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Strategies for Transitioning from Secondary to Primary Care in Gastroenterology

This document outlines a national and local strategy for enhancing primary care over the next three years, with long-term implications for a decade. It addresses the influx of funding and personnel into primary care, weighing the benefits against inherent risks. Key points include improved patient access and reduced costs, though at the potential expense of hospital revenue and training opportunities for medical staff. The conditions discussed include coeliac disease, stable inflammatory bowel disease, and liver diseases, emphasizing the role of GI specialist nurses and patient self-management.

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Strategies for Transitioning from Secondary to Primary Care in Gastroenterology

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  1. GI Services From Secondary to Primary Care

  2. National & Local Strategy • 3 years (10 years!!!) • Money (& People) into Primary Care • Benefits & Risks • What conditions?

  3. Better for Pts – easier access Cheaper Frees up acute Trust time for seriously ill pts Expensive Loss of income with PBR/PBC means Hospitals destabilised Reduced training for Drs (& nurses) Time-consuming Benefits & Risks

  4. What Conditions ? • Coeliac Disease (1% population) • Stable IBD (L. sided) • IBD immunotherapy • Stable Liver Disease (PBC, NAFLD) • ……..Alcohol – Related Liver Disease

  5. How? • GI Specialist Nurse • Pt self-management protocols • More regular contact between GPs & Consultants • Audit, Clinical Governance meetings

  6. First Steps • GI Specialist Nurse • Coeliac Disease • Immunotherapy Monitoring (Aza, 6-MP, Mtx, CyA)

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