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P242 Newly diagnosed Inflammatory Bowel Disease patients referred via the Straight To Test Lower GI two week wait pathway, Single Centre Study.

Samarasinghe, M.(1);Chariah, F.(1);Desilva, C.(1);Koutsoumpas, A.(2);

(1)Barnet and Chase Farm Hospitals, Gastroenterology, London, United Kingdom;(2)Barnet and Chase Farm Hospitals, Department of Gastroenterology, London, United Kingdom

Background

Fast track or 2‐week wait Lower GI pathways (2ww LGI), including  Straight To Test or Straight To Colonoscopy 2ww LGI (2ww LGI STT) for patients with suspected Colorectal Cancer (CRC), have been extensively implemented in the UK. Approximately 3.9% of patients referred via the 2ww LGI will get a new diagnosis of IBD; once CRC has been excluded however, there is no standardised pathway for the management of those newly IBD pts. We implemented in 2019 in our Trust a new service structure for rapid access of those new IBD patients to IBD clinics, with emphasis to Nurse Led IBD clinics. In this study we aimed to look at real world data for the management of those new IBD pts in a large district hospital.

Methods

Retrospective analysis of prospectively collected data for all newly (endoscopically) diagnosed IBD patients referred from the 2ww LGI STT service, between January 2019 and March 2020, at Chase Farm and Barnet Hospitals (BCF).

Results

There has been a steady increase over time in the number of new IBD pts identified via the 2ww LGI STT and referred to BCF IBD service. A total of 168 patients were referred to BCF IBD service via this pathway over the above 14 months. Within the first 2-4 weeks after colonoscopy, 86% patients were seen in the IBD Nurse led clinic. The remaining patients were seen within 6-8 weeks either in IBD Nurse or Consultants clinics.

Approximately 11% of patients were not started on any medication at the time of colonoscopy. The remaining patients were commenced on either Steroid or 5ASAs post colonoscopy, in accordance with our local pathway. Biologic treatments or immunosuppressants were required for 18% of those patients during the above timeframe.

Conclusion

2ww LGI STT identifies a significant number of newly diagnosed IBD patients in our Trust. 2WW LGI endoscopists of different levels and backgrounds (medical, surgical, nurses, fellows, insourced) should be aware of the first line IBD therapies and relevant IBD pathways, and prescribe those in Endoscopy Unit. Advanced Nurse IBD clinics are an integral part of the IBD service, especially for newly diagnosed IBD patients via the 2ww LGI STT.

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