SP 2.11 Variation in Acute Pancreatitis Service Provision Across UK Centres: A National PANDORA Site Survey

Background

Acute pancreatitis is a common surgical emergency, with patient outcomes influenced by timely access to specialist services and multidisciplinary care.

Methods

A national pre-audit site survey was conducted as part of the national PANDORA acute pancreatitis audit. Participating centres completed a structured questionnaire assessing organisational pathways and access to specialist services for acute pancreatitis management.

Results

114 centres completed the survey, comprising 14 tertiary pancreatic centres and 100 acute general hospitals. There was marked variation in service provision. Only 4% of centres reported 24/7 on-site ERCP access, 90% provided limited on-site ERCP access restricted to in-hours or scheduled lists, while 6% relied on referral to other trusts.

Access to interventional radiology (IR) was also variable; 44% of centres reported 24/7 on-site IR availability, 55% provided limited in-hours services, and 13% had no on-site IR, including one centre with no IR access. Access to tertiary services also varied, with 27% of centres reporting access to a formal acute pancreatitis MDT, and 57% relied on referral-only pathways for patient requiring tertiary management. 9% used informal advice models, and 6% reported no tertiary access.

Conclusion

There is substantial variation in acute pancreatitis service provision across UK centres. True 24/7 access to key specialist services, including ERCP and interventional radiology, is limited to a minority of hospitals, with clear differences between tertiary centres and other acute hospitals. These findings highlight potential inequalities in access to specialist care and provide an important baseline for benchmarking and service development ahead of patient-level audit data.