Inflammatory Bowel Disease Standards Research Articles

N44 Implementing Electronic Documentation of a Nurse-Led IBD Advice Line

Abstract Background Beaumont Hospital is a tertiary referral centre providing care to over 4500 patients with inflammatory bowel disease (IBD). This service offers an IBD nurse telephone advice line per international IBD standards. This was established to allow patients on-demand access to our service, improving the overall quality of care. Aims/Background • Time-to-response is recorded for all calls • Calls and emails are audited every month to ensure • Local KPIs are met • Identify potential weakness in service (i.e. access to emergency clinic spots) • Ensure continued improvement and service evolution • Track appropriate use of service by patients Methods Data was collected by establishing an Excel spreadsheet due to a lack of infrastructure to support a database. The spreadsheet will document the date of the call, date of the return call, patient name, hospital identification number, consultant name, reason for calling, and intervention time spent with each patient. Based on the initial audit of findings, the Patient Satisfaction Survey was distributed (n=110) and recorded. Patient feedback to identify areas for education and service development Results Two thousand six hundred and thirty-three (2,633) calls were received from January 2022 to September 2022. Auditing is performed monthly, identifying areas requiring improvement. Patients are frequently re-educated on how to best engage with our service. Pathways have been established to divert the calls to the appropriate alternative services such as administrators, endoscopy department, infusion services, and GP services, freeing our service for the appropriate calls only—30% of calls related to IBD flares. IBD nurses directly managed 82% of patients with flares. Overall, 75% of calls were managed virtually by an IBD nurse. An online patient satisfaction survey showed that 98% of patients expressed excellent satisfaction with the advice line service. Conclusion The precise documentation guided the established lean pathways for prescription renewal and pathways to redirect patients to endoscopy and non-IBD queries. The study results in aids to establishing protocols to limit prescriptions for patients who are non-compliant with blood/visits. It developed written and verbal information for patients on parameters for appropriate service use—education of patients: Modified written and oral patient education. The results of an online patient satisfaction survey showed 98% of patients report satisfaction with “excellent. The precise documentation and measurement of all the calls received facilitates service improvements and locally appropriate patient care. Patient involvement in improvement projects allows improvements to develop with patients at the centre.

Inflammatory bowel disease patient‐reported quality assessment should drive service improvement: a national survey of UK IBD units and patients

SummaryBackgroundHealthcare service provision in inflammatory bowel disease (IBD) is often designed to meet targets set by healthcare providers rather than those of patients. It is unclear whether this meets the needs of patients, as assessed by patients themselves. Aims: To assess patients' experience of IBD and the healthcare they received, aiming to identify factors in IBD healthcare provision associated with perceived high‐quality care.MethodsUsing the 2019 IBD standards as a framework, a national benchmarking tool for quality assessment in IBD was developed by IBD UK, comprising a patient survey and service self‐assessment.Results134 IBD services and 9757 patients responded. Perceived quality of care was lowest in young adults and increased with age, was higher in males and those >2 years since diagnosis. No hospital services met all the national IBD standards for recommended workforce numbers. Key metrics associated with patient‐reported high‐ quality care were: identification as a tertiary centre, patient information availability, shared decision‐ making, rapid response to contact for advice, access to urgent review, joint medical/surgical clinics, and access to research (all p < 0.001). Higher numbers of IBD nurse specialists in a service was strongly associated with patients receiving regular reviews and having confidence in self‐management and reporting high‐ quality care.ConclusionsThis extensive patient and healthcare provider survey emphasises the importance of aspects of care less often measured by clinicians, such as communication, shared decision‐ making and provision of information. It demonstrates that IBD nurse specialists are crucial to meeting the needs of people living with IBD.

