Review into Gastroenterology services at Great Ormond Street Hospital

We are always looking at ways to improve the way we work and provide the highest standards of care and experience to all our patients and their families.

Last year we asked the Royal College of Paediatrics and Child Health (RCPCH) to review our Gastroenterology service. The College recommended a further in depth external review of some of the packages of care for our patients with rare and complex conditions. This review is now complete.

What the review has found is that the vast majority of our gastroenterology patients and their families received good standards of care. This included all patients being treated for inflammatory bowel diseases, motility, autoimmune gut diseases, congenital pseudo obstruction and nutritional management.

In a small group of patients with, or suspected as having, a complex condition known as Eosinophilic Lower Gastroenterology Disease or complex food allergies the reviewers acknowledged that this was a rare and complex clinical area with a lack of national or international consensus on the best way to manage these patients. There are no agreed clinical guidelines for the treatment of these patients.

The reviewers found the care of some of these patients to be of the highest standard. However, they also found some examples where children had unnecessary endoscopies and exclusion diets and they questioned some drug treatments. In all these cases, the care packages have since been discussed with patients and their families and treatment has, where necessary, been modified. There is no evidence of any long term consequences to these patients.

Dr Vin Diwakar, Medical Director of Great Ormond Street Hospital, said: “These reviews are not simple but they are important. I am pleased that the independent reviewers found good standards of care across the vast majority of our gastroenterology services.

“Our focus was on reviewing those patients who we thought may have been investigated and treated more intensively than in other parts of the UK and ensuring they were on appropriate care packages going forward. This has been completed.

“No child should have more treatments or procedures than are necessary but I am reassured that there is no evidence of long term consequences from the approach that our service has used in the past.

“We now have a number of measures in place within our clinical service to ensure that this does not happen again.”

The review also made recommendations to further enhance patient care and their experience particularly in our communication with patients, our administration processes and better patient and family access to psychological support. We are now implementing a robust action plan to ensure improvements in these areas take place.

Throughout the review process we have shared our methodology and all findings with our commissioners NHS England, NHS Improvement and the Care Quality Commission.

We have also asked the RCPCH to carry out a further review in 2017 to ensure that improvements are being sustained and the services and experience offered to patients is of a consistent high quality.

We would like to reassure all our gastroenterology patients and their families that we have individually contacted all patients whose treatment plans we needed to review and discuss. Should gastroenterology patients and their families have any further questions they can contact us on 0207 762 6041, Monday to Friday 9am-5pm.