Community Care - New digestive disorders service

Adults in Sheffield now benefit from specialist community gastroenterology care. By Dr Marion Sloan

Patients can have rapid assessments of gastroenterological conditions (Photograph: Rex Features)
Patients can have rapid assessments of gastroenterological conditions (Photograph: Rex Features)

Last month, Central Sheffield GP Consortium (CSGPC) and the gastroenterology unit at Sheffield Teaching Hospitals NHS Foundation Trust launched a community-based gastroenterology service.

Sheffield is one the first places in the UK to offer patients such an innovative service, and we are proud of our achievement. CSGPC is a group of 27 practices working together to improve services for 134,000 patients in the city.

It is well known that as many as one in five GP consultations are about digestive disorders, and people needing advice and investigations are usually referred to hospital specialists.

So the new service will make a real difference to patients as they can gain access to specialist advice and certain tests and treatments in a local GP surgery.

Specialist suite
Our new service is available for people with a range of gastroenterological conditions including anaemia, diarrhoea, abnormal liver function and jaundice. These patients are seen at a specialist suite at my practice's new purpose-built premises, Sloan Medical Practice, which we moved into a few months ago.

Instead of being referred to hospital automatically, patients can be referred here by their GPs from CSGPC's member practices. As well as getting rapid assessments, patients will avoid problems finding parking spaces at the hospital or having to travel to outpatients by public or ambulance transport.

This service is another example of how GP commissioners can provide care in a friendly environment in the heart of the community and, hopefully, achieve better outcomes.

The service can quickly reassure patients if their symptoms are not indicative of a serious problem. Or, if further tests or a treatment plan are necessary, we can arrange them quickly.

CSGPC is leading the service, supported by specialists from Sheffield Teaching Hospitals NHS Foundation Trust. Our consortium covers the majority of inner city GP practices in Sheffield, where there are high levels of deprivation, chronic disease and social need, which puts it at the forefront of the government's healthcare reforms.

This gastroenterology service is the latest in a series of community-based service developments CSGPC has delivered in the past four years and should help in our efforts to reduce health inequalities in the city.

Cancer screening
For example, uptake rates for bowel cancer screening illustrate clearly how social and ethnic issues disadvantage some groups who miss out on this valuable disease prevention initiative.

Such patients often present late with advanced symptoms that are harder to deal with. If we can 'lift the lid on poo-taboo' and make it easy for patients to report symptoms to their local doctor without embarrassment, clinical outcomes are bound to be better.

A further benefit to the local NHS is that if we deal with straightforward gastroenterology conditions in primary care, hospital clinics are freed up for the conditions that really do need secondary care equipment, skills and expertise.

Local colleagues recognise that, as well as benefiting patients, the service offers hospital-based clinicians an opportunity to gain more understanding of the wider context of illness by seeing patients in the community.

The community gastroenterology service will give GPs from other CSGPC practices phone and email access to advice from specialist clinicians. An additional part of the service follows up longer-term conditions, such as Crohn's disease and ulcerative colitis.

Overall our new service is very much a 'win-win' scheme and is the latest example of how CSGPC is working to develop solutions to improve the quality and levels of care within its local community.

These include a 'telederm' service that should significantly reduce the number of patients with malignant melanoma initially misdiagnosed by GPs, and the number of people with benign, pigmented lesions or moles being referred unnecessarily to hospital.

CSGPC is also working on ways to encourage people with COPD to seek help at an early stage so that treatment can be more effective.

FACT FILE
  • The community gastroenterology service, based at the Sloan Medical Centre in Sheffield, launched in February 2011.
  • It is a joint initiative between the Central Sheffield GP Consortium (CSGPC) and Sheffield Teaching Hospitals NHS Foundation Trust.
  • A total of 550 patients are expected to be treated by the service in its first 12 months.
  • The service will cost around £60,000 a year and utilises existing hospital funding to provide primary care diagnostics.
  • The service is initially running as a pilot scheme and after 12 months, will be evaluated to see if it has succeeded in cutting hospital referrals significantly and improving treatment outcomes.
  • Founded in August 2006, CSGPC is made up of 27 practices that work together to identify ways to improve access to, and standards of, local healthcare services for patients.

Dr Marion Sloan: ‘win-win’ scheme

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