A SERVICE EVALUATION OF UNITED KINGDOM ENDOSCOPY USING THE NATIONAL ENDOSCOPY DATABASE

Aims The aim of this study was to undertake an evaluation of current UK endoscopy practice, to inform service planning.

Methods Data on all procedures between 1^st Mar 2019 – 29^th Feb 2020 were extracted from the national endoscopy database (NED). Endoscopy activity was assessed and the endoscopist workforce was described.

Results Overall 1,639,640 endoscopic procedures were performed (OGD 693,663; colonoscopy 586,464; flexible sigmoidoscopy 335,439; ERCP 23,074), at 407 sites (79% of UK total) by 4990 endoscopists. Median patient age was 59 (IQR 49-71) but was substantially younger in the independent sector; age-specific procedure rates for OGD and colonoscopy peaked in 75-79 year-olds. 51% were female. 89% of procedures were performed in NHS sites. 17% took place each weekday, 10% on Saturdays and 6% on Sundays. Training procedures comprised 6% of procedures, over 99% of which took place in NHS sites.

Endoscopists were predominantly male (74%), while gastroenterologists and surgeons each comprised one-third of the endoscopist workforce. Non-medical endoscopists comprised 12% of the workforce, yet undertook 23% of procedures. 12% of UK sites did not use non-medical endoscopists. Approximately half of endoscopists performing OGD (52%) or colonoscopies (48%) did not meet minimum recommended numbers of annual procedures.

Conclusions We have identified that half of all endoscopists perform fewer than the recommended minimum annual numbers of procedures – this particularly affects medical endoscopists. A national strategy to address this, along with expansion of the non-medical endoscopist workforce, will help increase endoscopist capacity, which could be used to exploit the substantial endoscopy capacity that is available at weekends.

Publication History

Article published online:
14 April 2022