N10 The impact of an educational and networking event on nurses caring for Inflammatory Bowel Disease (IBD) paediatric patients receiving biologic therapy

Abstract Background Biologic therapies usage is increasing across the United Kingdom. Gastroenterology departments and all stakeholders need to continuously update their knowledge and practice to the safe use of this therapy (IBD Standards, 2013). Paediatric gastroenterology services in tertiary hospitals often cover a wide geographical region and deliver care in collaboration with district general hospitals closer to the child’s home. A virtual educational and networking event was developed in order to deliver interprofessional education (IPE) and facilitate networking for nurses caring for IBD paediatric patients receiving biologic therapy in two large regions of the United Kingdom (South West of England and South Wales). The aim of this study was to establish the level of self-reported competencies of nurses involved in the administration of biologic therapy in paediatric IBD patients and to evaluate the impact that the event had on the self-reported competency of the participants and their practice. Methods The event compromised a range of relevant topics and it was delivered by experts in the field in a virtual platform and using a range of participant interacting virtual tools. Participants were requested to complete an online questionnaire before and after the event. It was open to registered nurses working in paediatric community and/or day care settings, and caring for paediatric IBD patients receiving biologic therapy. Results There were 21 participants registered to attend the event that completed a pre –event questionnaire. 55% (11) of the participants had more than 5 years’ experience in post. 81% (17) reported no previous formal training on paediatric IBD and biologic therapy. 19.9% did not feel competent in the administration of biologic therapy and monitoring of the patient; and 28.6% did not feel competent to meet the holistic needs of the patient and their family. After the event, a total of 13 completed evaluations were received. All participants (13) reported feeling more competent in caring for paediatric IBD patients receiving biologic therapy and their families; and 84.7% felt more competent in administering and monitoring biologic therapy. All comments relating to the event were very positive and 10 participants could identify changes to make to their own clinical practice directly related from attending this event. Conclusion This study highlighted the need for IPE for nurses caring for paediatric IBD patients, particularly where care is delivered in district general hospitals. Feedback demonstrated that virtual educational events are effective in raising self-reported nursing competencies and in ensuring high standards of practice related to biologic therapy.

P025 A review of the newly implemented Inflammatory Bowel Disease dietetic service

Abstract Background Nutrition plays an important role in the onset and later the management of inflammatory bowel disease (IBD). Patients are becoming progressively interested in non-pharmacological methods of managing IBD and the dietary advice around this. It is reported that only 7% of services have enough dietitians to meet the IBD Standards recommendation. A year after the implementation of a new dietetic post at Whipps Cross Hospital, it was decided to review the effectiveness of this post for patients with a survey. Methods The inclusion criteria were patients with a diagnosis of IBD, reviewed at least twice by the IBD dietitian and patients who are under the IBD team at Whipps Cross Hospital. Patients were telephoned and asked if they consented to providing their email address for the anonymous survey link to be sent to. The survey was emailed to 40 patients. Six questions were asked on the survey, the survey provider was Survey Monkey. Results The final cohort included a 53% response rate to the survey. Age range was 18–64 years old. 95% of patients felt their consultation time was long enough. 95% of patients thought they had sufficient dietetic contact. 95% of patients felt the dietitian involved them in decision making. 67% of patients thought nutrition input improved their health/quality of life, with 29% being unsure. 100% thought having access to an IBD dietitian was useful. 71% of patients rated their dietetic care as excellent and 29% rated it as good. Conclusion The response from the majority of IBD patients was that nutrition input was helpful; with all patients finding the care provided by the dietitian was either good or excellent. All patients found it supportive to have dietetic access as part of a multidisciplinary approach to their IBD care. These findings support the best practice guidelines for having a dietitian post as part of the IBD team.

P129 IBD care in the UK: A comprehensive, novel service assessment with feedback from 10,222 patients and 166 NHS organisations to inform a vision for quality improvement

