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New Barrett's oesophagus surveillance guidelines: significant cost savings over the next 10 years on implementation
  1. Rhys Hewett,
  2. Derek Chan,
  3. Jin-Yong Kang,
  4. Andrew Poullis
  1. Department of Gastroenterology, St George's Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Rhys Hewett, Department of Gastroenterology, St George's Hospital, Ground Floor, Knightsbridge Wing, Tooting, London SW17 0QT; rhyshewett{at}doctors.net.uk

Abstract

Objective We aimed to estimate the cost saving (over the next 10 years) by our trust implementing the new British Society of Gastroenterology (BSG) surveillance guidelines for Barrett's oesophagus (BO).

Design Retrospective endoscopy database analysis.

Setting Two endoscopy units of St George's Hospital NHS Trust, London.

Patients Gastroscopy records between 2009 and 2012 were retrieved and patients with an endoscopic diagnosis of BO were identified. BO segment length was recorded and the presence (or absence) of intestinal metaplasia in the oesophageal biopsy samples was reviewed from pathology databases. Patients were then stratified into risk groups in accordance with the new BSG guidelines.

Interventions Nil.

Main outcome measures The projected surveillance costs using the new and the old guidelines were calculated over the next 10 years and the cost saving by the implementation of the new guidelines thus determined.

Results The 10 year projected cost saving for our trust by implementing the new BO surveillance guidelines was £720 330 (or £72 033 per annum). Projected across the NHS, implementation of the new guidance may save £100 million over the next 10 years.

Conclusions All trusts should review their Barrett's surveillance population and implement these new recommendations expeditiously.

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