How can we improve care for patients recovering from acute pancreatitis following discharge from hospital?
| ISRCTN | ISRCTN30583116 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN30583116 |
| Integrated Research Application System (IRAS) | 349680 |
| Central Portfolio Management System (CPMS) | 64883 |
| National Institute for Health and Care Research (NIHR) | 165210 |
| Sponsor | University of Birmingham |
| Funder | National Institute for Health and Care Research |
- Submission date
- 11/06/2026
- Registration date
- 27/07/2026
- Last edited
- 27/07/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Digestive System
Plain English summary of protocol
Background and study aims
Acute pancreatitis is a common condition that causes inflammation of the pancreas and leads to thousands of hospital admissions in the UK each year. Although most people recover enough to leave hospital, many continue to experience health problems after discharge. These can include difficulties with digestion, problems controlling blood sugar, anxiety, depression, and ongoing pain. Some people also return to hospital after they have been discharged.
At present, there is no standard approach to follow-up care after acute pancreatitis in the UK. The PANORAMA study aims to understand what support people need after leaving hospital, how current care pathways are working, and how care could be improved. The researchers also want to identify which patients are most likely to need additional support or further healthcare after discharge. Findings from the study will be used to develop recommendations for future care pathways.
Who can participate?
Different parts of the study involve different groups of people:
1. People aged 16 years or over who have experienced acute pancreatitis and received care through the NHS
2. Family members or carers of people who have experienced acute pancreatitis
3. Healthcare professionals involved in caring for patients with acute pancreatitis, including hospital doctors, specialist nurses, allied health professionals and GPs
4. Patients currently in hospital with acute pancreatitis who are due to be discharged and are able to give informed consent
The study is recruiting participants from across the United Kingdom.
What does the study involve?
The study is made up of five linked work packages (WP).
In WP1, patients, carers and healthcare professionals will be invited to complete a survey about their experiences and views of care after discharge from hospital.
In WP2, some patients and carers will be invited to take part in a virtual interview lasting up to 1 hour. Participants will discuss their experiences after leaving hospital and describe what they think could improve care.
In WP3, healthcare professionals will take part in similar interviews to explore their experiences of supporting patients after acute pancreatitis and their views on how care could be improved.
In WP4, patients who are about to be discharged from hospital after acute pancreatitis will be asked to complete questionnaires about their quality of life, mental health, digestive health and healthcare use. These questionnaires will be completed at discharge and then again after 7 days, 28 days, 3 months and 6 months. Each questionnaire session may take up to 30 minutes.
In WP5, selected patients, carers and healthcare professionals will be invited to attend a workshop to discuss the study findings and help develop recommendations for improving care after acute pancreatitis.
What are the possible benefits and risks of participating?
Participants may not receive any direct medical benefit from taking part. However, their experiences and opinions could help researchers understand how care after acute pancreatitis can be improved. The findings may help shape future services and support for patients recovering from this condition.
The risks of participation are expected to be low. Some people may find it upsetting to discuss their experiences of illness during interviews. If a participant becomes distressed, the interview can be paused or stopped, and information about support services can be provided. Participants in the questionnaire study who report signs of severe mental distress or risk of self-harm will be advised to seek help from NHS 111 or their GP.
Where is the study run from?
The study is sponsored and led by the University of Birmingham and is being conducted in collaboration with NHS hospitals across England and Scotland. Participant data will be managed through secure systems hosted by the University of Birmingham.
When is the study starting and how long is it expected to run for?
July 2026 to September 2027.
Who is funding the study?
The study is funded by the National Institute for Health and Care Research (NIHR).
Who is the main contact?
