Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

The national census of UK endoscopy services 2021

Srivathsan Ravindran, Siwan Thomas-Gibson, Madeline Bano, Emma Robinson, Anna Jenkins, Sarah Marshall, Hutan Ashrafian, Ara Darzi, Mark Coleman and Chris Healey
Download PDF
DOI: https://doi.org/10.7861/fhj.9-2-s16
Future Healthc J July 2022
Srivathsan Ravindran
AJoint Advisory Group on Gastrointestinal endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Siwan Thomas-Gibson
BSt Mark's Hospital, Harrow, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Madeline Bano
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Emma Robinson
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anna Jenkins
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sarah Marshall
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hutan Ashrafian
DImperial College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ara Darzi
DImperial College London, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark Coleman
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Chris Healey
CJoint Advisory Group on GI Endoscopy (JAG)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Introduction

The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) biennial census provides an insight into the provision of UK endoscopy services.1,2 Since the last census 2 years ago, there has been a significant change in every aspect of endoscopy, brought on by the COVID-19 pandemic.3–5 We report on the 2021 census which was conducted to understand both the impact of COVID-19 and ongoing pressures on endoscopy services.

Methods

The JAG Quality working group developed an initial question set which was refined and reviewed by key JAG stakeholders. The census was disseminated to all JAG-registered services in April 2021 using an online survey platform. Prior to analysis, any missing data from services were sought as part of a second-step verification process. Data were analysed across the domains of endoscopic activity, waiting time targets, workforce, COVID-19, safety, gastrointestinal (GI) bleeding, anaesthetic support, equipment and decontamination. Outcome variables from each section of the census were analysed against independent variables derived from service-specific core demographic data (JAG accreditation status, sector and region) using a variety of statistical methods. Statistical significance is indicated by p<0.05.

Results

Overall, 321 services completed the census, with information pertaining to 393 individual units (response rate 79.2%). In the first 3 months of 2021, 66.0% of services met urgent cancer waits, 38.7% met routine waits and 33.9% met surveillance waits (Fig 1). Workforce redeployment was the predominant reason cited for not meeting targets. There were significant regional differences in the proportion of patients waiting 6 or more weeks (p=0.001). During the pandemic, 64.8% of NHS endoscopy services had staff redeployed and there was a mean sickness rate of 8.5% with no clear variation across sectors or regions. Endoscopic activity was outsourced. Services were, on average, at 79.3% activity compared with 2 years ago. JAG accredited services were more likely to meet urgent cancer waits, with a lower proportion of patients waiting 6 weeks or more (p=0.03). Clinical endoscopists, who make up 11.0% of the endoscopist workforce, had a significantly greater number of annual planned sessions per individual than consultant colleagues (p<0.001), who make up 81.0% of the workforce (Fig 2). Out of acute services, 86.9% had access to out-of-hours GI bleed cover. Anaesthetist-supported lists were provided in 65.4% of services. Over 10% of services stated that equipment shortage interferes with service delivery. Overall, 42.7% of services would require additional building works to decontaminate more scopes.

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

Clustered bar chart demonstrating percentage of services meeting waiting time targets over successive census years.

Fig 2.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 2.

Scatter diagram of planned annual sessions per individual by number of individuals, defined as clinical or consultant endoscopist.

Conclusion

Services are adapting to continued pressure and there are signs of a focused response to demand during a time of ongoing uncertainty. Adherence to service performance was more likely in JAG accredited services. Additionally, a significant minority of services reported equipment shortage and the need to improve infrastructure. These findings will inform ongoing guidance from JAG and key stakeholders.

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. Shenbagaraj L
    , Thomas-Gibson S, Stebbing J, et al. Endoscopy in 2017: a national survey of practice in the UK. Frontline Gastroenterol 2019;10:7–15.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Ravindran S
    , Bassett P, Shaw T, et al. National census of UK endoscopy services in 2019. Frontline Gastroenterol 2021;12:451–60.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    1. Rutter MD
    , Brookes M, Lee TJ, et al. Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection: a National Endoscopy Database Analysis. Gut 2021;70:537.
    OpenUrlAbstract/FREE Full Text
  4. ↵
    1. Hayee B
    , Thoufeeq M, Rees CJ, et al. Safely restarting GI endoscopy in the era of COVID-19. Gut 2020;69:2063–70.
    OpenUrlFREE Full Text
  5. ↵
    1. Rees CJ
    , East JE, Oppong K, et al. Restarting gastrointestinal endoscopy in the deceleration and early recovery phases of COVID-19 pandemic: Guidance from the British Society of Gastroenterology. Clin Med 2020;20:352–8.
    OpenUrlAbstract/FREE Full Text
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
The national census of UK endoscopy services 2021
Srivathsan Ravindran, Siwan Thomas-Gibson, Madeline Bano, Emma Robinson, Anna Jenkins, Sarah Marshall, Hutan Ashrafian, Ara Darzi, Mark Coleman, Chris Healey
Future Healthc J Jul 2022, 9 (Suppl 2) 16-17; DOI: 10.7861/fhj.9-2-s16

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
The national census of UK endoscopy services 2021
Srivathsan Ravindran, Siwan Thomas-Gibson, Madeline Bano, Emma Robinson, Anna Jenkins, Sarah Marshall, Hutan Ashrafian, Ara Darzi, Mark Coleman, Chris Healey
Future Healthc J Jul 2022, 9 (Suppl 2) 16-17; DOI: 10.7861/fhj.9-2-s16
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Methods
    • Results
    • Conclusion
    • References
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Service evaluation of the impact of direct ambulance calls from paramedics to the ambulatory assessment unit in the John Radcliffe hospital, Oxford
  • A case for a bottom-up approach in the implementation of health policy in Africa
Show more Research and innovation

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians