“The calprotectin test is better than a colonoscopy”
Patient quote

Overview

Faecal Calprotectin is an Y&Hinnovative diagnostic test that supports GPs in discriminating between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Early identification of patients with IBD is enabling quicker referral to the expert secondary care needed to diagnose and manage their condition effectively. It also means that patients with IBS are not unnecessarily referred to secondary care and do not have to undergo invasive investigations (such as colonoscopies) resulting in an improved patient experience, cost savings and better use of NHS clinical resources.

Challenge/ problem identified

IBS affects 10-20 percent of the population, half of whom will consult their GP, with 79,000 new cases being diagnosed each year. IBD, which includes Crohn’s Disease and ulcerative colitis, occurs much less commonly, being seen three percent of the time.

As distinguishing IBS from IBD is difficult, as many as 19 out of 20 patients are unnecessarily referred to secondary care, which often includes an invasive colonoscopy.

Actions taken

The new Faecal Calprotectin Pathway was introduced by Dr James Turvill, Consultant Gastroenterologist at York Teaching Hospitals NHS Foundation Trust.

The Yorkshire & Humber AHSN has actively supported the roll out of the new pathway by funding an economic impact analysis carried out by the York Health Economic Consortium and creating an implementation pack for Trusts, Clinical Commissioning Groups (CCGs) and GPs. This includes the following tools and templates:

  • Template business cases
  • Downloadable pathway templates for EMIS and SystmOne
  • An educational video to explain the Faecal Calprotectin pathway
  • Educational slide deck
  • GP leaflet to provide more detail of the pathway and why and when to test
  • Patient leaflet to explain what the test is and why it is being carried out

Impacts/ outcomes

  • Currently, seven CCGs and 198 GP practices are using the new pathway.
  • This has resulted in a 40-57 percent reduction in new hospital outpatients’ appointments and a 21-50 percent reduction in colonoscopies. There are projected savings to each CCG of £95,000 – £146,000, equating to a saving of £2.5 million across the Yorkshire and Humber region.Y&H Faecal Calprotectin
  • The NHS Business Services Authority has produced a case study about the spread of implementing the Faecal Calprotectin pathway and, in March 2017, the project won an award for service improvement at the annual Medipex Awards.
  • The Faecal Calprotectin Pathway is also now shortlisted for an HSJ Award in the Acute, Community or Primary Care Services Redesign category.

“The test was enough to confirm that it is nothing more than IBS”
Patient quote

Plans for the future

  • A further nine CCGs are fully engaged with implementation plans in place
  • A full economic analysis will be completed by the York Health Economic Consortium by Autumn 2017
  • The national algorithm for the Faecal Calprotectin pathway, has been submitted to the Chief Scientific Officer for approval. Once finalised, this will have a national launch
  • There will be a GP survey to understand how the new pathway has been received by GPs
  • There will be a patient survey to understand their satisfaction with the pathway and the leaflet they were presented with

Which national clinical or policy priorities does this example address?

  • Care and Quality
  • Funding and Efficiency

Start and end dates

  • April 2016 – ongoing
  • YHEC report due Autumn 2017

Contact for help and advice

Project contact for further information
Victoria Hilton
T: 01924 664717
E: Victoria.hilton@yhahsn.com

Media contact for further information
Esme Crabtree
T: 01924 664728
E: esme.crabtree@yhahsn.com

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