Ravindran Srivathsan, Bassett Paul, Shaw Tim, Dron Michael, Broughton Raphael, Johnston Debbie, Healey Chris J, Green John, Ashrafian Hutan, Darzi Ara, Coleman Mark, Thomas-Gibson Siwan
Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK.
Surgery and Cancer, Imperial College London, London, UK.
Frontline Gastroenterol. 2020 Jun 24;12(6):451-460. doi: 10.1136/flgastro-2020-101538. eCollection 2021.
The 2017 Joint Advisory Group on Gastrointestinal (GI) Endoscopy (JAG) census highlighted the pressure endoscopy services were under in meeting national targets and the factors behind this. In 2019, JAG conducted a further national census of endoscopy services to understand trends in activity, workforce and waiting time targets.
In April 2019, the census was sent to all eligible JAG-registered services. Collated data were analysed through various statistical methods. A further comparative dataset was created using available submissions from the 2017 census matched to services in the current census.
There was a 68% response rate (322/471). There has been a 12%-15% increase in activity across all GI procedures with largest increases in bowel cancer screening. Fewer services are meeting waiting time targets compared with 2017, with endoscopist, nursing and physical capacity cited as the main reasons. Services are striving to improve capacity: 80% of services have an agreed business plan to meet capacity and the number using insourcing has increased from 13% to 20%. The workforce has increased, with endoscopist numbers increasing by 15%, nurses and allied health professionals by 14% and clerical staff by 30%.
The 2019 JAG census is the most recent and extensive survey of UK endoscopy services. There is a clear trend of increasing activity with fewer services able to meet national waiting time targets than 2 years ago. Services have increased their workforce and improved planning to stem the tide but there remains a continued pressure to deliver high quality, safe endoscopy. In light of the COVID-19 pandemic, JAG recognises that these pressures will be severely exacerbated and waiting time targets for accreditation will need adjustment and tolerance during the evolution and recovery from the pandemic.
2017年胃肠内镜检查联合咨询小组（JAG）普查突出了内镜检查服务在实现国家目标方面所面临的压力以及背后的因素。2019年，JAG对内镜检查服务进行了进一步的全国普查，以了解活动、劳动力和等待时间目标的趋势。
2019年4月，普查问卷被发送至所有符合条件的JAG注册服务机构。通过各种统计方法对整理后的数据进行分析。利用2017年普查的可用提交数据与本次普查中的服务机构进行匹配，创建了一个进一步的比较数据集。
回复率为68%（322/471）。所有胃肠检查程序的活动量增加了12% - 15%，其中肠癌筛查增幅最大。与2017年相比，达到等待时间目标的服务机构减少，主要原因是内镜医师、护理和实际能力方面的问题。各服务机构正在努力提高能力：80%的服务机构有商定的业务计划以满足能力需求，采用内部资源的机构数量从13%增加到了20%。劳动力有所增加，内镜医师数量增加了15%，护士和专职医疗人员增加了14%，文职人员增加了30%。
2019年JAG普查是对英国内镜检查服务的最新且全面的调查。活动量呈明显上升趋势，但能够达到国家等待时间目标的服务机构比两年前减少。各服务机构增加了劳动力并改进了规划以遏制这一趋势，但在提供高质量、安全的内镜检查方面仍持续面临压力。鉴于新冠疫情，JAG认识到这些压力将被严重加剧，在疫情演变和恢复期间，认证的等待时间目标将需要调整和宽容。
