@article {Gordonflgastro-2016-100716, author = {H M Gordon and D A J Lloyd and A Higginson and R McCrudden and C Bent and F W Shek and R Beable and A Al-Badri and B Green and E Jaynes and B Foria and B S F Stacey}, title = {A regional EUS service using a collaborative network}, elocation-id = {flgastro-2016-100716}, year = {2016}, doi = {10.1136/flgastro-2016-100716}, publisher = {British Medical Journal Publishing Group}, abstract = {Endoscopic ultrasound (EUS) is increasingly used in the management of hepatobiliary lesions, allowing staging and tissue acquisition. It is operator-dependent, and fine needle aspiration (FNA) of solid lesions provides an auditable standard; high-volume centres have shown excellent results for solid pancreatic lesion FNA with sensitivities of 92\%{\textendash}97\%. The British Society of Gastroenterology guidelines stress that clinical quality should determine service provision, with geographical accessibility a secondary consideration. We set up the Wessex EUS network, working from a single hepatobiliary (HPB) pancreatic multidisciplinary team, with EUS provided in four local centres providing agreed standards and audit. Pancreatic solid lesion FNA results showed a pooled sensitivity of 94\%, comparable with high-volume single centres. This demonstrates a network with good clinical governance is a plausible solution to providing a specialist service such as EUS and may be a roadmap that other specialist services under pressure could follow.}, issn = {2041-4137}, URL = {https://fg.bmj.com/content/early/2016/08/09/flgastro-2016-100716}, eprint = {https://fg.bmj.com/content/early/2016/08/09/flgastro-2016-100716.full.pdf}, journal = {Frontline Gastroenterology} }