Dr Richard Ingram

GI (gastro-intestinal bleeding)

Guts UK caught up with Dr Richard Ingram, who led a network of trainee doctors in successfully applying for the Guts UK/BSG Trainee Research Awards. The team conducted their research into gastro-intestinal bleeding.

Our guts have been underfunded, understaffed and undervalued for decades.

These awards inspire the bright, enquiring minds of junior doctors at the start of their career, our way of ensuring our future leaders and researchers remain within gastroenterology.

Once published, their study made it into the top 30 most read United European Gastroenterology Journal (UEGJ) articles ever, in just three weeks!

Talk us through your project

Our project was focussed on gastrointestinal (GI) bleeding, for example caused by a stomach ulcer.

Over 50 junior doctors across 19 hospital sites in the East and West Midlands were involved. Our networks conceived, developed and delivered the first regional and multi-regional trainee-led network projects in UK gastroenterology. We were also really lucky that our colleagues in the North West established their own regional network soon after and joined in with the project.

We audited the care received by any adults admitted to hospital with GI bleeding over a 30 day period, who had an endoscopy to diagnose and/or treat the bleeding. The audit was against national and international standards of care. We were able to bring together anonymous data for 458 patients across 29 hospitals.

This is the power of having a network of trainees across different hospitals/regions all working towards the same goal.

Why did you choose to address GI bleeding?

There were three main reasons behind choosing GI bleeding as our project focus:

Firstly, GI bleeding is a common emergency that affects a lot of people in the UK.

Secondly, there are several evidence-based assessments and treatments that, if all done consistently as part of a “bundle of care”, mean that people who have GI bleeding may have better outcomes (like recovering and being able to go home from hospital more quickly).

Finally, as this was a project involving doctors in specialty training to become gastroenterologists, we felt it was important to focus on a major area in the day-to-day work of almost all gastroenterologists.

One aim of your project planned to improve quality of care received by using a care bundle. Can you tell us if you have been able to do this and what is the situation now?

Actually, a larger national project was established around the same time to develop a care bundle for GI bleeding. Our project and some of the people involved were able to contribute to this work. So there is now a care bundle available that can help our patients to receive the best quality care, which is great!

Now the national bundle needs to be fully implemented and its success evaluated by repeat audit projects, across multiple regions and perhaps nationally. Trainee networks are ideally placed to drive and deliver these types of quality improvement projects.

How important was the award you received from Guts UK/BSG in helping you begin your research?

This type of project is not expensive. The main challenges were coordinating between lots of people and different hospitals, then sifting through all the data. However, there are some general costs for trainee research networks that the Guts UK/BSG awards can really help to support.

For me, the most important benefit from our award was that more people have been getting involved. When trainees are enthused to work together with their colleagues across different hospitals and regions, rather than working in isolation for themselves, this means that more patients can receive better care.

Why do you believe Guts UK/BSG’s trainee awards are important?

The Guts UK/BSG awards specifically support the next generation of bright young minds. Trainees can bring fresh insights and then share this knowledge, as they rotate between different hospitals and catch up at regional and national meetings. My hope is that more trainees will also learn, earlier in their careers than they otherwise might, of the benefits (and challenges!) of working together with others as part of a larger network.

Anyone can be involved in a trainee research network: specialty registrars training to become GI specialists, allied health professionals, junior doctors thinking about training in gastroenterology, medical and nursing students etc. So the awards support the next generation of clinicians, researchers and scientists, and can encourage health workers to choose and remain within gastroenterology.

Another great thing is that a relatively small amount of money goes a long way. The centralised coordination and support provided through the BSG really helps trainee networks to grow and flourish, and importantly to deliver benefits for patient care.

If you’re a researcher/research network interested in applying for these awards, click here.