeraj BhalaJames O Lindsay, Peter M Irving, Charlie W Lees, Shaji Sebastian

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Pages (from-to)	343-350
Number of pages	8
Journal	Frontline Gastroenterology
Volume	11
Issue number	5
Early online date	16 Jun 2020
DOIs	https://doi.org/10.1136/flgastro-2020-101520
Publication status	E-pub ahead of print - 16 Jun 2020

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OA_343.fullFinal published version, 1.07 MBLicence: Creative Commons: Attribution Non-Commercial (CC-BY-NC)

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Kennedy, N. A., Hansen, R., Younge, L., Mawdsley, J., Beattie, R. M., Din, S., Lamb, C. A., Smith, P. J., Selinger, C., Limdi, J., Iqbal, T. H., Lobo, A., Cooney, R., Brain, O., Gaya, D. R., Murray, C., Pollok, R., Kent, A., Raine, T., ... Sebastian, S. (2020). Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic. Frontline Gastroenterology, 11(5), 343-350. Advance online publication. https://doi.org/10.1136/flgastro-2020-101520

@article{26f68967df8440fab76693a4a3bba989,

title = "Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic",

abstract = "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.",

author = "Kennedy, {Nicholas A} and Richard Hansen and Lisa Younge and Joel Mawdsley and Beattie, {R Mark} and Shahida Din and Lamb, {Christopher A} and Smith, {Philip J} and Christian Selinger and Jimmy Limdi and Iqbal, {Tariq H} and Alan Lobo and Rachel Cooney and Oliver Brain and Gaya, {Daniel R} and Charles Murray and Richard Pollok and Alexandra Kent and Tim Raine and Neeraj Bhala and Lindsay, {James O} and Irving, {Peter M} and Lees, {Charlie W} and Shaji Sebastian",

note = "{\textcopyright} Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2020",

month = jun,

day = "16",

doi = "10.1136/flgastro-2020-101520",

language = "English",

volume = "11",

pages = "343--350",

journal = "Frontline Gastroenterology",

issn = "2041-4137",

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number = "5",

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Kennedy, NA, Hansen, R, Younge, L, Mawdsley, J, Beattie, RM, Din, S, Lamb, CA, Smith, PJ, Selinger, C, Limdi, J, Iqbal, TH, Lobo, A, Cooney, R, Brain, O, Gaya, DR, Murray, C, Pollok, R, Kent, A, Raine, T, Bhala, N, Lindsay, JO, Irving, PM, Lees, CW & Sebastian, S 2020, 'Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic', Frontline Gastroenterology, vol. 11, no. 5, pp. 343-350. https://doi.org/10.1136/flgastro-2020-101520

TY - JOUR

T1 - Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

AU - Kennedy, Nicholas A

AU - Hansen, Richard

AU - Younge, Lisa

AU - Mawdsley, Joel

AU - Beattie, R Mark

AU - Din, Shahida

AU - Lamb, Christopher A

AU - Smith, Philip J

AU - Selinger, Christian

AU - Limdi, Jimmy

AU - Iqbal, Tariq H

AU - Lobo, Alan

AU - Cooney, Rachel

AU - Brain, Oliver

AU - Gaya, Daniel R

AU - Murray, Charles

AU - Pollok, Richard

AU - Kent, Alexandra

AU - Raine, Tim

AU - Bhala, Neeraj

AU - Lindsay, James O

AU - Irving, Peter M

AU - Lees, Charlie W

AU - Sebastian, Shaji

PY - 2020/6/16

Y1 - 2020/6/16

N2 - 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.

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.

U2 - 10.1136/flgastro-2020-101520

DO - 10.1136/flgastro-2020-101520

M3 - Article

C2 - 32874484

SN - 2041-4137

VL - 11

SP - 343

EP - 350

JO - Frontline Gastroenterology

JF - Frontline Gastroenterology

IS - 5

ER -

Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

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