Abstract Background The IBD Benchmarking Tool, comprising an online Service Self-Assessment and Patient Survey, has provided a unique and comprehensive picture of Inflammatory Bowel Disease (IBD) care across the UK. The aim was to evaluate current local service performance to facilitate future quality improvement. Methods The IBD Patient Survey (PS) ran from July to November 2019 and the Service Self-Assessment (SSA) from October 2019 to January 2020. Detailed views were collected of the quality of IBD care from patient and clinician perspectives, measured against the UK IBD Standards 2019.1 The IBD UK National Report will be published in April 2021. Results 10,222 patients completed the PS. 89% (9,100/10,222) had found it hard to cope with having Crohn’s or Colitis over the previous year. 72% (6,954/9,640) rated the quality of their care as excellent, very good or good and 28% (2,686/9,640) rated the quality of their care as fair or poor. The top three factors that predicted how highly people with IBD rated their quality of care were: feeling supported by a team of specialists; having regular reviews; and discussing wider life goals and priorities, as part of planning their care. 26% (535/2,089) had waited more than a year for their diagnosis. 41% (849/2,087) had visited Accident &amp; Emergency at least once before being diagnosed. 32% (656/2,057) were not offered any information about their condition when diagnosed. 91% (8,284/9,099) did not have a personalised care plan. Over the previous 12 months, 70% (6,732/9,574) had one or more flares and 72% (1,622/2,250) of inpatient admissions were unplanned. A key finding from the SSA (166 centres: 134 adult, 32 paediatric) was that no adult IBD services reported meeting the IBD Standards’ recommendation for whole time equivalent (WTE) staffing across the IBD team. Where services reported meeting the WTE for IBD nurse specialists, patients were more likely to rate the quality of their care highly and to have regular clinical review of their Crohn’s or Colitis. Conclusion The results highlight four key areas for change: improvements in diagnosis and information provision; personalised care and support for self-management; faster access to specialist advice and treatment; and effective multidisciplinary team (MDT) working. The Report sets out recommendations for action in each of these areas. To our knowledge, this is the first time that healthcare professionals and patients have assessed care against a common set of standards. The IBD Benchmarking Tool provides location-matched service performance and patient experience as an exemplar for others to follow. Reference

Quality of care in inflammatory bowel disease: actual health service experiences fall short of the standards.

Quality of care in inflammatory bowel disease (IBD) has received much attention internationally; however, the available surveys focus on health professionals rather than patients. To assess the experiences of healthcare for people living with IBD against established Australian IBD Standards. An online cross-sectional survey was conducted with Australians ≥16 years old recruited via Crohn's & Colitis Australia membership, public and private clinics and the Royal Flying Doctor Service. Participants completed a questionnaire incorporating items addressing the Australian IBD Standards 2016, the Picker Patient Experience Questionnaire, IBD Control Survey and the Manitoba Index. Complete data were provided by 731 respondents (71.5% female, median age 46 years, ranging from 16 to 84 years). While the majority (74.8%) were satisfied with their IBD healthcare, the care reported did not meet the Australian IBD Standards. Overall, 32.4% had access to IBD nurses, 30.9% to a dietician and 12% to a psychologist in their treating team. Participants managed by public IBD clinics were most likely to have access to an IBD nurse (83.7%), helpline (80.7%) and research trials (37%). One third of respondents reported waiting >14 days to see a specialist when their IBD flared. Participants received enough information, mostly from medical specialists (88.8%) and IBD nurses (79.4%). However, 51% wanted to be more involved in their healthcare. These data show discordance between expectations of patients and national standards with current levels of service provision, which fail to deliver equitable and comprehensive IBD care.

N16 Inflammatory bowel disease (IBD) Nurses’ role and level of practice in Ireland: a National online survey

Abstract Background The role of the IBD nurse is evolving in Ireland. While Ireland has a sound base of expertise and infrastructure for providing IBD services, the lack of a dedicated specialist nurse was found to be the most significant barrier to delivering best care (ISG, 2016). There is currently no data on the role and level of practice of IBD nurse nationally. Methods A cross-sectional, descriptive online survey was undertaken. The 72-item survey was adapted from the tool used in the National UK IBD standards survey (Mason et al 2012) and underpinned by the Standards and Requirements for Clinical Nurse Specialists (NMBI, 2008). The survey was distributed to all members (n = 50) of the inflammatory bowel disease Nurses Association of Ireland (IBDNAI) and members were also invited to share the survey with colleagues not on the database. Results A total of 35 nurses working in IBD services across 22 hospitals nationally completed the survey, including IBD Clinical Nurse Specialists (CNS) (24%), IBD Clinical Nurse Managers II (CNM) (18%), IBD Nurses (12%), IBD Research Nurses (12%), Staff Nurses (9%); Infusion Nurses (6%), and IBD Advanced Nurse Practitioners (6%). The majority of respondents worked in adult IBD services (94%), with most working in their IBD role between 3 to 6 years and within gastroenterology up to 10 years. Only 44% of respondents work exclusively in IBD. The highest level of education reported was masters (40%), degree (40%); however, 75% of respondents have not completed a postgraduate diploma in gastroenterology. Services provided by nurses included patient education (94%), telephone advice line (81%), coordinating biologic service (69%), screening patients prior to administrating biologics (66%), email service for patients (59%), development of initiative for the IBD service (56%), coordinating care of inpatients (53%), follow-up (53%) and rapid access clinics (53%). Over half of respondents (61%) reported working unpaid overtime (typically 1–2 hours per week), with service suspended in their absence (45%). 36% of participants conducted original research and 48% conduct audits on their service. Conclusion IBD nurse’s role and level of practice varies greatly in Ireland. Many nurses are working in diverse roles with a wide variety of titles providing an extensive service to patients, often at a higher level than is recognised within their role title. IBD nurses are highly educated and well experienced; however the lack of specialist education has resulted in nearly as many IBD CNM’s as CNS’s which is causing variation in the title of the IBD nurse. There is a need for the development of a postgraduate programme in gastroenterology to include IBD and more IBD nurse specialists to deliver a quality, evidence-based service.

