Inflammatory bowel disease (IBD) affects more than 500,000 people in the UK – a number that continues to grow year on year – and places a significant burden on the NHS, with annual costs estimated at around £720 million.1 The condition is characterised by unpredictable flare-ups and periods of remission, and can cause debilitating symptoms such as abdominal pain, episodes of mucoid and bloody diarrhoea, and fatigue, all of which have a profound impact on quality of life. Each flare may lead to urgent clinical intervention, diagnostic testing, hospital admission and therapeutic escalation, placing a heavy load on already stretched services and costing the NHS over £10,500 per patient per year.2 In this blog, we will discuss faecal calprotectin testing for IBD management, and relay the benefits of at-home testing experienced by leading IBD clinics in the UK.
The movFaecal calprotectin testing to monitorement towards at-home IBD testing for the NHS
Faecal calprotectin is a sensitive and specific biomarker for gut inflammation, and regular monitoring can provide an early warning of IBD relapse before symptoms escalate. Traditionally, NHS patients collect stool samples at home using kits assembled and mailed out by their hospital, then return them within 48 hours via their GP or directly to the clinic. These samples are then tested for faecal calprotectin by the hospital laboratory alongside patient samples that are undergoing routine diagnostic testing in accordance with the NICE guidelines,3 allowing triage of patients presenting with IBS/IBD symptoms. However, for patients with Crohn’s disease or ulcerative colitis, real-time results are needed for disease activity monitoring, especially if a patient is experiencing symptoms of a flare-up or loss of response to treatment, when timely results are critical to outcome. The slower turnaround of results from laboratory testing could impede appropriate interventions, limiting the effectiveness of monitoring programmes. Patient feedback has also shown that, in practice, returning stool samples to the GP or directly to the clinic can be a complex process or logistical challenge, particularly during a possible relapse, reducing patient compliance.
The movement towards at-home IBD testing for the NHS
Faecal calprotectin is a sensitive and specific biomarker for gut inflammation, and regular monitoring can provide an early warning of IBD relapse before symptoms escalate. Traditionally, NHS patients collect stool samples at home using kits assembled and mailed out by their hospital, then return them within 48 hours via their GP or directly to the clinic. These samples are then tested for faecal calprotectin by the hospital laboratory alongside patient samples that are undergoing routine diagnostic testing in accordance with the NICE guidelines,3 allowing triage of patients presenting with IBS/IBD symptoms. However, for patients with Crohn’s disease or ulcerative colitis, real-time results are needed for disease activity monitoring, especially if a patient is experiencing symptoms of a flare-up or loss of response to treatment, when timely results are critical to outcome. The slower turnaround of results from laboratory testing could impede appropriate interventions, limiting the effectiveness of monitoring programmes. Patient feedback has also shown that, in practice, returning stool samples to the GP or directly to the clinic can be a complex process or logistical challenge, particularly during a possible relapse, reducing patient compliance.
The mFaecal calprotectin home testing for IBD managementovement towards at-home IBD testing for the NHS
Switching IBD care over to a PIFU pathway requires self-assessment tools that enable individuals to confidently monitor their own conditions at home. For IBD, reliable, non-invasive tools – such as the SmarTest® Faecal Calprotectin Home Test – now allow patients to track their disease activity outside of a hospital setting, easing pressure on hospital and laboratory services. This simple, portable faecal calprotectin test employs gold-conjugated anti-calprotectin antibodies in a lateral flow format, providing results in just 15 minutes. Unlike more complex home kits, SmarTest is compact, fast, intuitive to use and can be stored at room temperature, making it easy for patients to incorporate testing into daily life. The accompanying smartphone app offers step-by-step animated instructions and automatically reads and interprets the lateral flow test, calculating faecal calprotectin levels across a broad detection range with clearly defined thresholds. The real-time availability of results enables patients to initiate their own follow-ups when they require clinical support. Results are also automatically shared with the patient’s clinical team, ensuring that treatment efficacy and disease progression can be monitored remotely as part of routine disease management. Several NHS IBD clinics across the country – such as St Mark’s Hospital in London – are already using SmarTest for at-home patient testing, providing access to real-time results that allow timely and confident clinical decisions, dosage adjustments or follow-up investigations.
