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Original research
UK endoscopy workload and workforce patterns: is there potential to increase capacity? A BSG analysis of the National Endoscopy Database
  1. David Beaton1,2,
  2. Linda Sharp3,
  3. Nigel John Trudgill4,
  4. Mo Thoufeeq5,
  5. Brian D Nicholson6,
  6. Peter Rogers7,
  7. James Docherty8,
  8. Ian D Penman9,
  9. Matt Rutter1,2
  1. 1Gastroenterology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
  2. 2Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
  3. 3Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  4. 4Gastroenterology, Sandwell General Hospital, West Bromwich, UK
  5. 5Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
  6. 6Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  7. 7Weblogik.co.uk, Ipswich, UK
  8. 8Surgery, Raigmore Hospital, Inverness, UK
  9. 9Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr David Beaton, University Hospital of North Tees, Stockton-on-Tees TS19 8PE, UK; dbeaton1{at}nhs.net

Abstract

Background The lack of comprehensive national data on endoscopy activity and workforce hampers strategic planning. The National Endoscopy Database (NED) provides a unique opportunity to address this in the UK. We evaluated NED to inform service planning, exploring opportunities to expand capacity to meet service demands.

Design Data on all procedures between 1 March 2019 and 29 February 2020 were extracted from NED. Endoscopy activity and endoscopist workforce were analysed.

Results 1 639 640 procedures were analysed (oesophagogastroduodenoscopy (OGD) 693 663, colonoscopy 586 464, flexible sigmoidoscopy 335 439 and endoscopic retrograde cholangiopancreatography 23 074) from 407 sites by 4990 endoscopists. 89% of procedures were performed in NHS sites. 17% took place each weekday, 10% on Saturdays and 6% on Sundays. Training procedures accounted for 6% of total activity, over 99% of which took place in NHS sites. Median patient age was younger in the independent sector (IS) (51 vs 60 years, p<0.001). 74% of endoscopists were male. Gastroenterologists and surgeons each comprised one-third of the endoscopist workforce; non-medical endoscopists (NMEs) comprised 12% yet undertook 23% of procedures. Approximately half of endoscopists performing OGD (52%) or colonoscopies (48%) did not meet minimum annual procedure numbers.

Conclusion This comprehensive analysis reveals endoscopy workload and workforce patterns for the first time across both the NHS and the IS in all four UK nations. Half of all endoscopists perform fewer than the recommended minimum annual procedure numbers: a national strategy to address this, along with expansion of the NME workforce, would increase endoscopy capacity, which could be used to exploit latent weekend capacity.

  • endoscopy
  • health service research

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @BrianDNicholson, @GastronautIan, @Rutter_Matt

  • Contributors DB, LS and MR designed the study and drafted and revised the manuscript, with input from NJT, JD, MT, BDN and IDP. PR extracted data from the National Endoscopy Database. DB analysed the data and acts as guarantor for the work and conduct of the study. All authors approved the manuscript for 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 LS received funding for endoscopy-related research from Medtronic and 3D Matrix. BDN was supported by an NIHR Academic Clinical Lectureship.

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

  • 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.