UK IBD audit results and future plans

Published: 31 October 2012

The third round of the UK inflammatory bowel disease (IBD) audit has drawn to a close and, like the first two rounds, it has been a great success. The results are outlined below.

You may be involved in the fourth round of the audit which began in September 2012.

The audit began in 2006 and initially it addressed service provision and inpatient care for adult patients with IBD.

In round two (2008) the scope of the audit was extended to include paediatric patients with IBD.

In the third round of audit, three additional elements were assessed: IBD inpatient experience, a primary care questionnaire and an audit of the provision of biological therapies to IBD patients.

Overall, round three of the audit has shown that care for patients with IBD is improving, but many services are still not reaching the National IBD Service Standards, launched in February 2009 (visit the IBD Standards website).

The headline findings of each report are listed below and the national reports for each can be accessed via the Royal College of Physicians’ website

Round three IBS audit results

Adult organisational audit report

• Seventy-two per cent of sites reported some access to specialist IBD nurses, although most still have less than the levels of provision recommended in the IBD Standards.
• Particular improvement in access to specialist advice (94 per cent have a telephone helpline, 99 per cent provide written information to patients).

Paediatric organisational audit report

• A significant increase in the median number of full-time equivalent paediatric gastroenterology or IBD nurse specialists at each site.
• Eighty-three per cent of sites now have at least some paediatric gastroenterology or IBD specialist nurse provision, compared to just 61 per cent in 2008.

Adult clinical audit report

• Inpatient mortality in those with ulcerative colitis has halved over the three rounds of the audit.
• The percentage of patients being seen by an IBD nurse specialist during their admission has doubled since the first round.

Paediatric clinical audit report

• There has been a significant increase in the number of paediatric IBD patients being seen by an IBD nurse specialist during their admission.
• Only 20 per cent of ulcerative colitis patients had formal assessment of their disease activity made on their admission to hospital.

Inpatient experience questionnaire report

• More than 90 per cent of patients regarded their care as good, very good or excellent.
• Effective team working related strongly to overall patient experience.
• Pain relief and nutrition were highlighted as particular areas for improvement.

Primary care questionnaire report

• GPs want more information about local services for their patients (including contact information about IBD nurse specialists).
• Only 41 per cent of GPs report being able to refer relapsing patients for review by hospital services within seven days.

Download full reports or executive summaries via the Royal College of Physicians website.

Update from the ongoing biologics audit

Thank you to all who enter data into the biologics audit tool.

Using feedback from users we are continuing to develop the system and add functionality that will hopefully make it more and more useful to you.

Recent developments include the ability to:

• export the raw data you have entered for all locked submissions into an excel spreadsheet. This will allow you to analyse and report on particular locally relevant areas of your biologics service at any time
• produce a patient summary report, which details all of the treatment you have provided for a patient to date, including any adverse events. It provides the date by which the NICE annual review is required and the report itself. These reports can be used to replace manual entries in the case notes or be sent to a patient’s GP to demonstrate treatment received.

Please do provide us with your feedback in relation to this aspect of the audit by participating in the online biologics feedback survey; your views will be used to improve the system wherever we can.

Round four  UK IBD audit plans (2012 – 2014)

It is intended that the methodology of the audit will be improved in round four to provide more reliable and accurate findings for participating sites. This will be achieved in part by a reduction to the data set allowing for an increased number of cases to be collected.

Cases will also be collected prospectively, a significant change for this round. Data collection is likely to begin in early 2013 with ulcerative colitis cases collected and reported on during 2013 and more cases collected and reported on in 2014.

The biologics audit will continue to run throughout the two-year extension with annual full national and site level reports produced.

Collection of inpatient experience questionnaire data will allow for a first re-audit of this element. Again the audit will assess both adult and paediatric care and the full methodology was launched at the DDF meeting in June 2012.

Correspondence explaining the new methodology in more detail will be circulated shortly to all sites that participated in round three.

If your site did not participate but you are keen to hear more please contact us using the details below.

Contact information:

Dr Ian Arnott:  Clinical Director
Aimee Protheroe:  Project Coordinator
Karen Kemp:  IBD Nurse representation on group (Karen.kemp@manchester.ac.uk)
Telephone:   020 3075 1565 / 1566
Email:   ibd.audit@rcplondon.ac.uk