Clinical News

New Study Highlights Urgent Need to Improve GI Bleed Service Coverage

Friday, 03 July 2015 11:33

The British Society of Gastroenterology (BSG) has welcomed the publication of a landmark report into gastrointestinal (GI) bleed services, and repeated its calls for urgent action to improve service provision and protect safety for all patients in the UK.

Half of hospitals that patients are admitted to as an emergency cannot provide all the services they might need for a GI bleed, according to the study by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD). In addition, NCEPOD found that 32% of hospitals in their sample admitting GI bleed patients did not have a 24/7 endoscopy service, and issued a clear call for this to change.

The BSG has been working with its members and relevant agencies for several years to improve the provision of acute upper GI bleed (AUGIB) services, including through:

  • A series of clinical audits on GI Bleeds nationally, including the audit conducted with the National Blood Service reported in 2010
  • Working with NHS Improving Quality (NHS IQ) to audit services across England, documented in the launch of a report in 2014 which included models for service improvement
  • Developing an Upper GI Toolkit with the Academy of Medical Royal Colleges
  • Contributing to the development of NICE guidance
  • Holding workshops with NHS IQ for BSG members on how services could be improved
  • Held a number of events at its annual conferences to highlight the issue

In addition to this, work is ongoing with NHS England to re-audit services to see where improvements have been made over the past two years. The BSG membership is united in its determination to see service change to make sure that patients with a GI bleed have access to the specialist services they need in an appropriate and timely manner.

Commenting, British Society of Gastroenterology President, Dr Ian Forgacs, said:

"This report is another important reminder of the urgent need to ensure that patients everywhere have access to GI bleed services available 24/7 either onsite or through a comprehensive network.

"Working with members to improve these services has been a key priority both for myself and the BSG for many years now, and this report is a reminder that there is still some way to go to deliver the services patients need and deserve.

"With the current political focus on delivering seven day services, particularly in areas where there is a high risk of mortality without appropriate treatment, there is a strong case for improving GI bleed services to be a key part of that agenda and we hope this report will help to build momentum and will for change around this issue.

"Until we see wholesale change to safe, comprehensive and high quality service coverage, the improvement of GI bleed services will remain a top priority for the BSG and its members."

Royal College of Physicians census of consultant physicians and trainees 2013-2014

Monday, 29 June 2015 11:29

Census of consultant physicians and higher specialty trainees in the UK - Gastroenterology and Hepatology 2013–14

The Royal College of Physicians (London) has published the full report of the 2013/14 census of consultant physicians and higher specialty trainees in the UK. The census measures the number of consultant physicians and higher specialty trainees working in the UK, as well as gathering vital information about how physicians are working.

To accompany the full report of the census the Royal College of Physicians (London) are also publishing short reports and commentaries for each of the 29 physician specialties. These offer a more in depth look at the workforce in each individual specialty.

If you have any questions regarding the census please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Guidance for physicians on the detection of child sexual exploitation

Monday, 18 May 2015 14:41

Karen Rogstad, Dawn Wilkinson and Sophie Forsyth

Produced for the RCP on behalf of the Young Adults and Adolescents Steering Group of the RCP, the Joint Specialty Committee for Genitourinary Medicine, and the Adolescent Special Interest Group of the British Association for Sexual Health and HIV.

Background

This guidance is intended to support physicians to recognise potential cases of child sexual exploitation (CSE) and seek support to protect vulnerable children and young people.

An awareness of CSE is essential for physicians. Physicians could be working with current victims of CSE, young people at risk of CSE, or children and adults who have previously been victims of CSE. In law, a child is anyone who has not yet reached their 18th birthday. However, some young people aged 18 or over may have vulnerabilities that put them at risk of CSE, or it may be ongoing into young adulthood.

Recent high-profile cases have drawn attention to CSE. In many cases, reviews have shown that these young people had attended many adult services where CSE could have been, but was not, considered. Reports by the Office of the Children’s Commissioner’s Inquiry into Child Sexual Exploitation by Gangs and Groups have shown that CSE is extensive. Doctors cannot ignore this issue.

 

BSG supported STOPAH study shows a lack of evidence for drug treatments

Wednesday, 29 April 2015 08:22

The survival of patients with alcohol-related hepatitis is not being significantly improved by the main drugs currently widely used in treatment of this condition, according to a major new National Institute for Health Research sponsored study supported by members of the British Society of Gastroenterology.

Senior health professionals are highlighting an 'urgent need' for investment into research for the prevention and treatment of alcohol-related liver disease. Documented in the New England Journal of Medicine¸ a trial of over 1,000 patients using prednisolone and pentoxifylline did not achieve a statistically significant reduction in mortality after 28 days, 90 days, or a year.

The alarming findings come at a time when the incidence of alcohol-related liver disease is rapidly increasing, however the report does also show that the overall mortality has fallen compared to studies done in the past which suggests that specialist in hospital care of these very sick people can improve outcomes, and what could be achieved more widely contrasting with the 2013 NCEPOD report on the care of cirrhosis where care was often found to be lacking.

Commenting, British Society of Gastroenterology Vice President (Hepatology), Dr Stephen Ryder, said:

"STOPAH has answered some key questions in the treatment of alcohol-related hepatitis and highlighted the urgent need for research into the prevention and treatment of alcohol-related liver disease, which is on the rise.

Whilst the study does suggest that patients are receiving better care than reported in previous reviews, unfortunately it also shows that neither steroids or pentoxifylline are effective treatments and there is no real indication now for their use.

The stark finding in STOPAH remains the high late mortality related to resumption of alcohol intake and emphasises the need for universal implementation of the BSG recommendations on alcohol care teams, that seems likely to be a far more effective intervention than any medical therapy for the acute episode.

One of the great successes of this study was to show that UK hepatologists and gastroenterologists from over 50 UK centres can collaborate to deliver important large scale clinical studies aimed at improving outcomes for patients with liver disease."

 

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