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."
Hepatitis C Good Practice Roadshow
Monday, 18 May 2015 10:44
Hepatitis C is a major cause of the UK’s rise in mortality from liver disease, and represents a serious health inequality issue that predominantly affects disadvantaged and marginalised groups. Raising awareness, diagnosing and treating more people with hepatitis C, especially in areas of high prevalence such as London - will be key to addressing health inequalities across the country and reducing costs to the NHS resulting from HCV-related liver disease. CCGs have a crucial role to play in ensuring this happens. With the aim of encouraging local service improvements and seizing the opportunity for progress provided by a new generation of highly effective hepatitis C drugs, this roadshow is focused on:
- Showcasing and sharing good practice in the prevention, testing, diagnosis and treatment of hepatitis C
- Identifying specific problems and potential solutions for tackling hepatitis C in the London area, as one of the highest prevalence areas in England
The roadshow will include talks on the commissioning of services, workforce development, awareness and testing, and opportunities for the elimination of hepatitis C as a major public health concern provided by new treatments. Afternoon workshops will be held on specific issues affecting hepatitis C services in London, including on at-risk immigrant communities; awareness and testing in drug services and testing and treatment pathways in prisons.
Registration and coffee will be from 09.00 to 09.55 and the event will run from 10.00 to 15.15. The event will be held at Coin Street Neighbourhood Centre, 108 Stamford Street, London SE1 9NH. The venue is a short walk from Waterloo station. For further details about the venue and to book your place, please visit the event website.
'Together for Health': Welsh Government Liver Disease Delivery Plan
Thursday, 07 May 2015 08:52
The Welsh Government has published its liver disease delivery plan - Together for Health.
It is split into six themes:
- Preventing liver disease and promoting liver health
- Timely detection of liver disease
- Fast and effective care
- Living with liver disease
- Improving information
- Targeting research
For each theme, the following is set out:
- Key service issues
- Specific priorities
- Population outcome indicators and NHS assurance measures
HCV in Cirrhosis - An Update on Treatment Access
Friday, 01 May 2015 11:53
Peter Moss (Chair HCV CRG) & Graham Foster (Vice Chairman HCV CRG)
We are writing to update you on access to treatment for patients with chronic HCV infection. As you know the first review of the Early Access Program was presented at EASL last week. These data show that therapy for patients with decompensated cirrhosis has been very successful and this program will continue.
NHS England has confirmed that access to treatment should be extended, and the CRG have completed a proposal for a new scheme to offer the best available oral antiviral therapy to all patients with cirrhosis. There is a formal sign off step to be completed but we anticipate that the scheme will be up and running by late May. However given the inevitable slippage in delivery times it may be prudent to advise patients that treatment may not commence until early June 2015. The precise details of how treatment will be delivered are still under discussion but we envisage a network approach, and details of centre selection will be circulated as soon as possible, probably within the next 10 days.
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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