Journal Article

P128 The GP with extended role in gastroenterology (GPwER-G) training programme: implementable, impactful and cost-effective

Anderson, Rebecca, Andrews, Charles, Pohl, Keith, Mallender, Jacque, Feeney, Mark, Howden, Adam, Taylor, Charlotte, Dunckley, Paul

2025

Overview

IntroductionTo date there has been no formalised training programme for GPs working within Gastroenterology. In 2023 the first GP cohort was enrolled onto a 2-year GPwER-G programme endorsed by the BSG. The programme comprises weekly supervised clinics, webinars, case-studies and quality improvement projects (QIP). GPs are formally assessed before and after each online module (Upper GI, Lower GI & Hepato-pancreaticobiliary). We present their feedback and outcomes after year 1 and discuss the cost-effectiveness and potential impact of the programme.MethodsAll GPs who had completed year 1 (and their supervisors (CS)) were invited to participate in an interview and consented for analysis of their assessment scores and feedback. Interviews were subjected to thematic analysis. Interview and feedback data is presented qualitatively. A paired student T-test was used to identify differences in pre and post module test scores. An external health economics company analysed the cost-effectiveness of the programme.ResultsFour GPs completed year 1. 100% found the e-portal easy to use and praised the webinars. CSs were unanimously positive about hosting a GP, despite occasional clinic delays (ave 20-40 mins discussion/clinic). Each GP had the capacity to see 258 patients per annum in parallel clinics. All GPs felt they would be confident to work independently after 2 years.A paired t-test demonstrates that both Lower and Upper GI assessment scores significantly increased after completion of the modules (LGI=63%-86% [t=3.5, p<0.05, df=3], UGI=49%-82% [t=4.6, p<0.01, df=4]). QIPs are ongoing but one has significantly reduced local straight to test colonoscopy referrals.All GPs aspired to develop an interface pathway between primary and secondary care upon programme completion. 100% felt more motivated for their concurrent GP work.Cost analysis demonstrated that upon completion of the programme, each GPwER would need to reduce onward secondary care referrals by only 59/annum over 5 years for the programme to be cost-effective. Costs would reduce if the programme was adopted nationally.ConclusionsThis shows that the GPwER-G programme is implementable, effective and cost-effective. It allows quality assurance of GPwERs which did not previously exist. Lord Darzi’s report1 into the state of the NHS highlighted long secondary care waiting times and placed an emphasis on the primary-secondary care interface. During the programme, GPs provide outpatient care, thus alleviating waiting lists. After training, alumni have the potential to set up community Gastroenterology pathways which will improve patient experience and reduce the burden on secondary care GI services. We recommend that the GPwER-G programme is adopted nationally with support from regional Integrated Care Boards.ReferenceDarzi. Independent Investigation of the NHS in England 2024.

• Publisher: BMJ Publishing Group LTD
• Subject: Clinics / Colon / Cost analysis / Feedback / Gastroenterology / Quality assurance / Quality control