Selby College

National Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a 'traffic light' system for risk and a clinical management pathway. To evaluate this care pathway. The care pathway was introduced into five primary care practices for a period of six months and the clinical outcomes of patients were evaluated. Negative and positive predictive values (NPV and PPV) were calculated. GP feedback of the care pathway was obtained by means of a web-based survey. Comparator gastroenterology activity in a neighbouring trust was obtained. The care pathway for FC in primary care had a 97% NPV and a 40% PPV. This was better than GP clinical judgement alone and doubled the PPV compared with the standard FC cut-off (250 mcg/g and were diagnosed by 'straight to test' colonoscopy within three weeks. The care pathway was considered helpful by GPs and delivered a higher diagnostic yield after secondary care referral (21%) than the conventional comparator pathway (5%). A care pathway for the use of FC that incorporates a higher cut-off value, a 'traffic light' system for risk and supports clinical decision making can be achieved safely and effectively. It maintains the balance between a high NPV and an acceptable PPV. A modified care pathway for the use of FC in primary care is proposed.

Teaching Poetry is an indispensible source of guidance, confidence and ideas for all those new to the secondary English classroom. Written by experienced teachers who have worked with the many secondary pupils who ‘don’t get’ poetry, this friendly guide will help you support pupils as they access, understand, discuss and enjoy classic and contemporary poetry. With an emphasis on active approaches and the power of poetry to enrich the lives of both teachers and students, Teaching Poetry: Provides a succinct introduction to the major ideas and theory about teaching poetry Covers the key genres and periods through tried and tested favourites and a range of less well known new and historical poetry Illustrates good practice for every approach covered, through case studies of theory and ideas in action in the classroom Includes activities, ideas and resources to support teaching at Key Stages 3, 4 and 5. Teaching Poetry tackles head on one of the aspects of English teaching that new and experienced teachers alike find most difficult. It offers both a comprehensive introduction to teaching poetry and a rich source of inspiration and support to be mined when faced with an unfamiliar text or an unresponsive class.

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