Quality statement 4: Reviewing treatment and management

Quality statement

Adults with irritable bowel syndrome agree their follow‑up with their healthcare professional.

Rationale

Regular review of treatment and management ensures that people with irritable bowel syndrome continue to be supported to manage their condition and to improve or maintain their quality of life. However, because self‑management is the best approach for many people, the patients themselves should play a key role in determining when they need the review. The review, which may form part of an annual patient review, gives the opportunity for discussing and optimising medicines, lifestyle and diet, considering management alongside other related conditions, considering new treatments, and prompting further investigations or referrals if red flag indicators emerge.

Quality measures

Structure

a) Evidence of local arrangements to ensure that adults with irritable bowel syndrome agree their follow‑up with their healthcare professional.

Data source: Local data collection.

b) Evidence of local arrangements (for example through local protocols on appointment reminders) to ensure that adults with irritable bowel syndrome have follow‑up as agreed with their healthcare professional.

Data source: Local data collection.

Process

a) Proportion of adults with irritable bowel syndrome who agree their follow‑up arrangements with their healthcare professional.

Numerator – the number in the denominator who agree their follow‑up arrangements with their healthcare professional.

Denominator – the number of adults with irritable bowel syndrome.

Data source: Local data collection.

b) Proportion of adults with irritable bowel syndrome whose follow‑up takes place by the date agreed with their healthcare professional.

Numerator – the number in the denominator whose follow‑up takes place by the date agreed.

Denominator – the number of adults with irritable bowel syndrome who have a follow‑up date agreed with their healthcare professional.

Data source: Local data collection.

Outcomes

a) People with irritable bowel syndrome feel confident to manage their condition.

b) Satisfaction with care received for irritable bowel syndrome.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (GP practices) ensure that adults with irritable bowel syndrome agree their follow‑up with their healthcare professional. This can include the frequency and the format of the review; for example, it can be a face‑to‑face appointment or a telephone consultation. Adults with irritable bowel syndrome should be encouraged to make contact to arrange their follow‑up appointments as part of the self‑management of their symptoms.

Healthcare professionals in primary care (GPs) discuss the frequency and format of follow‑up with adults with irritable bowel syndrome and agree with them how and when this will take place. The format can be a face‑to‑face appointment or, if appropriate, a telephone consultation. Healthcare professionals should encourage adults with irritable bowel syndrome to make contact to arrange their follow‑up appointments as part of the self‑management of their symptoms.

Commissioners (clinical commissioning groups and NHS England) commission services that ensure that adults with irritable bowel syndrome can agree their follow‑up with their healthcare professional.

What the quality statement means for patients, service users and carers

Adults with irritable bowel syndrome agree how often they will see their healthcare professional to talk about their symptoms and their medications. They can agree whether the appointment will take place face‑to‑face or by telephone. They should be encouraged to make contact to arrange the appointments as part of the management of their own symptoms.

Source guidance

Definitions of terms used in this quality statement

Follow‑up

This is an opportunity for a person with irritable bowel syndrome to discuss their symptoms and how these are managed with their healthcare professional. This appointment can take place at a frequency agreed by the person and their healthcare professional, and can take the form that they feel is the most appropriate (such as attending the GP practice or a telephone conversation). Adults with irritable bowel syndrome should be encouraged to make contact to arrange the appointment because this will empower them to self‑manage their symptoms.

[Adapted from Irritable bowel syndrome in adults (NICE guideline CG61), recommendation 1.2.5.1 and expert opinion]

Equality and diversity considerations

Healthcare professionals should take into consideration the communication needs of people with irritable bowel syndrome, including cognitive impairment, when discussing and undertaking follow‑up. For those people who are unable to arrange the follow‑up appointments themselves, assistance should be provided to ensure their care continues appropriately.