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PWE-083 The Development of a Stratified Model of Follow up Care for Adult Patients with Inflammatory Bowel Disease
  1. K Kemp1,
  2. J Griffiths2,
  3. S Campbell3,
  4. K Lovell2
  1. 1School of Nursing/Gastroenterology, University of Manchester/Manchester Royal Infirm, Manchester
  2. 2School of Nursing, University of Manchester, Manchester
  3. 3Gastroenterology, Manchester Royal Infirmary, Manchester, UK

Abstract

Introduction There is concern in the UK that services for pts with long term conditions are not orgnised to promote independence with silo working in primary and secondary care with reactive services. These may be brought together formally through the development of model of care. Utilization of current out-pt spaces to regularly review stable pts is inappropriate and is challenged by commissioners. The question remains as to what models of follow up (FU) are we able to offer pts which are acceptable and feasible. The aim of this study was to develop an integrated, acceptable, modern model of FU care for pts with IBD.

Methods Using the MRC Framework for complex interventions,24 IBDs (18 pts had CD, 6 UC, age range 27–72 years, disease duration range 2 – 40yr), 20 purposively selected GPs from NW England, and 3 IBD Nurses (specialist, advanced practitioner, consultant nurse) were interviewed. Participants were asked about the role of FU in IBD, experience of FU patterns, service delivery, other models of FU. Thematic analysis was undertaken using NVivo 9.0. Analysis of 3 groups of interviews were synthesised by a Cons Gastroenterologist, patient, GP, IBD Nurse, to develop the model of FU care.

Results There were similarities between 3 groups of interviews. Pts did not want to be seen when well, GPs wanted more involvement in care and there is scope for an IBD outreach nurse at interface of primary/secondary care. Discharging quiescent pts into enhanced GP care, to ensure equitable treatment, was acceptable to all, as was the concept of ‘virtual’ clinics. Patients would initiate self referral within the virtual arm whilst pts under GP care would be referred by GP. Pts would be referred as a rapid FU < 7days and not as a new pt tariff. Complex IBD patients would remain under secondary care. Patients will move across the 3 arms depending on disease.

Conclusion This study provides an acceptable integrated model of FU for pts with IBD. It takes into account UK policy to reduce inappropriate FU, with emphasis on self management and integrating care, placing the pt closer to home, with secondary care emphasis on complex pt management.

Disclosure of Interest None Declared.

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