Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG).

Faecal immunochemical testing (FIT) has a high sensitivity for the detection of colorectal cancer (CRC). In a symptomatic population FIT may identify those patients who require colorectal investigation with the highest priority. FIT offers considerable advantages over the use of symptoms alone, as an objective measure of risk with a vastly superior positive predictive value for CRC, while conversely identifying a truly low risk cohort of patients. The aim of this guideline was to provide a clear strategy for the use of FIT in the diagnostic pathway of people with signs or symptoms of a suspected diagnosis of CRC. The guideline was jointly developed by the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology, specifically by a 21-member multidisciplinary guideline development group (GDG). A systematic review of 13 535 publications was undertaken to develop 23 evidence and expert opinion-based recommendations for the triage of people with symptoms of a suspected CRC diagnosis in primary care. In order to achieve consensus among a broad group of key stakeholders, we completed an extended Delphi of the GDG, and also 61 other individuals across the UK and Ireland, including by members of the public, charities and primary and secondary care. Seventeen research recommendations were also prioritised to inform clinical management.

Advanced level nursing in England: organisational challenges and opportunities.

AIM: To explore the background, activities and future development needs of advanced practice nurses within a large NHS Trust in England, allowing for a wider review of the current situation within the UK. BACKGROUND: There are currently no national requirements for advanced practice nursing within the UK, which has led to considerable variability in these roles. Recently, focus has been placed on local governance rather than regulation of advanced practice nursing. However, governance and coordinated workforce planning within the UK is in its infancy. METHODS: An electronic survey was sent to all nurses within one Trust identified as practising at an advanced level; a total of 136 responses were received. RESULTS: The survey identified considerable variation in titles, educational preparation and current activities even within similar roles. Some participants identified the need for more support in undertaking professional development activities. CONCLUSIONS: The findings echo the wider picture within the UK, and point to the need to actively work on developing strategies for governance, education, and succession planning for advanced practice nursing. IMPLICATIONS FOR NURSING MANAGEMENT: In the absence of national regulation, UK NHS Trusts should develop their own registers of advanced practice nurses in order to facilitate improved management, governance and workforce planning systems.