Why is it important?
Inflammatory Bowel Disease (IBD) is complex and fluctuating, and its physical and emotional effects can vary hugely from one person to another. This means that good multidisciplinary team working is essential to deliver high-quality care.
Every local area should have a dedicated IBD team, which may cover one or more areas. This specialist team should be able to support people with every aspect of their IBD care: from initial IBD assessment and diagnosis, to treatment, rapid care during flares, nutritional support, and surgery if required. It’s important here to communicate the roles of any team members clearly to patients.
Who is in an IBD team?
Core members should all have a special interest in IBD or gastroenterology. For a catchment population of 250,000 people (the average for a district general hospital), the IBD multidisciplinary team should include:
- 2 whole time equivalent (WTE) Consultant Gastroenterologists
- 2 WTE Colorectal Surgeons
- 2.5 WTE Clinical Nurse Specialists with a special interest and a competency in IBD
- 1.5 WTE Clinical Nurse Specialist with a special interest and competency in stoma therapy and ileoanal pouch surgery
- 1 WTE Dietitian allocated to gastroenterology
- 0.6 WTE Expert Pharmacist in IBD
- 0.5 WTE Psychologist
- 0.5 WTE Administrator to provide support for IBD meetings, IBD database recording and audit
- 0.5 WTE Radiologist with a special interest in gastroenterology
- 1 named Histopathologist with a special interest in gastroenterology
Essential supporting services
Additionally, there are healthcare professionals who provide essential supporting services. They should work alongside the core IBD team and have an IBD interest. These include:
- A Rheumatologist
- An Ophthalmologist
- A Dermatologist
- An Obstetrician
- A Hepatologist
- A Social Worker
- A Nutrition Support Team
- A Consultant Paediatrician
GPs should also be involved in supporting IBD care and in contact with the IBD team.
Paediatric and adolescent care
Paediatric and adolescent care needs additional consideration. Here, paediatric gastroenterologists, with specialist paediatric nursing and dietetic support, should work in a managed clinical network. This can help facilitate local shared care with adult gastroenterology colleagues and paediatricians with an interest in gastroenterology, particularly IBD. Each patient should have a named consultant paediatric gastroenterologist – even if their care is shared with a paediatrician in a general hospital.
NICE quality standard for inflammatory bowel disease: Multidisciplinary team support
Inflammatory bowel disease can have diverse effects on a person. In addition to its physical impact, there can be emotional, psychological and social consequences. A multidisciplinary team has a wide range of expertise that can help address these issues, and it is important that services for people with inflammatory bowel disease provide this support. (NICE Quality Standard).