This quality improvement project was undertaken within a large UK-based Inflammatory Bowel Disease (IBD) service to address increasing demand on the nurse-led helpline. Serving a population of approximately 530,000, with over 2,850 recorded IBD patients across five hospital sites, the service experienced significant clinical fatigue due to high levels of non-urgent patient contact. In response, the IBD team developed and distributed a standardised advisory letter to approximately 2,500 known patients, aimed at setting clearer expectations around helpline use. This was accompanied by centralising incoming calls through the medical secretarial team, removing direct mobile access to IBD nursing staff. Evaluation at the largest site, responsible for around 55% of the service's patients, showed a sustained reduction in call volume, with individual monthly decreases of up to 45% compared to pre-intervention data. Beyond measurable outcomes, the intervention improved clinical efficiency, allowed more time for priority patient care, and highlighted the importance of maintaining a consistent and accurate patient database. These changes have now been embedded into routine practice, with long-term sustainability demonstrated into 2025.
Dominic Devine (2026) studied this question.