1. GI Inpatient Services post AAU
Connect Meeting
April 2010

2. Outpatient Services Unchanged Clinics Hemel, SACH, HMH, Watford
IBD nurse specialist Hemel + SACH
Urgent reviews – contact sec or IBD nurse

3. Endoscopy services Hemel Watford BCSP OGD/Flexi/Colonoscopy ERCP
Therapeutic endoscopy (stenting etc), PEGs, laser therapy

4. Model for GI services
Early involvement of specialists in Emergency care has been shown to improve clinical outcomes
Darzi Delivery of high quality acute medical care by specialists

7. Inpatient Care - AAU
AAU – Daily am consultant rota for GI opinion (Mon – Fri)
Liasion with GI Radiologists - immediate access to cross-sectional imaging (US/ CT)
Inpatient Endoscopy list Mon- Fri pm on patients seen in the morning by same consultant

8. Inpatient Care – Cassio Ward
Cassio ward – 19 dedicated GI beds adjacent to Endoscopy Unit
Excellent team of nurses specialising in GI disease
5 consultants running monthly rota
Junior doc support (3 SpRs, 4FY2s, 3 FY1s)
Dietician & SALT support

9. Activity 2009-10 Endoscopy Inpatients 2700 11/list
Inpatient Emergency Admissions
2707
AAU + Cassio
Ave LOS (Cassio)
3.5 days
Medicine 7.5d
CoE 11.5d

10. Team working Upper and lower GI MDTs Weekly Radiology meeting (Hemel)
Monthly Academic GI Meeting – including mortality review
Monthly Clinical Governance Meeting

11. Nutrition
All PEG referrals (inpatient and outpatient) seen by consultant
PEGs inserted within 3 days for IP and 2 weeks for OP
Establishment of Nutrition Team

12. Service Development IBD services – National Targets
Nutrition Team – NICE/SHA
PEG service – NPSA/CEPOD
Out of Hours GI Bleeding Rota – can of worms…………!! - BSG
What else would you like?!

13. BUT
The elephant in the room……………...money…………………………PCT commissioning