SURGE is a national audit of how acute lower gastrointestinal bleeding is managed across UK hospitals. By linking patient outcomes with local service availability, the study aims to identify variations in care and opportunities to improve treatment pathways and resource use.
What issue does this study address?
Lower gastrointestinal bleeding (bleeding from the bowel) is one of the most common reasons for urgent hospital admission. While bleeding settles quickly for many patients, for others it can be life-threatening – requiring blood transfusions, intensive care, urgent scans, endoscopy, radiology procedures, or surgery. Access to these procedures affects patient safety, length of stay, recovery, and use of scarce NHS resources such as blood products.
UK guidance on the assessment and management of lower bowel bleeding was published in 2019, yet there is no contemporary national picture of everyday practice. Since the last national audit in 2016, care has changed significantly. More patients now take blood-thinning medicines (including newer drugs known as DOACs), hospitals are facing increasing pressure on beds and endoscopy services, and blood supplies are under strain. Without up-to-date national data, it is difficult to identify unwarranted variation, gaps in care, or priorities for improvement.
What are the aims and how could this work help?
SURGE will harness the UK surgical trainee research collaborative model to deliver a rapid, high-quality, prospective national study across NHS hospitals. Research collaborators have a proven track record, recently completing the MAGIC study of abscesses across 54 UK sites and currently running PANDORA – a national audit of pancreatitis care, at 99 confirmed sites. Using this established infrastructure, SURGE will collect standardised data on patients admitted with lower bowel bleeding alongside information on local service availability. By linking patient outcomes with service organisation, SURGE will generate actionable insights to improve care pathways and inform future research for people affected by bowel bleeding across the UK.
The research team
This research will be led by Ms Hayley Fowler at University of Manchester.