Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom.

Background and Aims Crohn’s disease and ulcerative colitis are the most common forms of inflammatory bowel disease affecting 1 in 250 of the population in the UK. It is accepted that access to a specialist nurse service improves patient experience and outcome. National Standards for inflammatory bowel disease care (2013) defined the number of nurse specialists required at 1.5 full time equivalent per 250,000 population. The aim of this study was to determine if these standards were being met and to publish a new, robust validated standard optimising the UK nursing workforce model. Methods Existing national data and specific workload and service data was collected from 164 IBD specialist nurses who completed a questionnaire designed to collect information on activity and complexity of work both done and undone. Results Data was received from all of the UK. Thirty-six percent of respondents were specialist nurses in the field for 3 years or less. A higher caseload than the recommended level was reported by 63% of respondents. Unpaid overtime was regularly carried out by 84%of respondents. The IBD specialist nurse was involved in all areas of the patient pathway. Areas of work left undone were psychological interventions, prescribing medicines and physical assessments. Conclusions Compared to other specialties IBD specialist nurses are less experienced. It is recommended that the current standard be increased to 2.5 full time equivalent specialist nurses per 250,000. patients to mitigate for the increasing complexity of the role, care and the “rookie” factor. Keywords: Inflammatory Bowel Disease, Specialist Nurse, Workforce Modelling