Crohn's &amp; Colitis Australia inflammatory bowel disease audit: measuring the quality of care in Australia

Australia has among the highest prevalence of Crohn disease and ulcerative colitis in the world. Management of the chronic gastrointestinal disorders results in significant societal costs and the standard of care is inconsistent across Australia. To audit the quality of care received by patients admitted for inflammatory bowel disease (IBD) across Australia against national IBD standards. A retrospective cross-sectional survey and clinical audit was undertaken assessing organisational resources, clinical processes and outcome measures. This study was conducted in Australian hospitals that care for inpatients with Crohn disease or ulcerative colitis. The main outcome measures were adherence to national IBD standards and comparison of quality of care between hospitals with and without multidisciplinary IBD services. A total of 71 hospitals completed the organisational survey. Only one hospital had a complete multidisciplinary IBD service and 17 had a partial IBD service (IBD nurse, helpline and clinical lead). A total of 1440 inpatient records was reviewed from 52 hospitals (mean age 37 years; 51% female, 53% Crohn disease), approximately 26% of IBD inpatient episodes over a 12-month period in Australia. These patients were chronically unwell with high rates of anaemia (30%) and frequent readmissions (40% within 2 years). In general, care was inconsistent, and documentation was poor. Hospitals with a partial IBD service performed better in many processes and outcome measures: for example, 22% reduction in admissions through emergency departments and greater adherence to standards for safety monitoring of biological (89% vs 59%) and immunosuppressive drugs (79% vs 55%) in those hospitals than those without. Patients admitted to hospital suffering from IBD are young, chronically unwell and are subject to substantial variations in clinical documentation and quality of care. Only one hospital met accepted standards for multidisciplinary care; hospitals with even a minimal IBD service provided improved care.

Inflammatory bowel disease standards updated for 2019

Lisa Younge, Lead IBD Nurse at the Royal London Hospital, introduces some key features of the new standards from IBD UK

Development of educational resources for patients and health professionals to enhance the inflammatory bowel disease (IBD) service

Diet and nutrition problems are extremely common in patients with IBD – Crohn’s disease and ulcerative colitis (UC). The UK IBD Standards (NICE 2015) recommend that in order to promote patient centred care all patients with IBD should have access to a dietitian and nutritional resources. However, many patients do not need the specialist services of a dietitian, but there is a need to improve awareness of the importance of good nutritional intake and to enable early interventions that can be delivered by other health professionals. Patient self-management should also be supported. Improving knowledge on diet and IBD to ensure nutritional adequacy and preventing nutritional depletion, managing food intolerances, symptom control, are just some aims of nutritional care.

