TY - JOUR T1 - Joint Advisory Group on Gastrointestinal Endoscopy (JAG) achieves enduring large-scale change JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 91 LP - 92 DO - 10.1136/flgastro-2018-101115 VL - 10 IS - 2 AU - Roland Valori Y1 - 2019/04/01 UR - http://fg.bmj.com/content/10/2/91.abstract N2 - It is nearly 20 years since the national colonoscopy audit demonstrated poor performance of colonoscopy and inadequate training of colonoscopists.1 In 2004, a National Confidential Enquiry into Perioperative Deaths in endoscopy identified major deficiencies in the service.2 These two seminal publications identified what the endoscopy workforce in the UK already knew: the service was falling well behind endoscopy services in other countries and delivering poor care to patients. There were multiple problems: inadequate facilities and equipment; long waits and poor patient experience; inadequately trained staff; minimal or no processes to ensure appropriate patient selection and safety; and no monitoring of quality.During the period 2001–2010, the endoscopy service in England received substantial national investment targeted at modernising the service and improving training, especially colonoscopy training.3 During the same period, bowel cancer screening programmes were implemented in each of the four nations. The challenge was to use the new money and impetus from screening wisely: to deliver clear improvements; and to achieve a sustainable position when investment was withdrawn. The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) has played a pivotal role in addressing this challenge, directing the service and empowering it to change.The JAG was created in 1994 to support endoscopist training. Prior to 2001, its main responsibility was … ER -