Dr Michala Pettitt
panorama-study@contacts.bham.ac.uk>
Contact information
Public, Scientific
Public Health Building
University of Birmingham
Birmingham
B15 2TT
United Kingdom
 ORCID ID |
0000-0002-4736-259X |
|---|---|
| Phone | +44 121 415 9106 |
| panorama-study@contacts.bham.ac.uk |
Principal investigator
Public Health Building
University of Birmingham
Birmingham
B15 2TT
United Kingdom
| ORCID ID |
0000-0001-9971-1635 |
|---|---|
| m.j.lee.1@bham.ac.uk |
Study information
| Primary study design | Observational |
|---|---|
| Observational study design | Cohort study |
| Participant information sheet | 49694 PANORAMA WP5 - Participant Information Sheet (Patient) v1.1 (11-May-2026).pdf |
| Scientific title | oPtimising post-dischArge care pathways after acute paNcreatitis: evaluatiOn of health seRvice utilisAtion, outcoMes |
| Study acronym | PANORAMA |
| Study objectives | 1. Develop conceptual framework for a ‘gold-standard’ post-hospital discharge pathway (WP1) 2. Explore patient experience of post-hospital discharge care (WP2) 3. Explore clinician approaches to post-discharge care (WP3) 4. Describe real-world pathways experienced by patients after hospital discharge (WP4) 5. Identify groups at highest risk of use of health care services (WP2&4) 6. Co-produce interventions for post-discharge care pathways (WP5) |
| Ethics approval(s) |
Approved 13/05/2026, South Central - Oxford B Research Ethics Committee (2 Redman Place, Stratford, London, E20 1JQ, United Kingdom; no telephone number provided; oxfordb.rec@hra.nhs.uk), ref: 26/SC/0148 |
| Health condition(s) or problem(s) studied | Acute pancreatitis |
| Methodology | There are 5 Work Packages (WP). These are complementary and intended to inform aspects of the final WP5 (see study summary graphic). WP1: Survey In order to ensure that themes addressed in the interviews cover all relevant aspects of post discharge care, we will undertake a short initial survey. This will recruit 20-40 from each group of patients/carers, secondary care clinicians (surgeons/gastroenterologists), nursing and allied health professionals, and general practitioners. The survey captures key demographic data, and asks participants to consider what opportunities exist to improve care after discharge, up to 6 months after acute pancreatitis. WP2: Patient interviews A topic guide has been prepared and will be refined with information from WP1. We will invite people with lived experience of acute pancreatitis to take part in a virtual interview of up to an hour. People can register an interest in participation following links from posts on social media and through interest groups, charities, and the NIHR Be Part of Research registry. They will be asked to complete a short expression of interest form. The research team will review expressions of interest and aim to recruit people with a range of experiences by looking at age, gender, ethnicity, geographical region, and whether pancreatitis was related to gallstones. When an appropriate participant is found, they will be contacted and the study further discussed with them. Should they wish to proceed, a digital consent form will be completed and a meeting arranged. The meeting will be conducted by a non clinical, experience qualitative researcher, and will be conducted by virtual meeting. The interview will explore experience of post-discharge care after pancreatitis, and what the participant feels might improve this. Should the participant become distressed, the interview will be paused, and terminated if necessary. Signposting to resources such as charities will be undertaken. Participation is complete at the end of the interview. The recording will be transcribed, and then dual coded by two researchers. A theoretical framework of post discharge needs will be developed using a thematic analysis approach. This will provide the patient perspective on post-discharge care. WP3: Clinician interviews A topic guide has been prepared and will be refined with information from WP1. We will invite clinicians who care for people with acute pancreatitis to take part. People can register an interest in participation following links from posts on social media and emails through specialist clinical associations. They will be asked to complete a short expression of interest form. The research team will review expressions of interest and aim to recruit people with a range of experiences by looking at clinical role, and geographical region. When an appropriate participant is found, they will be contacted and the study further discussed with them. Should they wish to proceed, a digital consent form will be completed and a meeting arranged. The meeting will be conducted by a non clinical, experience qualitative researcher, and will be conducted by virtual meeting. The interview will explore experience of post-discharge care after pancreatitis, and what opportunities there are to improve this. This will explore ideas around clinical reasoning and assessment of disease and patient recovery. Participation is complete at the end of the interview. The recording will be transcribed, and then dual coded by two researchers. A theoretical framework of post pancreatitis health risks and pathway opportunities will be developed. This will provide insight into clinical reasoning and priorities. WP4: Cohort study This will recruit people who are due to be discharged from hospital following an episode of acute pancreatitis drawing from several hospitals around the UK. Participants can be approached during their recovery and recruited up to the day of hospital discharge. This is supported by posters in the clinical area, a participant information sheet, and a short video. If a participant consents, they will complete a set of questionnaires on the day of discharge. These relate to quality of life, mental health, and impact of disease on digestion. These are repeated at day 7, 28, 3 months, and 6 months. There is an additional questionnaire about alcohol use at baseline. We will ask about health service use at 28 days, 3 months, and 6 months post discharge. Participants will receive reminders to complete by email, sms, or post. All post discharge contact is with the central research