Specialist inflammatory bowel disease nursing in the UK: current situation and future proofing

Abstract

ObjectiveTo determine the impact to date of the ongoing Crohn’s & Colitis UK inflammatory bowel disease (IBD) clinical nurse specialists (CNS) campaign.MethodsA survey-based design was used. 2 questionnaires were sent to the UK IBD nursing community and promoted via nursing and clinical networks. Respondents were asked to provide data at both an individual and trust level about their nursing services.Results394 IBD CNS posts were identified across the UK, with a 32% increase in posts since the start of the campaign. 27% felt the campaign had been influential in securing new posts. Greater numbers of posts were reported in England when compared with the devolved nations. Most services remain below the UK standards recommendation of 2.5 IBD CNS per 250 000 patient population. Cross site working was reported in 59% of services. 45% of respondents were non-medical prescribers, with 13% educated to MSc level. High levels of stress were reported by IBD CNS associated with managing advice line services.ConclusionsCrohn’s & Colitis UK’s ‘More IBD Nurses–Better Care’ campaign has contributed to the numbers of CNS posts in IBD continuing to rise, but they remain lower than the recommended standard of 2.5 IBD CNS per 250 000. Educational and career pathways are not clearly defined, and aspects of the role such as advice line provision contribute to stress within the workforce. The ongoing aims of the charity campaign hope to address these issues by improving access to formal education pathways with peer support for IBD specialist nurses, and advice line training, in addition to supporting trusts and services throughout the UK to reduce the workforce deficit with effective business cases.

Scoping review with textual narrative synthesis of the literature reporting stress and burn-out in specialist nurses: making the case for inflammatory bowel disease nurse specialists

“…There are numerous possible explanations: younger nurses moving into the specialist role soon after qualification without an arsenal of advanced skills gained in a ward-based role; mid-career nurses moving into lead or consultant nurse roles without the necessary staff management and senior level operational skills; and nurses with many more years in the role having gained skills and competence through the natural novice-expert progression that is typical across nursing 28. The need for better preparedness for the role is indicated in this review and evidenced in the literature 29–31…”

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

“…In UK IBD services, the IBD nurse specialist has an extremely important role, providing patient education, disease management and therapy monitoring, patient support, continuity of care, audit, rapid access for advice and review during disease flares. The role has been shown to improve quality of care and represent value for money 13–16 . As a result, nurse specialist numbers have risen, but only 14% of services had levels recommended in the 2019 IBD UK Standards 4 (2.5 per 250,000 population).…”

“…The role has been shown to improve quality of care and represent value for money. [13][14][15][16] As a result, nurse specialist numbers have risen, but only 14% of services had levels recommended in the 2019 IBD UK Standards 4 (2.5 per 250,000 population). This was however strongly associated with patients' perception of overall care (p = 0.004, OR 1.39 [1.17-1.65] (Table 1)).…”

Inflammatory bowel disease advice lines during the COVID-19 pandemic: a retrospective service evaluation

“…In It was concerning that the majority of services were unable to provide figures based on routinely collected audit data. The responses of 110 participants were reported from memory, which could represent pressures already felt before the pandemic (Younge et al, 2020b).…”