Although the administrative burden of the endoscopy quality improvement programme is immense, these measures have undoubtedly had a very positive impact on patient-centred endoscopic care in the UK.

The first large UK audit of colonoscopy standards undertaken by Bowles et al revealed a caecal intubation rate (CIR) of only 56.9% from 9223 procedures.1 The potential implications of this poor national performance were significant. One of the most important indications for colonoscopy is to prevent colorectal cancer deaths by detecting cancer at a curative stage or removing potentially cancerous polyps. Low CIRs are associated with colorectal cancer in patients who have undergone a colonoscopy in the past;2 therefore, the number of ‘missed’ cancers was likely to be unacceptably high in the UK at the time of this audit. The audit also highlighted that improvements needed to be made before the introduction of colorectal screening.

Following this audit, the Joint Advisory Group on Gastrointestinal …