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Abstract

The author will start by defining ambulatory care particularly in the sphere of colorectal disease. We will present what is available now worldwide but focus on current UK practice and the evidence for it. An economic model is presented for typical ambulatory colorectal services (ACS) in the NHS. The current and proposed structure of ACS will be summarized including integration with gastroenterological, endoscopic, radiology and day surgery services for minor coloproctogical procedures. In addition, a model of care for re-sectional surgery is presented encompassing patient selection, the tenets of enhanced recovery in surgery (ERAS), laparoscopic surgery, pre, peri and anesthetic care, 24 hour surgery wards, 2-5 day surgical facilities and integration with community or �hotel� based services. The role of multi-disciplinary teams (MDTs) in the management of ACS is discussed: core and extended members of the MDT defined and the overall focus on patient directed care. Current and future directions in provision of ACS will be summarized with focus on use of virtual technology to establish clinics and MDTS; social media; the increasing role of e and mHeatlh will be presented. A future patient focused clinical and economical model of ACS will be proposed with relevance for it in different health care systems

Biography

Email: pawan.mathur@nhs.net