Gastroenterologists call for reform

The latest clinical research, innovation and strategic thinking were highlighted at this year’s British Society of Gastroenterologists’ (BSG) conference, held in Liverpool. Clinicians, politicians and patients gathered at the annual meeting to discuss a wide range of issues – from the need for radical reform to reduce the burden of alcohol-related harm on the NHS; the future role of robot-assisted, incisionless surgery in gastroenterology; to the potential for improved models of service delivery aimed at ensuring quality care. Reflecting on recent progress achieved, under the guiding influence of the BSG, outgoing president, Professor Chris Hawkey cited a number of steps forward – including: the adoption of the National Liver Plan, launch of a national strategy for prevention and treatment of alcoholrelated illnesses, a relatively liberal ruling on anti-TNF agents in IBD, Government endorsement of IBD standards and establishment of a working party addressing needs for out of hours services for GI bleeding. However, Prof. Hawkey commented that the specialty of gastroenterology needs to “achieve more by doing less better”, pointing out that too much time is wasted on futile activity. “In order to deliver minimally intrusive, patient-focused care, one of the key goals must be to improve communication between primary and secondary care, through effective IT,” he commented, adding that there is a need to develop more coherent strategic planning to tackle key issues in gastroenterology and hepatology. In particular, the BSG is taking a strategic approach to addressing the burden of alcohol-related disease.

Alcohol strategy

Professor Jon Rhodes, the incoming president of the BSG, highlighted this as a priority issue for the society: “There has been a reluctance to get involved with patients with alcoholism and to shunt the problem elsewhere, but we need strong leadership and to take ownership. The strategy requires a multidisciplinary approach; the involvement of psychiatric services to deal with mental health issues; as well research into possible drug interventions aimed at improving abstinence,” he asserted. An important step, in his view, is the development of a new alcohol strategy report – launched at this year’s BSG conference. With as many as 40,000 deaths annually attributed to alcohol misuse, at a cost to the NHS of £2.7 bn, the BSG is calling for major reforms. The report, published by the BSG, the Alcohol Health Alliance UK and the British Association for Study of the Liver, sets out an evidence-based case for establishing a joint hospital and community outreach service, which together with a seven-day alcohol specialist nurse service, could result in a 5% reduction in alcohol related hospital admissions, with the potential for each district general hospital to save £1.6 m annually. Evidencing the need for action, the BSG pointed out that: