Endoscopy action plan

Short

Clerical review of those waiting over 6 weeks for the 4 key endoscopic tests followed by clinical review.

Short

Clerical review of those waiting beyond their surveillance date on each of the surveillance time bands followed by clinical review.

Short

Review booking processes and introduce patient focused booking if not already available.

Short

Boards to target capacity at patients by clinical priority as they are clinically validated.

Short

Calculate current capacity including any gains from improvement activities.

Short

Quantify and review nursing and medical workforce and training requirements and review job plans.

Short

Review endoscopy utilisation to optimise available capacity.

Medium

Assess the efficacy of Endoscopy Management systems in operation in some Boards with a view to roll-out across other Boards if appropriate.

Medium

Review demand including impact of changes in bowel screening testing.

Short

Implement immediate recovery plans for Boards with longest waits.

Short and Medium

Procure additional capacity via Independent Sector via National Procurement Framework to clear remaining backlog following validation.

Short

Develop and implement weekly diagnostic management reporting and monitoring with NHS Boards. Analysis to include breakdown of waits by source of referral and clinical urgency.

Medium

Link with ISD to develop additional diagnostic and surveillance datasets.

Short

Embed the Scottish Cancer Referral Guidelines for Suspected Cancer including reference to qFIT use in Urgent Suspected Cancer Referral for colorectal cancer.

Medium

Continue the roll-out of qFIT use in primary care for symptomatic patients to aid onward referral to GI services or colonoscopy. This has potential to reduce demand on colonoscopy by 20% by avoiding unnecessary scope.

Medium

Roll-out use of qFIT in secondary care to optimise patient choice and onward management. This has potential to reduce lists by 30-50%.

Long

In conjunction with HIS, audit NHSScotland endoscopy units to ascertain eligibility for accreditation across NHSScotland and explore accreditation.

Short

Develop clear clinical guidance for management of surveillance patients with emphasis on those on five year surveillance.

Short

Ensure that NHS Boards take full account of the planned repeat diagnostic surveillance within their local plans.

Medium

Develop clear pathways from referral to test to reduce unwarranted variation.

Long

Explore regional solutions to flex capacity.

Medium/Long

Consider purchase of mobile endoscopy unit for NHSScotland to provide extra capacity when boards are experiencing exceptional demand.

Medium/Long

NHS Boards to explore new technology such as transnasal endoscopy and SCOTCAP.

Medium/Long

Continuation and expansion of Nurse Endoscopist training.