Page last updated at 00:49 GMT, Monday, 23 March 2009

Wide variation in NHS bowel care

Women with stomach pain
Inflammatory bowel disease costs the NHS 720m a year

There is an "unacceptable" variation in care for inflammatory bowel disease in the UK, an audit has found.

Dietetic services and psychological support in NHS hospitals is particularly poor, the Royal College of Physicians said.

But some services have improved in recent years, the report found.

One in 250 people are affected by the two main types of inflammatory bowel disease - ulcerative colitis and Crohn's disease.

Both disorders commonly present in adolescence or early adulthood and cause chronic diarrhoea and abdominal pain.

At least 80% of people with Crohn's disease and 25% with ulcerative colitis require surgery at some time and there are about 30,000 related admissions to hospital per year.

Causes chronic inflammation of the colon
Symptoms include bloody diarrhoea, abdominal pain, frequent need to go to the toilet and weight loss
It can flare up and then go into remission for months or even years

Poor care in some hospitals and a lack of specialist care was first highlighted in 2006.

That first audit of NHS care did prompt some improvements, notably in the provision of more specialist nurses and gastroenterology wards, the latest analysis found.

However, there are still aspects of services that are failing patients.

Toilet facilities are still inadequate and do not meet patients' needs, the audit of 87% of hospitals found.

Dietetic services remain very poor, only one third of Crohn's disease patients being visited by a dietitian during their hospital admission

And only a tenth of hospitals offer psychological support for patients with inflammatory bowel disease.

The report concluded that there is still an "unacceptable variation" in services across the UK.

It urged trusts to review how they had done in the audit and improve standards where needed.


Earlier this year, the National IBD Service Standards were launched to ensure that patients get safe, effective and consistently high quality care.

Dr Ian Arnott, clinical lead of the audit, said the results showed significant improvements in a relatively short period of time

"But there is clearly more work to be done."

Asha Senapati, consultant surgeon and member of the Association of Coloproctology of Great Britain and Ireland said the provision of care by surgeons was high.

Causes inflammation of the gut
Symptoms include pain, ulcers and diarrhoea
Most patients will require surgery at some point

"Laparoscopic (keyhole) surgery is being done more often than in the last round of the audit, although provision needs to increase."

And he added that scans were being done in a more quickly.

Wendy Buckley, assistant director at The Health Foundation, the charity who funded the research, said they were encouraged by the improvements.

"However there are still areas where improvements need to be made to the services and quality of clinical care delivered to patients.

"This audit gives us a better picture of where there are still gaps between current and best practice."

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