GI Services

From Secondary to Primary Care

National & Local Strategy 3 years (10 years!!!) Money (& People) into Primary Care Benefits & Risks What conditions?

Benefits & Risks Better for Pts –

easier access Cheaper Frees up acute

Trust time for seriously ill pts

Expensive Loss of income

with PBR/PBC means Hospitals destabilised

Reduced training for Drs (& nurses)

Time-consuming

What Conditions ? Coeliac Disease (1% population) Stable IBD (L. sided) IBD immunotherapy Stable Liver Disease (PBC, NAFLD) ……..Alcohol – Related Liver Disease

How? GI Specialist Nurse Pt self-management protocols More regular contact between GPs &

Consultants Audit, Clinical Governance meetings

First Steps GI Specialist Nurse Coeliac Disease Immunotherapy Monitoring (Aza, 6-

MP, Mtx, CyA)