Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps the Government is taking to increase (a) access to and (b) use of faecal calprotectin in primary care in cases where inflammatory bowel disease is suspected.

NHS England and clinical commissioning groups (CCGs) are responsible for commissioning services for people with inflammatory bowel disease (IBD).

To support local commissioning, the National Institute for Health and Care Excellence (NICE) has published best practice guidance for the timely and accurate diagnosis, treatment care and support for patients with IBD.

NICE has published the guidance ’Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel’ which recommends that that faecal calprotectin testing as an option to help support clinicians distinguish between IBD and irritable bowel syndrome.

Faecal calprotectin testing will therefore help decide who should be referred for colonoscopy (the Gold Standard diagnostic test) and who may be amenable to management in primary care. Primary and secondary care clinicians are expected to follow the good practice guidelines and the quality standard.

NHS England commissions specialised Intestinal Failure Services. A number of these centres are currently involved in multidisciplinary training of health professionals in specialised IBD care. In addition, the Association of Coloproctology of Great Britain and Ireland are currently in the process of setting out national standards for surgical management of IBD. 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.

General practitioners and clinicians are expected to take account of relevant NICE guidance to ensure that patients with suspected inflammatory bowel disease are referred quickly and efficiently, and have a specialist assessment within four weeks of referral.

The NICE guidelines are available 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