Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

Nicholas A. Kennedy, Richard Hansen, Lisa Younge, Joel Mawdsley, R. Mark Beattie, Shahida Din, Christopher A. Lamb, Philip J. Smith, Christian Selinger, Jimmy Limdi, Tariq H. Iqbal, Alan Lobo, Rachel Cooney, Oliver Brain, Daniel R. Gaya, Charles Murray, Richard Pollok, Alexandra Kent, Tim Raine, Neeraj BhalaJames O. Lindsay, Peter M. Irving, Charlie W. Lees, Shaji Sebastian

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Objective: To determine the challenges in diagnosis, monitoring, support provision in the management of inflammatory bowel disease (IBD) patients and explore the adaptations of IBD services. 

Methods: Internet-based survey by invitation of IBD services across the UK from 8 to 14 April 2020. 

Results: Respondents from 125 IBD services completed the survey. The number of whole-time equivalent gastroenterologists and IBD nurses providing elective outpatient care decreased significantly between baseline (median 4, IQR 4-7.5 and median 3, IQR 2-4) to the point of survey (median 2, IQR 1-4.8 and median 2, IQR 1-3) in the 6-week period following the onset of the COVID-19 pandemic (p<0.001 for both comparisons). Almost all (94%; 112/119) services reported an increase in IBD helpline activity. Face-to-face clinics were substituted for telephone consultation by 86% and video consultation by 11% of services. A variation in the provision of laboratory faecal calprotectin testing was noted with 27% of services reporting no access to faecal calprotectin, and a further 32% reduced access. There was also significant curtailment of IBD-specific endoscopy and elective surgery. 

Conclusions: IBD services in the UK have implemented several adaptive strategies in order to continue to provide safe and high-quality care for patients. National Health Service organisations will need to consider the impact of these changes in current service delivery models and staffing levels when planning exit strategies for post-pandemic IBD care. Careful planning to manage the increased workload and to maintain IBD services is essential to ensure patient safety.

Original languageEnglish
Pages (from-to)343-350
Number of pages8
JournalFrontline Gastroenterology
Issue number5
Early online date16 Jun 2020
Publication statusPublished - 1 Sept 2020


  • health service research
  • infectious disease
  • inflammatory bowel disease

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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