A PCN-led bowel clinic pilot has cut patient waiting times by up to 70 weeks by providing bowel examinations for low-risk individuals in the community.
The Central Camden PCN clinic is run by physician associates (PAs), hired through ARRS, at Bloomsbury Surgery who use a handheld digital rectoscope to examine the lower part of the patient’s bowel. This can either eliminate the need for a formal endoscopy or identify cases that need a colonoscopy due to polyps, for example.
The aim of the service is to reduce the burden on endoscopy services and improve the diagnosis of cancer in patients who do not meet the criteria for urgent referral.
While the staff are funded through ARRS, the other costs are covered by the PCN and University College London Hospitals Foundation Trust. Clinical director at Central Camden PCN, Dr Ammara Hughes, said the PCN had around 1,500 episodes of rectal bleeding across its nine practices in 2022.
‘Typically these “low risk” patients are the ones waiting over 70 weeks to be seen,’ she said.
‘At our rectal pathology clinic we have staff trained to use a handheld device which gives a high-definition look inside the colon. We can expediently rule out rectal cancer and provide prompt treatment for non-cancerous bowel issues.’
The PCN estimated that the clinic would save North Central London Integrated Care Board (ICB) around £250,000, with the pilot service aiming to see around 200 patients this year. So far, 52 patients have been seen, and only seven were referred on to secondary care.
PA Vidhi Patel, who works in the bowel clinic, said the service has also helped to overcome some cultural barriers to accessing healthcare.
She said: ‘At Bloomsbury, we have patients from diverse backgrounds and we understand that there are also cultural barriers for many women who are suffering from bowel complaints. As a female practitioner it is wonderful to be able to help these women who may have refused treatment from a male doctor. I also think that being seen in a local GP surgery room, rather than the hospital is far less daunting.’
The service is run under the supervision of colorectal surgeon Mr Alexander Von Roon from University College London Hospitals NHS Foundation Trust.
He said: ‘We have seen really excellent results from the community bowel clinic. The staff have been trained in how to take histories, do examinations, do rectoscopy and proctoscopy with the help and support of the LumenEye device.
‘We can make patients feel better and take them out of the hospital capacity thus freeing up the hospital’s capacity for our cancer patients who may be in need of more specialist care. We’re shortening the treatment time, and the time to diagnosis.’
Mr Dale Vimalachandran, consultant colorectal surgeon, Bowel Research UK research grants committee member, said: ‘The Bloomsbury bowel clinic is an excellent example of what can be achieved. It has the potential to significantly speed up the treatment of low-risk patients at their local GP surgery and frees up capacity in hospitals to deal with the most urgent patients, including those with ulcerative colitis and bowel cancer.
‘Bowel cancer tragically takes the lives of over 16,000 people each year and remains the second most deadly cancer in the UK.’
The handheld digital rectoscope was provided by the company SurgEase for free as they wanted to see how it works in the community.
Original article can be found here:
PCN bowel clinic cuts patient waiting times by up to 70 weeks – Pulse Today
