Why NHS services need faster, simpler calprotectin pathways for IBD monitoring

Demand is rising for services across the NHS, and gastroenterology and inflammatory bowel disease (IBD) services are no exception. As the number of people with IBD increases without a substantial change in the financial landscape, services are under pressure to provide the same standard of care to a larger patient cohort. So far in this blog series, we’ve looked at the patient benefits of remote monitoring with the SmarTest® Calprotectin Home test (Preventis®), and how laboratory-comparable results underpin effective IBD service delivery. In this final instalment, we’re taking a closer look at the time and resource savings a more streamlined, patient-led care pathway offers.

The current faecal calprotectin testing pathway is failing IBD teams

Faecal calprotectin is a key biomarker for disease flares in IBD patients and, in theory, enables clinicians to make immediate adjustments to treatments to control the patient’s condition. Across the UK, many IBD services currently rely on faecal calprotectin testing provided by NHS pathology services. These biochemical calprotectin tests – which typically use an ELISA – have high accuracy, but are usually performed at a central laboratory location, requiring shipping of samples to the laboratory and significant hands-on time from clinical scientists. This inevitably leads to long turnaround times, delaying results and forcing clinicians to make empirical treatment decisions. This pathway also has a high administrative burden for IBD teams, requiring significant resources to be dedicated to contacting patients, managing transport logistics, and coordinating with laboratory services. In some cases, incomplete processing or poor quality samples can mean that the entire process must be repeated, further adding to administrative and testing workloads.

The hidden costs of traditional calprotectin testing

This inefficient pathway can contribute to delayed care for patients and puts additional pressure on understaffed teams that are already managing high caseloads. Many nurses find their time filled with administration instead of patient care, as they make requests, prepare kits, ensure patients have collected and sent a sample, track logistics, monitor test progression and field calls from anxious patients awaiting results. Lab-based calprotectin testing also places a high burden on laboratory staff, as tests can be time consuming and require significant hands-on time that could be spent on other tasks.

Long turnaround times for results may also result in worse outcomes for patients. Without the information provided by the test, care teams are often pushed to provide empirical courses of steroids or antibiotics. If calprotectin results later reveal the patient was not experiencing an IBD flare, such prescriptions are, at best, wasteful, but can be detrimental for patients due to the side effects. The alternative is to leave patients with uncontrolled symptoms until calprotectin results are returned and treatments can be adjusted. This can result in flares progressing to the point where patients must be hospitalised, significantly impacting the patient’s life and driving higher costs for the NHS.

Beyond flare detection, the inefficiency of this pathway makes it challenging to meet NICE and BSG requirements for regular monitoring. Guidelines suggest faecal calprotectin testing should be performed at least three times per year, but this is difficult to fit into clinical and laboratory workflows. The current pressures make it hard to create a sustainable monitoring system, and almost impossible to scale-up monitoring any further. New approaches, involving both point-of-care testing and remote monitoring, can potentially reduce the overall burden of calprotectin testing for care teams and laboratory services.

SmarTest allows a proactive, patient-led approach to care, including patient initiated follow-up (PIFU).1
Patients can be supplied with several SmarTest kits at a time, then self-test for routine monitoring or when they believe they are experiencing a flare. This helps to avoid unnecessary appointments and reliance on postal services and laboratory workflows – plus the associated administrative work for IBD teams – while also helping patients to feel more in control of their own care.

Increasing patient engagement in this way not only benefits the patients themselves, but also results in more efficient IBD service delivery. When IBD teams have access to timely, objective data across the entire patient cohort, they can prioritise patients more effectively, and intervene sooner when necessary. On the other hand, patients whose results indicate stable disease don’t need to be seen as often, ensuring that clinical resources are focused where they are needed most.

Efficient IBD monitoring with SmarTest

Traditional calprotectin pathways are slow and inefficient. Complex logistics, hands-on assays and high administrative burdens by IBD care teams mean that results often don’t arrive soon enough for timely care decisions. This can result in sub-optimal treatment outcomes, including hospitalisation, creating additional pressure on services. In contrast, faster, simpler monitoring can enable earlier intervention and more efficient care. Home testing can streamline monitoring, shifting the testing paradigm from reactive to proactive, giving clinical teams the information they need to make effective treatment decisions and provide care to the patients who need it most. This approach transforms the experience for clinicians, nurses, laboratory staff, IBD patients and wider service users alike, promoting better use of resources and ensuring care is provided as efficiently as possible.

Find out more about the benefits of the SmarTest Faecal Calprotectin Home test for your patients.

References

1.  NHS England. Patient initiated follow-up. Accessed 10^th of July 2026. Available at: https://www.england.nhs.uk/outpatient-transformation-programme/patient-initiated-follow-up-giving-patients-greater-control-over-their-hospital-follow-up-care/