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Improving acute upper GI bleeding services in a district general hospital

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We read with interest the articles by Ramiah and Wurm1 and Shokouti et al2 regarding gastroscopy (OGD) provision for acute upper gastrointestinal bleeding (AUGIB). Both groups started with no formalised provision outside normal weekday working hours. They both instituted simultaneously a 7-day service and 24-h on-call cover. It is therefore not clear from their outcome data which of these changes is mainly responsible for any service improvement achieved.

In our hospital, starting from a position with no system for prioritising OGD for AUGIB, we first …

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