I read my own report this morning and some of this made for uncomfortable reading. Whilst we were quite good at providing information about IBD and the use of steroids, our lack of IBD nurses meant that many aspects of our service were below what I considered to be acceptable. These are all vital aspects for patients and it is incumbent on all of us to do what we can do to improve our service.

The benchmarking tool and patient survey will be repeated again in two years’ time. Some aspects contained within these reports will be very difficult to change. These are typically structural and institutional issues such as waiting times. However this can be done. For example, we have recently developed a strategy, based on faecal calprotectin, that will allow general practitioners to refer patients with probable IBD to a specific pathway to ensure they do not wait an unacceptable time. There will also be aspects of your service that are within your control and are easier to change. These need to be done now.

Leadership and team working are critical to changing your service successfully. Most of you who have taken part will have an IBD team lead and working with them as a team to examine your report, decide on priorities and approach the key targets on a team basis (whilst having clarity around who does what) will see a great return. Sometimes embarking down the QI path is daunting and many are dissuaded by the prospect of an overwhelming work load. Team working is vital; if you spread the burden you can achieve significant change and this will improve the experience of living with these diseases.