Eluned Morgan MS, Minister for Health and Social Services
World Inflammatory Bowel Disease (IBD) Day is a reminder that Crohn’s disease and ulcerative colitis are chronic bowel disorders predominantly affecting young people, which can result in significant loss of time in education, in the workplace, and requiring long-term treatment with drugs and sometimes surgery.
A Wales IBD working group was set up three years ago and a national clinical Lead for IBD services, Dr Barney Hawthorne appointed to work with NHS services across Wales to share best practice and provide support to quality improvement activities.
The working group has now finished its work. World IBD Day is an appropriate moment to record what has been achieved and what activity is underway.
A detailed review of IBD services in Wales was completed in 2020. It found a number of challenges, such as variation in practice between health board services, workforce pressures, and difficulty accessing IBD teams and support services. This was in line with the findings of the UK-wide IBD benchmarking survey in 2019.
A key focus of the work has been to develop a national pathway to encourage consistent access to faecal calprotectin testing in primary care. The test is used to measure gut inflammation and is the most common way people with IBD present to the NHS. It is important that people, wherever they live in Wales, have access to the right test. All health boards are now implementing this pathway.
Digital Health and Care Wales and the Wales Value in Healthcare team have developed an IBD dashboard – a national digital resource which brings together routinely collected patient data to measure activity and quality, based on the 2019 IBD UK Standards. This is still work in progress but has the potential to support local service managers and clinical teams to improve services. It will provide important information about waiting times, emergency admissions, rates of complication and mortality. It will enable health boards to further improve services.
With support from the Wales Value in Health team, there has been a lot of focus on developing educational material to help people manage their condition. This includes educational videos. An online educational seminar for people who have been newly diagnosed with IBD has also been established.
There has also been ongoing and close cooperation with Crohn’s and Colitis UK. The organisation launched an Earlier Diagnosis for Lower Gut Disorders campaign in Wales last autumn. It is targeted at young adults and urges people with diarrhoea, pain or bleeding to get help rapidly. It is supported by an agreed clinical pathway for the investigation of lower gut diseases (IBD, coeliac disease, irritable bowel syndrome, colonic cancer, and many other disorders).
Following the establishment of the NHS Executive in April, a number of new national clinical networks will be set up to support ongoing service improvement. Gastrointestinal services will form one of these, incorporating an IBD implementation group, with a new clinical lead, following Dr Hawthorne’s retirement. I would like to thank Dr Hawthorne for all his work and wish him well for the future.