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Provision of out-of-hours services for acute upper gastrointestinal bleeding in England: results of the 2014–2015 BSG/NHS England national survey
  1. Bahman Nedjat-Shokouhi1,
  2. Michael Glynn2,
  3. Erika R E Denton3,
  4. Simon M Greenfield4
  1. 1Department of Medicine, University College Hospitals, London, UK
  2. 2Department of Medicine, Barts Health NHS Trust, London, UK
  3. 3Department of Radiology, University of East Anglia and Norfolk & Norwich University Hospital, Norwich, UK
  4. 4East and North Hertfordshire NHS Trust, Chairman Clinical Services and Standards Committee to the BSG, Stevenage, Hertfordshire, UK
  1. Correspondence to Dr Simon Greenfield, Gastroenterology Department, Lister Hospital, Coreys Mill Lane, Stevenage, Hertfordshire SG1 4AB, UK; simon.greenfield{at}nhs.net

Abstract

Background There has been a drive to raise the standard of management of acute upper gastrointestinal bleeding (AUGIB) in the UK, including three previous audits, sponsored by the British Society of Gastroenterology (BSG).

Objective To review the results of the latest BSG/National Health Service (NHS) England national survey of endoscopy services in England between 2014 and 2015.

Method All NHS hospitals accepting acute admissions in England (168) were invited to respond to the survey.

Results Overall, 142 hospitals (84%) returned data. 85% of hospitals used a validated risk assessment score at the time of patient's admission. While 80% of hospitals provided a 24/7 endoscopy service for unstable patients, and another 10% were in network to provide an acute service, only 60% performed an endoscopy within 24 hours for stable acute admissions or inpatients with AUGIB. 11% of hospitals operated an out-of-hours ad hoc rota. 43% felt that pressure from routine work affected their ability to offer a next-day oesophagogastroduodenoscopy service, while 20% of hospitals struggled to recruit endoscopists. 28% of units reported that the previous national audit performed in 2013 had a positive influence on service development.

Conclusions This survey has revealed significant deficiencies in provision of services for patients with AUGIB in England, without a significant increase in number of hospitals providing an emergency AUGIB service since the last national audit in 2013.

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Footnotes

  • Contributors BN-S contributed to the design of the survey, analysed the data and wrote the manuscript. ERED and MG contributed to the design of the survey and to the writing of the manuscript. SMG designed the survey, ran the data collection, advised on data analysis and contributed to the writing of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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