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Introduction IBD advice lines provide rapid access to specialist advice and support symptom management. Published UK-wide evidence of clinical and economic benefit remains limited. This study describes current IBD advice line provision across the UK, maps service delivery, and captures experience of delivering and managing IBD advice line services.Methods A novel cross-sectional survey developed by an expert panel and informed by prior scoping work was distributed electronically to IBD nurses via professional networks and social media.Services leads provided servicelevel data, and clinicians involved in advice line provision reported their experience of delivering advice lines. Descriptive analysis was undertaken.Results 177 responses received, 76 from service leads. Respondents were based in teaching hospitals (n=85; 49%), district general hospitals (n=62; 35%), and specialist centres (n=19; 16%). 98% (n=174) reported an active advice line with 3 reporting closures. Since 2020, 76% indicated increased call volumes (n=58), predominantly by 11–30 additional contacts per week (n=34, 47%).58% of IBD nurses were Band 7 (n=102), with Band 6 (n=47; 27%) and Band 8 (n=28; 16%). 40% had >10 years of IBD nursing experience (n=70, 40%). Prescribing qualifications were held by 56% (n=100), with 12% in training (n=22).Formal medical support was absent in 70% services (n=53). Where present this was usually ad hoc (n=13, 57%) rather than structured daily consultant (n=9, 39%) or registrar (n=4, 17%) input. Senior non-medical support was reported by 22 (29%), most often advanced practitioners (n=13, 59%) or specialist pharmacists (n=8, 36%).The most frequently cited challenges were high call volumes (n=129, 73%), call complexity (n=131, 74%), lack of urgent clinic slots (n=116, 66%), insufficient medical support (n=76, 43%), and insufficient administrative support (n=71, 40%).Facilitators included adequate staffing (113; 64%), MDT support (n=105; 59%), access to urgent clinic slots (n=88; 50%), and administrative support (n=82; 46%). Managing patient expectations (150, 85%) and sharing the workload (n=122, 69%) were the most effective strategies for sustaining advice services.Conclusion IBD advice lines remain widely available across the UK, operating under increasing pressure from rising demand and growing complexity of patient queries. Variability in medical and administrative support, alongside limited access to urgent review pathways, place significant strain on service delivery. However, services reporting adequate staffing, MDT support, access to urgent clinic slots, and administrative input consistently identified these as key facilitators of sustainability. Strengthening workforce capacity, improving access to urgent assessment, and embedding consistent support structures are therefore critical to sustaining safe, equitable, responsive IBD advice line provision.