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Bowel cancer screening workforce survey: developing the endoscopy workforce for 2025 and beyond
  1. Srivathsan Ravindran1,2,
  2. Jane Munday3,
  3. Andrew M Veitch4,5,
  4. Raphael Broughton1,
  5. Siwan Thomas-Gibson6,7,
  6. Ian D Penman8,9,
  7. Alistair McKinlay9,10,
  8. Nicola S Fearnhead11,12,
  9. Mark Coleman1,13,
  10. Robert Logan14,15
  1. 1Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
  2. 2Surgery and Cancer, Imperial College London, London, UK
  3. 3Lateral Knowledge, Chester, UK
  4. 4Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  5. 5Bowel Screening Advisory Committee, Public Health England, London, UK
  6. 6Wolfson Endoscopy Unit, St Mark's Hospital and Academic Institute, Harrow, London, UK
  7. 7Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
  8. 8Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
  9. 9British Society of Gastroenterology, London, UK
  10. 10Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK
  11. 11Colorectal Surgery, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK
  12. 12Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
  13. 13Colorectal Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
  14. 14Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
  15. 15NHS England and NHS Improvement London, London, UK
  1. Correspondence to Dr Srivathsan Ravindran, Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London NW1 4LE, UK; sravindran1{at}


Aim The demand for bowel cancer screening (BCS) is expected to increase significantly within the next decade. Little is known about the intentions of the workforce required to meet this demand. The Joint Advisory Group on Gastrointestinal Endoscopy (JAG), the British Society of Gastroenterology (BSG) and Association of Coloproctology of Great Britain and Ireland (ACPGBI) developed the first BCS workforce survey. The aim was to assess endoscopist career intentions to aid in future workforce planning to meet the anticipated increase in BCS colonoscopy.

Methods A survey was developed by JAG, BSG and ACPGBI and disseminated to consultant, clinical and trainee endoscopists between February and April 2020. Descriptive and comparative analyses were undertaken, supported with BCS data.

Results There were 578 respondents. Screening consultants have a median of one programmed activity (PA) per week for screening, accounting for 40% of their current endoscopy workload. 38% of current screening consultants are considering giving up colonoscopy in the next 2–5 years. Retirement (58%) and pension issues (23%) are the principle reasons for this. Consultants would increase their screening PAs by 70% if able to do so. The top three activities that endoscopists would relinquish to further support screening were outpatient clinics, acute medical/surgical on call and ward cover. An extra 155 colonoscopists would be needed to fulfil increased demand and planned retirement at current PAs.

Conclusion This survey has identified a serious potential shortfall in screening colonoscopists in the next 5–10 years due to an ageing workforce and job plan pressures of aspirant BCS colonoscopists. We have outlined potential mitigations including reviewing job plans, improving workforce resources and supporting accreditation and training.

  • endoscopy

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  • Contributors SR performed the primary statistical analysis with support of JM and wrote the manuscript with editorial oversight from AMV, STG, IDP, AM, MC, NSF and RL. AMV, STG, IDP, MC, AM, NSF and RL developed the BCS workforce survey questions on behalf of stakeholder bodies. RB, RL, NSF and JM supported the dissemination of the survey. All authors reviewed the final manuscript prior to submission.

  • 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 None declared.

  • Patient consent for publication Not required.

  • Ethics approval Formal ethics approval for this study was not required.

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

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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