Gastroenterology concerns addressed

The latest event, taking place at the Scottish Exhibition and Conference Centre, Glasgow, 23-26 March 2009, will further explore these topical issues, as well as highlighting the latest research and advances in the field.

The British Society of Gastroenterology (BSG) has been lobbying hard to improve the quality and safety of services and has been taking active steps towards increasing its influence on public policy. A key issue highlighted at last year’s Annual Scientific Meeting was the need to improve out-of-hours emergency services for patients presenting with gastrointestinal (GI) emergencies and, in particular, upper-gastrointestinal bleeding. A survey of 188 acute NHS hospitals, previously carried out by the BSG, found that 64% felt their emergency endoscopy service services were unsatisfactory, while 38% thought it was unsafe. Some 51% of hospitals had no formal rota covering emergency endoscopy services; 44% of respondents received no remuneration for their out-of-hours work and more than half did not have this work specified in their contract. The BSG has also collaborated with the Blood Transfusion Service to conduct an audit on GI bleeding, with 80% of hospitals in the UK participating in the study. The results were presented at last year’s BSG annual meeting and highlighted serious implications for the service. The GI bleed audit found that more than half of patients were presenting out-of-hours at a time when many rotas were not in place. Professor Chris Hawkey, presidentelect at BSG, and professor of gastroenterology, University of Nottingham, commented: “GI bleeding is one of the most dangerous and common conditions encountered in patients arriving at hospital. Although mortality has been reduced, it is still at 10%. In the last 10 years, management of GI bleeding has been revolutionised – it is now possible to treat bleeding lesions, though endoscopy, by physical therapy. The problem is that many hospitals do not have properly established out-ofhours services.” Having evaluated the implications for the service and patient safety, the BSG is now encouraging doctors to work in more flexible ways. Where a rota cannot be covered at a single hospital, they are being urged to collaborate with other hospitals in the area to ensure there is cover out-of-hours. “We have looked at the gaps in the service and ways in which the management of these patients could be improved. The BSG has also been conducting meetings with the National Patient Safety Agency to conduct work in this area to set out guidance for managers to operate an effective GI bleeding service that provides safe care around the clock,” added Dr Adam Harris, senior secretary of the BSG. “The British Society of Gastroenterology has made significant progress in making GI bleeding a mainstream issue that the Department of Health is concerned with and wants to address. Over the last year, we have exchanged numerous letters with Lord Darzi and met with the medical director and various ministers to discuss the issue. What is encouraging is the fact that Lord Darzi has acknowledged that there is a need for improved coordination within the service. He felt that existing resources could be better used,” Dr Tom Smith, BSG chief executive, continued. In light of the BSG’s recent focus, “emergencies in gastroenterology” will be a key topic of the “Post-graduate Course”, held at this year’s conference. Delivered by representatives of the UK Digestive Federation, the programme will include discussion on upper-GI bleeding; obscure, severe GI bleeding; and active variceal bleeding. There will also be sessions on oesophageal emergencies, acute pancreatitis and acute colitis. BSG has also launched a project to obtain feedback from patients with the aim of understanding their views and experiences, and ultimately to establish how gastoenterology can become more patient focused and services improved. Surveys are currently being carried out across three hospitals. “As a proactive medical society, this is the type of work that we are striving to become more involved in – to have an influential role in service development and a prominent voice on policy issues,” Dr Harris commented.

Inflammatory bowel disease