N810 Audit of patient satisfaction with telephone reviews for inflammatory bowel disease

Background: Patients with inflammatory bowel disease (IBD) require long term follow up. However, many patients attending routine clinic appointments are in remission and require only verbal assessment of their condition. It was noted that the nurse led IBD clinics were often overbooked and access to appointments when required was difficult. Telephone reviews for those with Coeliac disease were already being carried out successfully and it was felt that this may also be a suitable alternative to traditional face to face clinic appointments for patients with stable IBD. Methods: Over a three month period 50 patients scheduled to attend the nurse-led IBD clinic were invited to receive a telephone review rather than face to face consultation. Blood request forms were sent to patients along with the appointment letter notifying them of the time and telephone number they would be contacted on. They were asked to have the blood tests done 1–2 weeks prior to their review. Following the 3 month trial period all patients who had been invited to participate in the telephone clinic were sent a questionnaire to evaluate their satisfaction with the telephone reviews. Results: Of the 50 patients invited to have a telephone review, two had requested to be seen in clinic, of the remaining patients the Clinical Nurse Specialist (CNS) had been unable to contact 3 patients. Two had normal blood results and returned answer phone messages to notify the CNS that they were symptomatically well. 32 questionnaires were returned (64%). There was a fairly even spread of patients in terms of duration of the disease with 16 having IBD for <10 years and 17 patients >10 years. Male and female ratio was also even with 16 male and 14 female (2 had not answered). Two patients who returned the questionnaire had not completed all sections as they had requested to be seen in clinic. Of the 30/32 patients who had received a telephone review general satisfaction was high and the majority would be happy to continue with this method of follow-up. 26 (87%) were happy to continue telephone reviews, 1 (3%) was undecided and 3 (10%) preferred to come in to clinic. In an overall rating for the telephone review 1–10 (1 being very poor) 24 (80%) rated it as 8 or above. Conclusions: The telephone reviews were well received by patients and offer an acceptable alternative to the traditional clinic follow up appointments for those with stable IBD. The level of satisfaction with all aspects of the telephone review was high. Offering telephone reviews meets the recommendations of the IBD Standards in terms of providing choice to patients and maintaining patient-centred care.

Achieving and maintaining quality of care in inflammatory bowel disease: The Crohn's and Colitis Australia audit.

Crohn's and Colitis Australia (CCA) provide support programs, education, research funding, and advocacy for the health and well-being of over 75 000 Australians living with inflammatory bowel disease (IBD). IBD is common, costly, ranking among the most expensive diseases and has a severe impact on the lives of mostly young people with associated indirect costs. There is no cure for IBD, and best practice guidelines are often not followed. Crohn's and Colitis Australia have recently commenced a Quality of Care audit with just over 80 hospitals across Australia enrolling. The first step in developing the audit was to define quality of care, but because IBD is not defined as one disease, quality of care in IBD needs to be adaptive, effective, and personalized. The STEEEP acronym defines quality of care as Safe, Timely, Effective, Efficient, Equitable and Patient-centered. While standards of care focus on clinical guidelines, position statements, clinical trials, and meta-analysis leading to evidence-based practice, quality of care involves assessing patient outcomes and measurable improvements to enhance the actual delivery of care. Measuring quality of care requires examination of the degree of consistency in care, understanding variation in the care received by patients, and how evidence-based practice translates into actual clinical pathways. A US survey of quality of care found that there is significant geographic variation in IBD-related biologic and hospital utilization.1 IBD2020 is a global forum for professionals and patients where they can discuss how best to improve the quality of care for patients with IBD.2 The forum involves 55 participants, 18 countries, and 15 representatives from national IBD patient organizations. Their aim is to share aspirations, describe different initiatives, learn from each other, and seek common ground. IBD2020 conducted a survey with 5000 IBD patients from six countries to capture patients' perspectives on quality of care. The survey found that around 20% had experienced continuous flare-ups for 12 months, more than a third had been absent from work for more than 5 days due to IBD, and around 30% had an emergency admission. While patients were often satisfied with the overall quality of IBD care, 25% of patients had waited more than 1 year for diagnosis; less than half of patients received basic information about their diagnosis; less than 25% of patients had discussed the aims of care and for many a lack of access to multidisciplinary teams including dietitians and psychologists. CCA have developed Interim Australian IBD Standards; received funding from federal government, pharmaceutical companies, and CCA members; and these have been endorsed by peak multidisciplinary learned bodies. The CCA quality of care audit aims to examine the provision and organization of IBD care to provide an evidence-based case for increased IBD resources consistent with national needs. The audit is supported by the key stakeholder groups and aligns with government policy objectives. The CCA audit draws on experience from the UK IBD audit in 2014 and uses the Donabedian framework, which uses process, structural, and outcome measures. The organizational audit closed on 15 February 2016; however, the clinical audit started on 22 February 2016 and is currently ongoing. The CCA audit results are expected to be available in the third quarter of 2016. These will enable local and national advocacy to improve the resources, health professionals, and capacity for the delivery of high quality IBD care for all Australians.

