Case study: Surgical IBD nurse, University College London Hospitals NHS Trust

Case study: Surgical IBD nurse, University College London Hospitals NHS Trust

Effective communication and coordination between different professionals are crucial when a person living with IBD is considering surgery. IBD nurse specialists play a key role in providing information, support and holistic care before and after surgery, including on the potential impact on lifestyle and approaches to long-term management.

Joint medical/surgical clinic review and discussion at multidisciplinary team meetings is important for good patient outcomes. Dietitians, pharmacists and other members of the team can also help ensure patients are as well physically prepared as possible ahead of an operation. This involvement minimises the risk of complications and aids recovery.

Statement 5.1

Patients should have access to coordinated surgical and medical clinical expertise, including regular combined or parallel clinics with a specialist colorectal surgeon (paediatric colorectal surgeon where appropriate) and IBD gastroenterologist.

Statement 5.5

Prior to elective surgery, a full assessment and optimisation of medical treatment and physical condition should be undertaken to minimise risk of complications and aid post-operative recovery.

Who's doing it well?

University College London Hospitals NHS Foundation Trust (UCLH) now employs a surgical IBD nurse – an innovative post bridging the medical and surgical teams. As a tertiary referral centre covering adolescents and adults with complex needs, they realised that they needed to improve support for patients before, during and after their surgery. It is early days in terms of formal evaluation, but feedback so far has been incredibly positive. Other IBD services have asked for the job description, as they consider a similar role.

The idea

Before this post was established there was often a disconnect between the medical and surgical services in IBD, which lead to delays in post-operative clinic review and appropriate post-operative medication management, and sub-optimal pre-surgical optimization. The IBD nurse specialists received a large volume of pre and post op queries via the IBD advice line, which could at times be difficult to manage and help resolve.

Over the last 18 months the surgical IBD nurse has become an integral part of the IBD team. She has a background in stoma care and post-operative recovery and can support patients throughout their surgical journey. She sees patients in clinic to discuss options and support them with decision making. She liaises with dietetic colleagues to ensure that patients are optimised for surgery. She reviews patients on the ward whilst they are in hospital. She has protocols in place to review patients after discharge and replies to surgical queries coming in to the IBD advice line. She ensures that all histology is reviewed in the MDT and timely, appropriate decisions about ongoing medical treatment are taken.

Alongside this she has been learning all about medical IBD management, ensuring that she can truly bridge the divide between medical and surgical teams.


The last 18 months have been a learning curve. The role that was initially envisaged has developed as it became clearer where the gaps were and what was needed. With the coronavirus pandemic intervening and the surgical IBD nurse being redeployed, this embedding process has taken longer than expected. But the team and patients are already seeing the benefit of greater integration. A more formal evaluation of impact will follow.

Having a specialist surgical IBD nurse by my side through every step of my journey surgically has been priceless, especially during a pandemic that meant I wasn’t allowed any visitors in hospital. She was a constant source of support whilst I was in hospital and I know she is always just at the end of an email should I ever need anything. Undergoing surgery happened very quickly for me, and it was incredibly helpful to have someone to speak about not only the logistics of the surgery, but about my worries and concerns. I know quite a lot about medications for IBD, but surgery was a completely new aspect for me and so it was great to talk to a specialist.


Date created: April 2021