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

Abstract

ObjectiveTo determine the challenges in diagnosis, monitoring, support provision in the management of inflammatory bowel disease (IBD) patients and explore the adaptations of IBD services.MethodsInternet-based survey by invitation of IBD services across the UK from 8 to 14 April 2020.ResultsRespondents 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.ConclusionsIBD 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.

React, reset and restore: Adaptation of a large inflammatory bowel disease service during COVID-19 pandemic

“…As reported in other IBD centres 7 and noted in the recent UK survey, 11 there was an exponential increase in the volume of contact with IBD advice lines at the beginning of the pandemic. Consistent messaging through different modes of communication that we implemented have resulted in this returning to regular activity figures.…”

“…The numbers of IBD specialist staff, in particular IBD specialist nurses, vary widely in hospitals around the UK. 11 The integrated model of our service, which may not be available in some centres, allowed us to pool resources and reassign new roles to staff already familiar with the clinical practice environment. Several healthcare professionals have been redeployed to frontline COVID-19 duties which may negatively impact on provision of specialist services.…”

The effects of COVID‐19 on IBD prescribing and service provision in a UK tertiary centre

“…1 This study builds upon our existing understanding of the impact that COVID-19 has had on IBD services in the UK. That knowledge, largely based upon a survey of IBD clinician opinions towards the beginning of the pandemic, 25 has been corroborated and added to here, through the collection of data relevant to IBD clinical management and service provision. These aspects should be considered strengths of this study and may be considered helpful in planning service recovery.…”

COVID-19-related health anxieties and impact of specific interventions in patients with inflammatory bowel disease in the UK

“…1 Sweeping changes to elective and emergency hospital services were rapidly enforced resulting in patients facing unprecedented changes to their care. 2 3 Inflammatory bowel disease (IBD) affects over 600 000 people in the UK 4 . With many patients with IBD requiring immunosuppressive therapies, it is likely that the COVID-19 pandemic resulted in significant anxieties.…”