A project that improved the management of a painful bowel condition, and reduced hospital referrals in Somerset has won this year’s 2016 NICE Shared Learning Award. Delegates at the NICE Forum held in Manchester voted for the project for its work in improving outcomes for patients with irritable bowel syndrome (IBS).
IBS can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation. While the condition is common, it can often be difficult to diagnose as symptoms can be similar to ulcerative colitis or Crohn’s disease. NICE recommends that people with IBS should be offered dietary and lifestyle advice to manage their condition. Patients should also be given information so that they can effectively self-manage IBS.
In Somerset, NICE’s recommendations on IBS were not being carried out in several areas. This was leading to unnecessary referrals to hospital outpatient clinics, inconveniencing patients and wasting money. Consequently, Somerset Gastroenterology Flexible Healthcare Team decided to improve the diagnosis and management by better aligning practice with NICE guidance.
The project had five aims:
• To cut down referrals to secondary care for 16 to 45 year-old patients with IBS
• Use NICE guidance to provide training for GPs on how to diagnose IBS
• Implement NICE-recommended faecal calprotectin tests to help GPs diagnose IBS
• Promote effective self-management of IBS symptoms through diet
• Use the resources saved from reduced referrals to fund a community based dietician clinic
It achieved these aims through providing training sessions to GPs on:
• When to use faecal calprotectin
• When to refer to secondary care
• Diet and lifestyle management
After 3 years, the team found that there was a 5% reduction in appointments among 16 to 45 year olds likely to have IBS. Furthermore, the faecal calprotectin test, recommended by NICE was being used by GPs in its area to identify which patients needed referral to hospital. Of the patients who received dietitian-led treatment, 65% said they had symptom relief, and 74% reported improved quality of life. In addition, 70% reported satisfactory control of symptoms 6-18 months after they received treatment.