With the standard service, by the time calprotectin results come back, the patient’s condition may have changed, so the result may no longer reflect the clinical reality. The SmarTest app notifies us of the results immediately, allowing us to intervene quickly in the event of a flare or other complication.
Tracey Tyrrell, Lead IBD Advanced Nurse Practitioner, St Mark’s Hospital
This quick intervention helps to reduce the need for in-person appointments and hospitalisation, enabling healthcare workers to focus more time on those patients that need immediate help, such as those in a severe flare situation, or those who are unable to use digital tools. For example, over the course of one recent trial where SmarTest was integrated with a dedicated digital IBD patient management platform, the IBD care team at University Hospital Southampton (UHS) NHS Foundation Trust was able to extend the time between in-person outpatient appointments from 118 days in January 2023 to 364 days in January 2025.8 Early results show a reduced need for diagnostic endoscopy, faster treatment initiation, shorter hospital stays and more efficient use of clinical time within IBD care, potentially leading to further cost savings in the long term.8
Validated home faecal calprotectin tests can be equivalent to the laboratory tests that we would normally perform in secondary care. The digital integration of the home calprotectin test result with our system allows patients to essentially conduct their own digital outpatient appointment with virtual clinical supervision by our IBD team.
Dr Markus Gwiggner, Consultant Gastroenterologist, UHS NHS Foundation Trust
In addition to the measurable clinical benefits, IBD clinics are also observing important patient-centred gains. St Mark’s Hospital found that SmarTest home calprotectin testing places patients firmly at the centre of their own care, offering a more convenient approach that improves compliance while reducing stress and embarrassment. Similarly, IBD nurses at Queen Alexandra Hospital in Portsmouth have reported that the faster turnaround of results enables more timely and precise treatment decisions. As a result, patients are experiencing fewer flare-ups and greater disease stability, allowing them to maintain daily routines, return to work more quickly and participate more fully in everyday life.
“SmarTest has been a game changer for us – it’s easy, patient friendly and allows us to provide treatment more quickly. Instead of waiting weeks or treating based on symptomatic indications alone, we now have the diagnostic data we need almost immediately.”
Dayna Tulloch, Lead Inflammatory Bowel Disease Nurse Specialist, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust
Advancing IBD care
Advances in the management of IBD are revolutionising how patients engage with their condition and treatment, shifting from a traditionally clinic-centred model to one that offers more patient autonomy. Integrating at-home and patient-led therapies with remote testing technologies for faecal calprotectin empowers patients to actively monitor and manage their IBD from the comfort of their own homes. This helps to maintain proactive communication between patients and healthcare providers, ensuring that clinical teams have oversight of their patients’ conditions while keeping in-person follow-ups to a minimum. At-home testing therefore shows considerable benefits for reducing the resource burden of regular appointments and hospital investigations on the NHS, supporting a more resilient future for healthcare services.
References
- All about Crohn’s and Colitis. 2024. Crohn’s and Colitis UK. Accessed 3rd September 2025. Available from: https://crohnsandcolitis.org.uk/media/jppjhz3h/all-about-crohns-and-colitis-ed-8a-2024_final.pdf
- IBD UK. Crohn’s and Colitis Care in the UK The Hidden Cost and a Vision for Change. Accessed 16th May 2025. https://s3.eu-west-2.amazonaws.com/sr-crohns-craft/documents/CROJ8096-IBD-National-Report-WEB-210427-2.pdf
- National Institute for Health and Care Excellence. (2013). Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel. Accessed 3rd September 2025. Available from: https://www.nice.org.uk/guidance/dg11
- Whicher, T. Why PIFU could transform outpatient care. Clinical Services Journal. Published online May 19, 2022.
- The NHS Long Term Plan. https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/
- The King’s Fund. The government’s 10-year plan for health and care. https://www.kingsfund.org.uk/insight-and-analysis/projects/governments-long-term-plan-health-and-care
- NHS England. Integrating in vitro point of care diagnostics: guidance for urgent community response and virtual ward services. https://www.england.nhs.uk/long-read/integrating-in-vitro-point-of-care-diagnostics-guidance-for-urgent-community-response-and-virtual-ward-services/.
- Gwiggner M, et al. P323 Calprotectin home testing with digital integration into the electronic health record (EHR) in an inflammatory bowel disease (IBD) support service. Gut. 2025;74:A288. doi:10.1136/gutjnl-2025-BSG.456.