Charlie Andrews talks to Dr Anthony (Tony) Wisken, Consultant Paediatric Gastroenterologist in Bristol.

The Ingest podcast is hosted by Dr Charlie Andrews a GPwER in gastroenterology based near Bath. Charlie works as a GP partner at Somer Valley Medical Group, trained as an endoscopist and leads the national GPwER in gastroenterology training programme, launched in 2023 in the southwest of England. Charlie is a committee member of the PCSG (Primary Care Society of Gastroenterology). For more information visit pcsg.org.uk

With significant waiting lists and growing demand for secondary care services, Advice and Guidance is being increasingly explored as one potential solution to this problem.

In this episode, Charlie Andrews discusses an innovative and extremely successful use of advice and guidance in Northumbria with gastroenterologists Matthew Warren and Richard Thomson. Through the enhanced use of advice and guidance for all incoming referrals for secondary care input, they have demonstrated a significant reduction in waiting times for routine outpatient care.

They discuss their advice and guidance model, and what they have learned from developing this service and the impact it has been having on their waiting times, and how it has been received by primary care colleagues (3:30). We go on to discuss some common advice and guidance queries that Matt and Richard see (19:30) and I ask the question - what makes a good advice and guidance query? (43.30).

Key takeaways from the IBS Part 1 episode of the PCSG Ingest podcast:

Diagnosis of IBS

The episode is focused on making a diagnosis of Irritable Bowel Syndrome (IBS)and features Dr. Anton Emmanuel, a consultant gastroenterologist and Professor of neuro-gastroenterology at University College Hospital London.

Importance for Primary Care

• IBS is a common condition that primary care clinicians need to have a structured approach to diagnosing.

Topics Covered

• Causes of IBS
• Different subtypes of IBS
• Challenges in making a positive diagnosis

Clinical Pearls

Dr. Emmanuel shares several insights:

• Key questions to include in the patient history
• How to describe the condition to patients
• Practical tips for enhancing IBS diagnosis in primary care

Diagnostic Approach

The episode emphasises the importance of:

• Taking a structured approach to diagnosis
• Understanding the various presentations of IBS
• Recognizing the challenges in making a definitive diagnosis

Patient Communication

Guidance is provided on:

• Explaining IBS to patients effectively
• Addressing patient concerns and misconceptions

Additional Resources

The episode mentions useful guidance from the British Society of Gastroenterology, which listeners were encouraged to reference for more detailed information. Part 2 focusing on the management of IBS to be released soon.

bsg.org.uk/clinical-resource/british-society-of-gastroenterology-guidelines

The Ingest podcast is hosted by Dr Charlie Andrews a GPwER in gastroenterology based near Bath. Charlie works as a GP partner at Somer Valley Medical Group, trained as an endoscopist and leads the national GPwER in gastroenterology training programme, launched in 2023 in the southwest of England. Charlie is a committee member of the PCSG (Primary Care Society of Gastroenterology). For more information visit pcsg.org.uk