The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has published a review of the care received by patients aged 16 and over undergoing surgery for Crohn’s Disease titled Making the cut?. Based on data from two periods (1 September 2019 to 29 February 2020 and 1 September 2020 to 28 February 2021), analysis was undertaken on questionnaires from 553 clinicians, 414 sets of case notes, and 138 organisational questionnaires, all supported by qualitative data from patient surveys and focus groups.
The report found, for patients with drug resistant Crohn’s disease, surgery should be considered earlier in the treatment pathway, instead of surgery being perceived as a failure of medical management. It states that, once a decision to perform surgery has been made, it should be undertaken within a month to prevent patients on elective waiting lists deteriorating and requiring emergency surgery. Other key messages include:
- Holistic support should be provided for all patients with Crohn’s disease, as they have many wider health needs e.g. psychological, dietary and peer support
- Medication for Crohn’s disease should be managed effectively at all stages of the pathway, and
- All multidisciplinary team discussions should be documented in the patient’s clinical record at the time of the meeting, with a summary provided to the patient and their GP.
