New report outlines variations in treatment and care for bowel disease
A new report published today (12 January 2016), by theAssociation of Coloproctology of Great Britain and Ireland (ACPGBI) and Bowel Cancer UK, highlights numerous areas of service provision that fall short of having the resources needed to provide optimum service and safety for bowel disease patients.
'Resources for Coloproctology 2015', funded by Bowel Cancer UK and Bowel Disease Research Foundation, maps the level of resources - across a number of services such as radiology, nursing and oncology - needed to ensure patients with bowel disease receive uniformly good care; helping to remove the 'postcode lottery' of service provision that so many patients experience.
The research was necessitated by significant changes in colorectal services in the last 10 years, including the introduction of the 14/31/62 day cancer waiting times standards, provision of laparoscopic (and robotic) surgery, the commissioning of services, increasing levels of emergency surgery, all leading to an increase in resources required.
An extensive questionnaire containing 300 questions was sent to 175 Trusts. The resulting report contains 16 key recommendations for improvements to services and outlines the resources required to provide a service based on a population of 500,000.
The resourcing issues highlighted by the report included:
- Over half (56 per cent) of centres reported inadequate resourcing in radiology services to meet the audit standards of the Bowel Cancer Screening Programme
- Four out of ten (40 per cent) trusts questioned said that more pathologists were required to cope with the colorectal workload. Two thirds indicated that they had unfilled positions in their departments
- It's anticipated that nearly 20,000 procedures will be required each week in the UK to meet an increase in demand for colonoscopy services
The new report outlines key resources required:
Pathology
- Approximately two histopathologists are required per 500,000 of the population to service the colorectal workload
Radiology
- At least two Working Time Equivalent (WTE) consultant Gastrointestinal (GI) Radiologists in terms of time are required, but covered and delivered by at least three consultant GI Radiologists within the overall GI Radiology service
Day case surgery
- For a population of 500,000, 24 colorectal day cases a week may need to be treated, utilising approximately five dedicated sessions
Outpatients
- For a population of 500,000, over 100 new patients each week will need to be seen by the colorectal unit
Deborah Alsina, Chief Executive of Bowel Cancer UK said "This report will not only aid healthcare professionals to plan effective service delivery but also empower patients to question if the care they receive is fit for purpose. It's vital that any shortcomings in resources are addressed as a matter of urgency. We hope this report stimulates debate and thinking within colorectal units to ensure they are adequately resourced to provide an improvement in outcomes for patients."
Bowel cancer is the fourth most common cancer and the second biggest cancer killer in the UK. Over 41,500 people are diagnosed each year and 16,000 people die from the disease. Around 290,000 people living in the UK today have had a diagnosis of bowel cancer at some point in their lives and thousands more live with other bowel conditions such as inflammatory bowel disease.
The pathways for looking after these patients involve a number of different NHS services; the delivery of each can make a significant impact on patient outcomes. For example pathology and radiology are key to patients receiving an accurate diagnosis and the right treatment and care.