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Impact of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) on endoscopy services in the UK and beyond
  1. Keith Siau1,2,3,
  2. John T Green2,4,
  3. Neil D Hawkes2,5,
  4. Raphael Broughton2,
  5. Mark Feeney2,6,
  6. Paul Dunckley2,7,
  7. John Roger Barton2,8,
  8. John Stebbing2,9,
  9. Siwan Thomas-Gibson2,10,11
  10. on behalf of the Joint Advisory Group on Gastrointestinal Endoscopy
  1. 1 Endoscopy Unit, Dudley Group NHS Foundation Trust, Dudley, UK
  2. 2 Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
  3. 3 College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  4. 4 Department of Gastroenterology, Cardiff and Vale University Health Board, Cardiff, UK
  5. 5 Department of Gastroenterology, Cwm Taf University Health Board, Llantrisant, UK
  6. 6 Department of Gastroenterology, South Devon Healthcare NHS Foundation Trust, Torquay, UK
  7. 7 Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK
  8. 8 Newcastle University Medicine Malaysia, Nusajaya, Johor, Malaysia
  9. 9 Department of GI Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  10. 10 Wolfson Unit for Endoscopy, St Marks Hospital, Harrow, UK
  11. 11 Imperial College London, London, UK
  1. Correspondence to Dr Keith Siau, Endoscopy Unit, Dudley Group NHS Foundation Trust Dudley UK; keithsiau{at}


The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) was initially established in 1994 to standardise endoscopy training across specialties. Over the last two decades, the position of JAG has evolved to meet its current role of quality assuring all aspects of endoscopy in the UK to provide the highest quality, patient-centred care. Drivers such as changes to healthcare agenda, national audits, advances in research and technology and the advent of population-based cancer screening have underpinned this shift in priority. Over this period, JAG has spearheaded various quality assurance initiatives with support from national stakeholders. These have led to the achievement of notable milestones in endoscopy quality assurance, particularly in the three major areas of: (1) endoscopy training, (2) accreditation of endoscopy services (including the Global Rating Scale), and (3) accreditation of screening endoscopists. These developments have changed the landscape of UK practice, serving as a model to promote excellence in endoscopy. This review provides a summary of JAG initiatives and assesses the impact of JAG on training and endoscopy services within the UK and beyond.

  • gastrointesinal endoscopy
  • health service research
  • diagnostic and therapeutic endoscopy

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  • Twitter Dr Keith Siau: @drkeithsiau; Dr Siwan Thomas-Gibson: @SiwanTG; JAG Endoscopy: @JAG_Endoscopy

  • Contributors KS performed the literature review and produced the initial draft. RB provided historical insight in the development of JAG. JAG section headings were cowritten by the leads of JAG subdivisions (MF: JAG International; NH: Quality Assurance of Training; JTG: Endoscopy Services Quality Assurance Group; PD: JETS lead). JRB and JS are previous chairs of JAG and confirmed the accuracy of the manuscript. ST-G holds the current chair of JAG, initially commissioned the review and is the article guarantor. All authors provided critical review and helped to shape the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors have either held a position on JAG or worked on behalf of JAG

  • Patient consent Not required.

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

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