PTH-152 The Patient Perspective of a Nurse-Led Inflammatory Bowel Disease (IBD) Telephone Helpline Service

Introduction Barnsley Hospital NHS Foundation Trust (BHFT) has approximately 1300 IBD patients. All patients have access to an IBD helpline (as recommended by IBD standards1) which is answered by an IBD specialist nurse between 12.30–13.30 pm, Monday to Friday. The specialist nurse assesses the symptoms of the patient, answers questions, gives reassurance and advice, and arranges follow-up, hospital admission, or alterations in prescription. The patients’ perspective of the helpline was analysed in this study. Methods To evaluate the patients’ view of the nurse-led IBD telephone helpline at BHFT. Patient views were collected by questionnaire. Questions explored the accessibility of the service, the clinical competency of the specialist nurse, and what the patient thought was useful. 134 patients attended the nurse-led IBD clinic from November 2015 to January 2016. 37 responses (28%) were received and analysed. Results 54% of the responses were anonymous. 24% of respondents did not use the helpline. 100% of those who used the helpline found the service valuable: 86% had positive feedback; 14% had negative feedback; 100% agreed that the specialist nurse had sufficient clinical knowledge and experience to answer all questions. Positive comments included: The knowledge that help and advice was readily available was reassuring and provoked less anxiety. Being able to talk about the disease to someone who understands. Easier access to imaging, endoscopy, outpatient services, inpatient admission, and the gastroenterologists compared to GPs Discussion of treatment options when in dilemma. The negative comments concerned the popular demand of the service, leading to long wait times before calls were answered, and the lack of cover for sickness and leave. Conclusion The IBD helpline is an invaluable service to the patients. It answers any immediate concerns, prioritises unwell patients in the community, and facilitates prompt investigation and clinical review. Additional investment in the service will optimise the accessibility of the helpline to the local IBD population. Reference 1 Service Standards for the healthcare of people who have Inflammatory Bowel Disease (IBD), IBD Standards Group, 2009, Standard 11A. Disclosure of Interest None Declared

P458. Multidisciplinary working when developing the UK inflammatory bowel disease standards and IBD audit

P458. Multidisciplinary working when developing the UK inflammatory bowel disease standards and IBD audit

The financial impact of a nurse-led telemedicine service for inflammatory bowel disease in a large district general hospital

IntroductionIt has become increasingly recognised that outpatient management is more cost-effective in inflammatory bowel disease (IBD). IBD Standards (Revised 2013) recommend telephone advice for patients with regard to symptoms and...

PTU-310 Ibd patient satisfaction survey results

Introduction Long term follow up is required for patients with inflammatory bowel disease (IBD). In line with the IBD Standards,1an important element of providing a quality service to IBD patients is that mechanisms are in place to ‘obtain and respond to patient feedback’ Method A questionnaire was developed asking questions about patients’ opinion on their outpatient care, consultation and access to IBD services, in a ‘tick box’ format. There was also the opportunity to write further comments at the end of the questionnaire. It consisted of 5 sections and was 10 pages long. The questionnaires were handed out to the first 100 patients attending an IBD nurse or doctor appointment at York Hospital over a two week period at the beginning of July 2014. Results Of the 100 questionnaires that were handed out, 93 were returned. Only 14 were fully completed. There was an even split between male and females completing it (51.6% female). Just over half the patients (50.5%) had Crohn’s disease, 44.1% stated they had ulcerative or indeterminate colitis, with the rest stating they were not sure. Broadly speaking, patients were happy with the services that they were receiving. Overall, 84 of the 87 patients (97%) who completed section 3 were either ‘very satisfied’ or ‘satisfied’ with the IBD treatment they had received. Patients unanimously considered that staff to be friendly and courteous with the vast majority feeling that they were listened to. Section 3 also asked about their emotional support and understanding they had received; 24% of patients were neutral or dissatisfied. 78 out of 84 patients (93%) were ‘very satisfied’ or ‘satisfied’ with the information they had received about their illness from the IBD team, but just under a half of patients were unsatisfied with their GP’s level of knowledge about their illness. Conclusion Patients attending IBD clinics in York Hospital are, broadly speaking, satisfied with the care they receive. Work needs to be done to educate local GPs about IBD and more could be done to provide emotional support to patients. Future questionnaires need to be much shorter and focus on these areas. As yet none of the National IBD audits have evaluated patients’ outpatient experience but with some of the recent changes outlined in the NHS England 5, year plan2we need to remain vigilant and ensure our services reflect the changing NHS whilst continuing to meet our patient’s individual needs and safe guarding high quality care. Disclosure of interest None Declared. References Arnott I, Bloom S, Edwards C, Hawkey C. Standards for the healthcare of people who have Inflammatory Bowel Disease (IBD). London: Oyster healthcare Communications, 2013 NHS England. Five year forward view. London: NHS England, 2014

