Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Flare to care – future management of long-term conditions

Antony Aziz, Rebecca Reynolds, Claire Bull, Karen Street, Branita Mills, Patrick Kerr, Jeremy Hyde and Azhar Ansari
Download PDF
DOI: https://doi.org/10.7861/futurehosp.6-1-s85
Future Healthc J March 2019
Antony Aziz
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rebecca Reynolds
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Claire Bull
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karen Street
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Branita Mills
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patrick Kerr
BEast Surrey CCG, Oxted, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeremy Hyde
CPatient Representative Lead, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Azhar Ansari
AGastroenterology, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Aims

To promote citizens with long-term conditions as authors of their own health data and competent self-managers supported by specialist clinical guidance that is tailored to their situation through a novel technology-driven management solution.

Methods

Through close collaborative working with patients, clinical commissioning groups and demand for an out-of-hospital experience, the inflammatory bowel disease (IBD) service at East Surrey Hospital (ESH) was radically redesigned. In 2014, a new model of care that put patients at the centre of the care pathway and opened access to all patients with IBD through telephone and email support enabled citizens to drive the change. The outcome of this led to the use of a web-based patient management portal called Patients Know Best (PKB). This synchronised the integration of patient entered symptom tracking with their own clinical information (including pathology and imaging results) and appropriate communication tools. It served as a repository for standardised patient information reducing variation among clinicians and promoting patient education. This facilitated a rapid and efficient support for patients at scale.

Patients as the assets at the centre of the change directed their own healthcare, initiated self-assessment and self-management with appropriate advice, guidance and support provided by the IBD team within 48 hours and tailored to patients’ needs. The sickest patients were detected more rapidly and offered a clinical review within a week, while stable patients were offered comprehensive routine follow up non-face-to-face. Patients with IBD were invited to PKB at clinic appointments.

The service was evaluated in 2015 with data extracted from all non-face-to-face interactions that year.

Results

  • In 2015, there were 4,358 non-face-to-face interactions, through which the IBD service avoided 80 hospital admissions, 134 emergency department attendances and 440 outpatient appointments.

  • 1,500 contacts related to immunosuppression therapy monitoring. There were no reported breaches of clinical safety.

  • The patient journey time to access specialist care at the time of a flare reduced from 6 weeks down to 1 week.

  • Fifty active users of PKB in 2015 increased to 700 in 2017 due to consumer led need and demand for a total IBD population of approximately 4,000.

Conclusion

The redesigned IBD service at ESH is a citizen-led low-cost technology-enhanced care delivery model that has improved patient experience and clinical outcomes.

This new model of care breaks down traditional boundaries of the service user and provider, promoting collaborative working with patients with long-term conditions.

The IBD service at ESH is being delivered with lower than the national recommended number of consultants (65%) and clinical nurse specialists (50%), yet has provided care to more patients requiring close immunosuppression therapy monitoring than would have been possible without a non-face-to-face service, without compromising on safety. Future investment in resources can now be better focused on improving service through resilience and quality utilising co-produced mechanisms guiding the type and size of manpower to deliver patient-centred working.

Conflict of interest statement

None declared.

  • © Royal College of Physicians 2019. All rights reserved.
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Flare to care – future management of long-term conditions
Antony Aziz, Rebecca Reynolds, Claire Bull, Karen Street, Branita Mills, Patrick Kerr, Jeremy Hyde, Azhar Ansari
Future Healthc J Mar 2019, 6 (Suppl 1) 85; DOI: 10.7861/futurehosp.6-1-s85

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Flare to care – future management of long-term conditions
Antony Aziz, Rebecca Reynolds, Claire Bull, Karen Street, Branita Mills, Patrick Kerr, Jeremy Hyde, Azhar Ansari
Future Healthc J Mar 2019, 6 (Suppl 1) 85; DOI: 10.7861/futurehosp.6-1-s85
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Aims
    • Methods
    • Results
    • Conclusion
    • Conflict of interest statement
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • The association between admission hyperglycaemia and the no-reflow phenomenon in STEMI patients undergoing primary percutaneous coronary intervention
  • Developing an enhanced induction process for international medical graduates in the NHS
  • Improving adolescent care in a cross-sector system
Show more Research and innovation

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians