The audits, which look at the treatment and care of adults, children and adolescents in hospital, show some significant improvements since the previous round of audit, but also highlight some important areas of real concern.
More people are seeing an IBD nurse during their hospital stay and receiving the necessary bone protection to prevent osteoporosis alongside their steroid drug treatments, while children are being monitored more closely than was the case previously and overall mortality rates are continuing to decrease.
However, data from the audit suggests some admissions to hospital could have been prevented if patients’ symptoms had been picked up sooner and treatment had started earlier. There is also a concern over a high number of patients with anaemia who were apparently not treated for their iron deficiency. Despite improvement, the level of IBD nurse provision continues to fall significantly below the recommended standards and 60% of patients were still not seen by a dietitian.
Patients reported a variety of experiences, including overall high levels of trust and confidence in the doctors, nurses and other healthcare professionals treating them. Yet there is still a clear issue with discharge arrangements and the provision of essential information about the condition and its management at this important stage, including potential side effects from drug treatment and danger signs to watch out for. Additionally, some patients reported being turned away from emergency departments only to be admitted to hospital in a worse condition two weeks later, which then resulted in surgery. Other patients commented on healthcare staff not being knowledgeable enough about IBD and specialist medicines in order to be treated effectively.
Adolescents were asked separately about their care and, while 75% rated this as “excellent” when being treated within a paediatric service, only 25% who were being looked after within an adult service gave this rating.
There is no doubting the significant improvements in IBD care which have been seen over the past few years. These are clearly leading to better experiences and outcomes for people with IBD. However, these latest reports also highlight some major concerns which urgently need to be addressed. They also underline the importance of this data so that we can clearly identify where we need to focus efforts to improve care.
Helen Terry,
Director of Policy, Public Affairs and Research at Crohn’s & Colitis UK
These audit reports inpatient care and inpatient experience will be followed in September by audits of overall IBD service provision and biological therapies. Collectively, these represent the fourth round of IBD audit. The first UK IBD audit was undertaken in 2006 and led to the development of the IBD Standards, which were produced collaboratively by patient and professional organisations, led by Crohn’s & Colitis UK, and updated in 2013.
More information
Further information about the IBD audit and IBD standards is available at www.crohnsandcolitis.org.uk/ibdstandards
The full reports, including individual hospital data for specific indicators are available at www.rcplondon.ac.uk/ibd
If you have any queries or comments, please email ppr@crohnsandcolitis.org.uk
