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IBD relapse referrals ‘should be seen within a week’



GPs should be able to refer all patients with a relapse of their Crohn’s disease or ulcerative colitis to be seen within seven days, say new standards.

The standards – aimed at CCGs and NHS managers – also say that GPs and hospital staff must agree clearly-defined rules for shared care of patients with inflammatory bowel disease (IBD), specifying the circumstances in which the patient is referred back into hospital care, the standards say.

The standards are based on a national audit of IBD services which took place in 2006 and have been agreed by experts from the British Society of Gastroenterology the Primary Care Society for Gastroenterology, the Royal Pharmaceutical Society and the Royal College of Physicians among other groups.

The audit revealed that many GPs – 59% – reported being unable to get their patients seen in secondary care within seven days in the event of a relapse.

It also showed that only one third of IBD services have a protocol in place with GPs for the shared outpatient management of patients.

The standards say: ‘The arrangements and scope for shared care, and the circumstances in which the patient should be referred back to hospital care, must be clearly defined between the hospital staff and the GP.

‘They must be explained verbally to the patient, and written information on this provided, using clear, straightforward and appropriate language.

‘A system for sharing of information about test results or treatment changes should be in place through the use of IT, written communication between the GP and hospital or a patient-held record.’

The ongoing safety monitoring of immodulator and biological therapies can be part of the shared-care arrangement agreed with patients and their GPs although these treatments should be initiated and managed by IBD specialists, the standards say.

They also suggest that local IBD services should have an established link with a named GP to provide a liaison and educational role with local GPs.

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