“My IBD STARS Award is amazing, but it’s bigger than just me.”

The idea for the DSP came from Babitha’s concerns about an unmet need that emerged during the COVID pandemic. Patients with IBD on surveillance lists were being missed or dropping off waiting lists.

The Trust first developed an IBD surveillance Link Nurse role for Babitha, with dedicated clinical sessions identified within the job plan to allow for role development and service delivery.

Then, to develop a pathway for high-risk (dysplasia) patients, who might otherwise miss appointments for screening, Babitha worked with the wider multidisciplinary team (MDT) to set up the DSP.

The role of the DSP is to ensure surveillance is timely whilst supporting patients through the process of surveillance monitoring; and to also provide a source of expert knowledge for the wider IBD MDT in the Trust by:

• Maintaining a dysplasia database to support and inform the DSP
• Acting as a bridge between the endoscopist, the histopathologist and the referring clinician
• Providing expertise in the monitoring of dysplasia in IBD to help plan timely follow-up and monitoring of patients on the pathway, i.e., within MDT discussions about dysplasia cases
• Providing auditable information that could be used to support service development

There was also the opportunity to develop patient communications. Babitha explained, “When patients are asymptomatic, they can question the need to attend their appointment – phoning patients helped them understand the importance, and so improve attendance rates.”

Education and counselling for IBD patients on surveillance pathways are now providing consistent, holistic and informative support for patients on the pathway – helping to alleviate their concerns and provide support with shared decision-making in this often emotive area of IBD care.

Babitha summarises what this new standard of practice means to both clinicians and patients. “The DSP is now providing a systematic pathway for IBD surveillance, with closer monitoring in the early detection of colorectal cancer. By helping to engage other clinicians, (including pathologists) and improve the communication between the IBD and endoscopy teams, there is greatly improved collaboration between the two services.

“Attendance at surveillance clinics is also helping to improve patient engagement and therefore their understanding of surveillance monitoring requirements. Prior to the Link Nurse post and DSP, there was a risk of a disconnect between surveillance procedures and clinical follow-up. But, since April 2022 to today, we’ve had no missed cancers.”

Evidencing the positive results
Since April 2022, 162 patients have been referred to the DSP. 50 patients have been reviewed in the surveillance clinic. 10 have been referred to the joint surgical clinic to discuss surgery for dysplasia; 2 patients have had surgery; 2 patients are waiting for surgery; and 2 patients declined and remain on the DSP.

The success of this novel DSP project has travelled far and wide, with multiple hospitals and Trusts also expressing an interest. Her abstract won her an additional award at the Kerala Nurses UK Conference and was also selected for the European Crohn’s and Colitis Conference, taking her to Sweden to present.

Some final words from Babitha
When asked what advice she might give IBD nurses, Babitha says that she would encourage junior nurses to get as deep an understanding of every day practice in IBD as they can – from getting inside the minds of the patients to learning different ways of working. “What we do is important in terms of changing people’s lives so if you identify better practices, take courage. Gather a team behind you and make it happen!”