Clinical News

NICE Evidence Update: Acute Upper Gastrointestinal Bleeding

August 2014

A summary of selected new evidence relevant to NICE clinical guideline 141 'Acute upper gastrointestinal bleeding: management' (2012)

This Evidence Update provides a summary of selected new evidence published since the literature search was last conducted for the following NICE guidance: Acute upper gastrointestinal bleeding. NICE clinical guideline 141 (2012) A search was conducted for new evidence from 23 September 2011 to 20 February 2014. A total of 6061 pieces of evidence were initially identified. After removal of duplicates, a series of automated and manual sifts were conducted to produce a list of the most relevant references.

SAGE Awards 2014

Wednesday, 20 August 2014 13:01

This year the SAGE Award (Shire Award for Gastrointestinal Excellence) first place has been presented to a team of clinicians from the Luton & Dunstable University Hospital for their project, Inflammatory Bowel Disease – Supported Self Help and Management Programme (IBD-SSHAMP) during the British Society of Gastroenterology Annual meeting held this year in Manchester. The project has shown considerable innovation and excellence in gastrointestinal care and will receive a grant of £10,000 for furthering and enhancing the development of the project.

IBD-SSHAMP is the UK's first patient friendly, internet based, remote management service for IBD patients. It aims to provide every one of its IBD patients with their own disease specific personalised website. The websites provide patients with a direct access between themselves and hospital specialists. Patients can access the service from anywhere in the world provided they have internet access.

Vacancies on NICE Quality Standards Advisory Committees (QSAC)

Tuesday, 08 July 2014 10:07

NICE is currently recruiting for additional members to join their Quality Standards Advisory Committees (QSAC) to support delivery of the library of quality standards topics.

NICE's quality standards are central to supporting the Government's vision for a health and social care system focussed on delivering the best possible outcomes for people who use services. Derived from NICE guidance and other accredited sources, they are a concise set of prioritised statements designed to drive measurable quality improvements within a particular area of health or care. The standards are also used to develop indicators for potential inclusion within the Clinical Commissioning Groups Outcome Indicator Set (CCGOIS) and Quality and Outcomes Framework (QOF) for general practice.

ERCP – The Way Forward, A Standards Framework

Mark Wilkinson, (BSG Endoscopy, working party convenor and chairman) et al.

June 2014

Executive Summary:

To improve the quality and availability of ERCP in the UK, a working party was set up incorporating a number of stakeholders (Appendix 3) to make recommendations to achieve this goal. The attached framework document is the output of that process. It is recognised that not all changes can be achieved immediately, but that these are the standards to be aimed for. Though regulatory frameworks differ among the 4 nations of the UK (and delegates from Scotland, Wales and Ireland were represented on the working party) it is intended that this framework will be applicable to the whole of the UK.

In brief its recommendations are:

  1. ERCP should only be carried out in facilities dedicated to high standards of performance and safety, as measured by key performance indicators.
  2. That there should be a minimum of 75 cases per annum for ERCP endoscopists, and 150 cases minimum per facility, although we should be aiming for a minimum of 100 cases and 200 cases respectively.
  3. That ERCP services should work collaboratively in a regional or hub-and-spoke model, with simple and rapid referral pathways established.
  4. That facilities for urgent or emergency ERCP should be widely available.
  5. That minimum standards for independent practitioners should be based on intention to treat and include a >=85% cannulation rate of virgin papillae, CBD stone clearance for >=75% of those undergoing 1st ever ERCP, and for patients with an extra-hepatic stricture, successful stenting with cytology or histology where appropriate at 1st ERCP in >=80%.
  6. That performance criteria should be monitored by a detailed audit and feedback process via a strengthened JAG/GRS process, and be incorporated into consultant appraisal.
  7. That the organisation and standards for training for ERCP should follow from the above performance criteria.
  8. That newly appointed consultants are mentored to ensure a safe and effective transition from trainee to independent practitioner.
  9. That high quality performance in ERCP service and training should support high quality research.
  10. There should be a national registry of ERCP cases to monitor practice and outcomes which will aid a cycle of continuous improvement and provide research data to plan better care in the future.

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