Single-round modified Delphi consensus to optimise the care of patients with sickle cell disease across multidisciplinary teams within the NHS
Atoyebi, Wale Velangi, Mark Anie, Kofi A Huemer, Josef Sharpe, Claire C Kesse-Adu, Rachel
Atoyebi, Wale
Velangi, Mark
Anie, Kofi A
Huemer, Josef
Sharpe, Claire C
Kesse-Adu, Rachel
Abstract
OBJECTIVE: Sickle cell disease (SCD) is one of the most common inherited haemoglobinopathies worldwide and the most prevalent monogenic disorder in the UK. Real-world implementation of existing guidance remains variable particularly in emergency and community settings. The study aims to build national consensus among multidisciplinary stakeholders as a crucial first step towards standardising practice and improving outcomes.
DESIGN: Using a single-round modified Delphi methodology, a Steering Committee of six UK-based specialists identified key domains for discussion and generated 48 consensus statements relevant to the care of patients with SCD. Using a four-point scale, a survey including all statements was disseminated among a wider audience of healthcare professionals (HCPs) to determine agreement. The threshold for agreement was set at ≥75%. Eligible participants for this study included National Health Service (NHS) haematologists (adult or paediatric) and clinical or community nurse specialists from across the UK.
RESULTS: In total, 112 completed surveys were received. Consensus (≥75% agreement) was achieved for 46 of 48 statements (96%), including 32 (67%) that reached ≥90% agreement. The strongest consensus (>95%) was observed in statements emphasising the need for: broader access to specialist clinics and multidisciplinary care, prioritisation of community-based management and prevention of end-organ damage, education of emergency department staff on acute SCD management and improved HCP understanding of the multisystem nature of SCD and its psychosocial impacts. Two statements (S37, S43) did not meet the threshold, both concerning variability in adherence to national guidelines and allocation of dedicated SCD funding.
CONCLUSIONS: A modified Delphi consensus achieved national multidisciplinary team expert recommendations to optimise NHS SCD care. These recommendations use expert opinion to clarify priorities, identify resource and education gaps, and aim to standardise practice for consistent, high-level patient care and robust outcome assessment.
MIDER Authors
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Date
2026-07-03
Type
Article
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Citation
Atoyebi W, Velangi M, Anie KA, Huemer J, Sharpe CC, Kesse-Adu R. Single-round modified Delphi consensus to optimise the care of patients with sickle cell disease across multidisciplinary teams within the NHS. BMJ Open. 2026 Jul 3;16(7):e117211. doi: 10.1136/bmjopen-2026-117211.