team. The questionnaires may take up to 30 minutes to complete. If a participant reponds to mental health questionnaires indicating high risk of self harm, they will be contacted and advised to seek help via 111 or their GP. This WP will provide data on health utilisation in the 6 months following discharge. It will provide novel data on the development of anxiety or depression, general quality of life, and patient reported symptoms of pancreatic exocrine insufficiency. We will use these data to construct models to allow us to stratify people who are most likely to use health care services following acute pancreatitis. WP5: Implementation workshop People who have shown interest in participation in previous WP will be invited to express interest in participating in a workshop to discuss the findings of the study. We will use purposive sampling to identify those to invite to the workshop. A PIS will be provided to those selected to participate, and consent secured. This will continue until we have a minimum of 20 participants, 10 of whom are patients or carers, and the remainder a mix of health care professionals with roles in care of acute pancreatitis. We will present the findings of the study to the whole group. We will then break off into smaller groups to discuss key themes. It is not yet clear what these are, but they may include dietary intervention, mental health support, stratified follow-up, pain management. Smaller groups of 4-5 participants includind patients and clinicians will discuss a single theme. A facilitator will lead this, using a 'so what, now what' framework. This will encourage reflection, contextualising findings, and encouraging participants to share ideas on how to address these challenges. We will take fields notes on the discussions and compile a list of 'recommendations to change practice' and 'recommendations for further research'. These ideas and reflections will be presented back to the wider group for comment. We will share this list with policymakers, clinicians, patients, and researchers to influence future care. Data will be held on secure servers. Expression of interest and cohort data including PROMS will be captured on REDCap hosted at the University of Birmingham. This is encrypted and password protected, using two factor authentication. |
| Intervention type | Other |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) | |
| Completion date | 30/09/2027 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 16 Years |
| Upper age limit | 100 Years |
| Sex | All |
| Target sample size at registration | 1017 |
| Key inclusion criteria | WP1: Any lived experience of adult acute pancreatitis care in NHS as patient or carer, clinician providing NHS care to patients with acute pancreatitis in secondary or primary care. WP2: Adults (or their carers) with experience of acute pancreatitis care in the NHS within the preceeding six months. Ideally have a conversational standard of English, but translation can be arranged. WP3: Clinicians (surgeons, gastroenterologists, specialist nurses, allied health professionals, GPs) providing NHS care to patients with acute pancreatitis. WP4: People currently admitted to hospital for acute pancreatitis who are due to be discharged. Must be able to consent to participate. WP5: Any lived experience of adult acute pancreatitis care in NHS as patient or carer, clinician providing NHS care to patients with acute pancreatitis in secondary or primary care. Minimum age of participants in any work stream is 16 years old, and participants may be up to 100 years old. |
| Key exclusion criteria | WP1: Must be able to complete survey in English WP2: Must have experienced care as an adult WP3: Non UK clinical practice WP4: Unwilling to consent; no capacity to consent |
| Date of first enrolment | 17/06/2026 |
| Date of final enrolment | 30/09/2027 |
Locations
Countries of recruitment
- United Kingdom
- England
- Scotland
Study participating centres
Mindelsohn Way
Edgbaston
Birmingham
B15 2GW
England
Lydeard House
Musgrove Park Hospital
Taunton
TA1 5DA
England
Beckett Street
Leeds
LS9 7TF
England
Oxford Road
Manchester
M13 9WL
England
Wigginton Road
York
YO31 8HE
England
Prescot Street
Liverpool
L7 8XP
England
Headley Way
Headington
Oxford
OX3 9DU
England
2-4 Waterloo Place
Edinburgh
EH1 3EG
Scotland
Lakin Road
Warwick
CV34 5BW
England
Marlborough Street
Bristol
BS1 3NU
England
Queens Medical Centre
Derby Road
Nottingham
NG7 2UH
England
Hermitage Lane
Maidstone
ME16 9QQ
England
Sandford Road
Cheltenham
GL53 7AN
England
Newton Road
Torquay
TQ2 7AA
England
1055 Great Western Road
Glasgow
G12 0XH
Scotland
Southmead Road
Westbury-on-trym
Bristol
BS10 5NB
England
Stoke-on-trent
ST4 6QG
England
Uttoxeter Road
Derby
DE22 3NE
England
Castle Business Park
Stirling
FK9 4TS
Scotland
Shrewsbury
SY3 8XQ
England
2 Eday Road
Aberdeen
AB15 6RE
Scotland
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | WP2 (Carer) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP2 (Patient) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP3 (Healthcare) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP4 version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP5 (Carer) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP5 (Healthcare) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Participant information sheet | WP5 (Patient) version 1.1 |
11/05/2026 | 22/06/2026 | No | Yes |
| Protocol file | version 1.1 | 11/05/2026 | 22/06/2026 | No | No |
Additional files
- 49694 PANORAMA WP2 - PIS (Carer) v1.1 (11-May-2026).pdf
- WP2 (Carer)
- 49694 PANORAMA WP2 - PIS (Patient) v1.1 (11-May-2026).pdf
- WP2 (Patient)
- 49694 PANORAMA WP3 – Healthcare PIS v1.1 (11-May-2026).pdf
- WP3 (Healthcare)
- 49694 PANORAMA WP4 - Participant Information Sheet v1.1 (11-May-2026).pdf
- WP4
- 49694 PANORAMA WP5 – Healthcare PIS v1.1 (11-May-2026).pdf
- WP5 (Healthcare)
- 49694 PANORAMA WP5 - Participant Information Sheet (Carer) v1.1 (11-May-2026).pdf
- WP5 (Carer)
- 49694 PANORAMA WP5 - Participant Information Sheet (Patient) v1.1 (11-May-2026).pdf
- WP5 (Patient)
- 49694 PANORAMA PROTOCOL v1.1 (11-May-2026).pdf
- Protocol file
Editorial Notes
11/06/2026: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).