PTU-288 Taking the ibd standards forward in scotland: a national patient survey

Introduction Crohns and Colitis UK, working with Scottish Government, have commited to a project to raise the standards of care for patients with Inflammatory Bowel Disease (IBD) in Scotland. The programme’s objective is to develop a national strategy for IBD service improvement, led by a national steering group supported by the findings from pilots in two diverse Health Boards. As part of the process, a large national survey was commissioned. The aim of the study, therefore, was to present the data generated from 777 partcipants who responded to the survey. Method An on line questionnaire was developed and completed by people living in Scotland who have IBD. The survey was a snap shot of their views and experiences of their NHS health care provision, with a particular focus on their most recent flare up. The survey contained a combination of quantitive and qualitative (reported seperately) questions. The survey was designed to be completed on-line (Survey Monkey) and was distributed through the Crohns and Colitis UK website and membership database. Social digital networks were also used to promote the survey. The survey was conducted between March and May 2013. Results 777 particpants responded to the survey (68% female). The majority of respondents were aged 16–65 (88%). 64% said that they had an IBD nurse. 79% of patients had an annual review. This review was principally by a gastroenterologist (78%). 50% of patients had suffered a disease flare in the previous 6 months. Principal symptoms of the last flare will be presented. 19% of patients self-treated during their last flare, 41% contacted their GP and 33% contacted their IBD nurse. Patients would like to have had a referral to an Occupational therapist, careers adviser and social worker. over 328 patients took time off during their last flare, with 40% taking over a week off. Conclusion This survey provides confirmation that there are many people with IBD living in Scotland whose NHS service provision falls below that outlined in the IBD Standards. Prompt diagnosis, readily available information, quick access to advise and support are issues that are frequently raised. The results of the survey have informed the pilot Health Boards, who have developed workstreams to address areas of deficiencies, Disclosure of interest None Declared.

PWE-108 Factors Influencing The Management Of Inflammatory Bowel Disease In Primary Care

IntroductionBetween 30–70% of United Kingdom (UK) adults with Inflammatory Bowel Disease (IBD) are managed solely by their General Practitioner (GP).1,2 There is, however, limited knowledge as to how UK GPs...

PWE-097 Patient Knowledge Of Inflammatory Bowel Disease Is No Better Than In 1999

IntroductionIn the UK, key professional organisations have collaborated to provide inflammatory bowel disease (IBD) Standards to be delivered by the NHS, highlighting the importance of patient education and support.1 Little...

The revised inflammatory bowel disease (IBD) standards and the IBD nurse role

It has been 4 years since the introduction of the inflammatory bowel disease (IBD) Service Standards ( IBD Standards Group, 2009 ). Promoted widely and supported by quality improvement initiatives, the IBD Standards have contributed to a marked improvement in the delivery of IBD services and care, as measured by the IBD audit. However, there remain many challenges. The 2013 updated IBD Standards aim to provide a comprehensive and up-to-date framework that will enable IBD services across the UK to address challenges and deliver a consistent and high-quality service to IBD patients. This article will outline the need for change and current trends in the NHS, the differences between the original and revised IBD Standards, the role of the new IBD Standards in improving care across the country, the role of the IBD specialist nurse in relation to the IBD Standards and what IBD patients can expect in the future.