Dr Kevin Barrett’s interview
‘IBD is a very complex, chronic condition that affects just about every area of the patient’s life and, ideally, every patient would receive personalised care for their individual disease pathway,’ says Dr Kevin Barrett, who is Chair of the Primary Care Society for Gastroenterology, and was the IBD Spotlight Project Lead Clinical Champion for the Royal College of GPs.
‘The IBD Spotlight Project was born out of a widespread recognition that there was a significant need for more support for primary care doctors who were, in the main, responsible for the ongoing care of IBD patients,’
‘However, whilst most patients were being managed at a primary care level, their treatment, including crisis treatment, was usually determined by their secondary care team and communication between the two wasn’t always as good as it could have been. In addition, most GPs would only have a few IBD patients and were often inexperienced in handling crises such as ‘flares.’ Nor did they always have the experience to advise on issues such as pregnancy, travelling or sexual activity for patients with IBD..’
The Project began in 2017 with a survey of over 520 GPs and GP trainees who were interviewed about their experiences of, and needs, whilst working with IBD patients.
The survey quickly revealed that whilst GPs were confident that they could recognise the symptoms of IBD, they were less so when interpreting faecal calprotectin tests and managing flares. Many didn’t feel qualified to advise on the day to day problems encountered by IBD patients, which were more usually handled by IBD nurse specialists in a secondary care setting. Overall there was a widespread enthusiasm for a method of accessible information which could provide rapid and accurate information across a wide spectrum of IBD issues.
‘Several things developed from these findings,’ says Dr Barrett. ‘The first was the launch of the IBD Toolkit on the RCGP website as a safe, user friendly one-stop tool for GPs. The toolkit covers IBD topics ranging from psychological support, contraception and nutrition to colon cancer risk factors and osteoporosis along with training and patient support resources.
‘Right from the start it proved to be extremely popular with clinicians, nurses and patients. Since 2017 it has been accessed over 16,000 times from as far afield as Australia, the UAE and Thailand. Even now it is still averaging around 500 visits a month.’
In response to a clear need for training, a group of UK-wide regional Clinical Champions, including Dr Barrett, committed to raising awareness of IBD whenever and wherever possible across their region. They took on the task of presenting at educational events ranging from national and regional conferences to individual GP surgeries, wrote articles and blogs, contributed to learning guide tools and made themselves available to be interviewed in the media, all of which will still be available even after the closure of the project.
‘In 2019, the focus of the Spotlight Project moved towards long term management of the condition,’ says Kevin. ‘In particularly how to manage and preferably pre-empt flares. We devised the Crohn’s and Colitis Flare Pathway which was added to the top of the Toolkit.’
The Flare Pathway later won the RCGP Annual Conference Clinical Poster Award in 2019 with judges noting its ‘clarity of message, the involvement of patients in the project and the potential impact that this work has to improve the lives of patients with IBD.’
More recently the Project has provided online learning in the form of webinars and podcasts and has been instrumental in the expansion of IBD in the RCGP post-graduate curriculum.
‘The Toolkit, which is the main legacy of the Spotlight Project had been incredibly successful,’ comments Dr Barrett. ‘It has become a one hub providing a wide range of information that is clear, accessible and regularly updated. Thousands of IBD clinicians, nurses, dieticians and, perhaps most significantly patients, have utilized the information and we hope been able to provide or receive better IBD care as a result.’