Quality statement 5: Annual review

Quality statement

People with coeliac disease are offered an annual review.

Rationale

An annual review should be offered to people with coeliac disease so that adherence to a gluten-free diet and symptoms can be reviewed, information and advice about the condition and diet can be refreshed, and any further support needs can be identified. Annual reviews for children with coeliac disease also allow any impact on development to be assessed. Annual reviews provide the opportunity to identify people with refractory coeliac disease that does not improve with a gluten‑free diet and to monitor any emerging long‑term complications of coeliac disease.

Quality measures

Structure

Evidence of local arrangements to ensure that people with coeliac disease are offered an annual review.

Data source: Local data collection.

Process

Proportion of people diagnosed with coeliac disease for more than 12 months who received an annual review in the previous 12 months.

Numerator – the number in the denominator who received an annual review in the previous 12 months.

Denominator – the number of people diagnosed with coeliac disease for more than 12 months.

Data source: Local data collection.

Outcome

a) Health-related quality of life for people with coeliac disease.

Data source: Local data collection.

b) Identification of complications associated with coeliac disease.

Data source: Local data collection.

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

Service providers (such as general practices, community healthcare providers and secondary care) ensure that people with coeliac disease, including those discharged from secondary care, are offered an annual review and are given information about why they may need a review to encourage attendance. Service providers should consider innovative approaches to undertake reviews, including using technology to improve access to specialist advice.

Healthcare professionals (for example, dietitians, consultants, and GPs) offer an annual review to people with coeliac disease, including those discharged from secondary care, and encourage them to attend by giving them information about why they may need a review.

Commissioners (for example, clinical commissioning groups and NHS England) ensure that they commission services that offer an annual review to people with coeliac disease, including those discharged from secondary care. Commissioners encourage service providers to use innovative approaches to undertake reviews, including using technology to improve access to specialist advice.

What the quality statement means for patients and carers

People who have coeliac disease have a check-up once a year to check their symptoms and diet, and to find out whether they need further advice or assessment.

Source guidance

Definitions of terms used in this quality statement

Annual review

An annual review for people with coeliac disease should include:

  • measuring weight and height

  • review of symptoms

  • considering the need for assessment of diet and adherence to the gluten‑free diet

  • considering the need for specialist dietetic and nutritional advice

  • considering the need for referral to a GP or consultant to address any concerns about possible complications or comorbidities.

    [Coeliac disease (NICE guideline NG20) recommendations 1.4.3 and 1.4.4]

Equality and diversity considerations

People living in socioeconomically deprived areas are less likely to attend an annual review. Healthcare professionals in these areas should therefore agree a local approach to encourage as many people as possible to attend.