Why is this important?
An effectively managed IBD service doesn’t just happen. It requires a defined leadership team, which includes both clinician and managerial input. They are responsible for a documented annual plan for the service – with named leads for all key activities and clear timescales for completion. At a minimum, the leadership team should include: a gastroenterologist and or paediatric gastroenterologist, a colorectal surgeon, an IBD Nurse Specialist, and a manager, but other members of the MDT can be included depending on service and skill sets.
This leadership team should agree a clear structure for a series of documented meetings. This, for example, might include a regular business meeting every 8 weeks, an annual governance meeting, and an annual review and strategy meeting.
Increasingly, we are recognising the value of a specialist pharmacist as a key element of the core IBD team and its leadership. This responds to the growing range of high cost, complex drug treatments available – and the greater responsibility this brings to ensure they are being utilised, prescribed, administered and monitored appropriately. A specialist pharmacist is ideally placed to advise on medicines management, optimisation and value as part of ensuring overall medicines governance.1,2,3
We are also recognising the value of an expert dietitian in providing oversight of dietetic assessment and intervention. IBD patients may experience changes in body composition, muscle strength and bone mineral density, particularly when patients are taking corticosteroids, emphasising the importance of nutritional concerns and management being discussed as part of IBD MDT meetings.4
Likewise, it is important that MDT leadership teams work with a psychologist with an interest in IBD. We know that IBD can have a significant impact on patients’ mental health, with several studies also indicating that psychological distress can trigger relapse, worsen disease course, and impact response to treatment.5 Despite this, only 6% of services who completed the 2023 Service Self-Assessment met staffing recommendations for psychologists in the MDT.