Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, What assessment (a) his Department and (b) NHS England has made of the potential resource efficiencies of redesigning NHS Inflammatory Bowel Disease services outside of the hospital setting.

No assessment has been made. The majority of services for people with Crohn’s disease or ulcerative colitis, which are collectively known as inflammatory bowel disease (IBD), are planned and delivered locally by clinical commissioning groups. NHS England commissions services for a small proportion of patients requiring complex surgery either because of their previous surgical history or because of the nature of their disease.

To support local National Health Service deliver services for people with IBD, the National Institute for Health and Care Excellence (NICE) has published best practice in the diagnosis, treatment care and support of patients with Crohn’s diseases and ulcerative colitis in its guidance Crohn’s Disease Management in Adults, Children and Young People, published in October 2012 (updated in May 2016), and Ulcerative Colitis Management in Adults, Children and Young People, published in June 2013.

IBD can cause serious complications and damage requiring surgery. The condition can also impact on the wider health and wellbeing of patients and is also linked to the development other serious conditions. NICE recommends patients are managed by a multidisciplinary team (MDT) with the necessary expertise to enable appropriate monitoring, support and advice necessary to manage the side effects of treatment, flare-ups and to review and maintain remission. MDT support, and the associated diagnostic and investigative resource necessary for IBD patient care will usually be found in secondary care settings. Both sets of NICE guidance can be found at the following links:

www.nice.org.uk/guidance/cg152/resources/crohns-disease-management-pdf-35109627942085

www.nice.org.uk/guidance/cg166/resources/ulcerative-colitis-management-pdf-35109695126725