Demand for gastrointestinal (GI) endoscopy in the UK is expected to increase over the next decade due to increased patient expectations, emphasis on early diagnosis and better uptake of screening.
To address demand, GI endoscopic procedures that have traditionally been carried out by doctors are increasingly being performed by nurses and other practitioners – known as clinical endoscopists. Nurse endoscopists already undertake as much of 20% of the workload in an endoscopy unit, and NHS Improving Quality initiatives have estimated that up to 40% of low risk, high volume endoscopic procedures could potentially be carried out by clinical endoscopists.
Training an additional 200 clinical endoscopists by 2018
We’ve launched a new training programme to support the Secretary of State’s commitment of an additional 200 clinical endoscopists by 2018.
Following a pilot selection process developed with the Joint Advisory Group on GI Endoscopy (JAG), 40 registered health professionals from across England were selected to train in two cohorts starting in January and April 2016. The programme provided a comprehensive blended learning package including completion of the Competence Assessment Portfolio.
Having successfully completed the course, trainees from the first cohorts are now able to deliver procedures in either upper-gastrointestinal (GI) endoscopy or flexible sigmoidoscopy, providing expanded workforce capacity, greater skill mix and improved services for patients.
Accelerated training proves a success
The Office for Public Management (OPM) was commissioned to conduct an independent evaluation of the training pilot. The independent report, which looked at the impact and effectiveness of the training, detailed the success of the programme while also offering recommendations to improve, which have been implemented throughout the report development. It found that the majority of trainees from the first cohort are helping to meet endoscopy service demands within their own Trusts, freeing up medical colleagues and impacting positively on patient care. The trainees themselves also welcomed the professional and career development opportunity, whilst Trusts valued the accelerated approach.
The programme is being rolled out more widely and applications are invited from suitably qualified professionals. You can read more about this programme on the clinical endoscopy training programme page.
Jane Homer, one of the first cohort trainees at Western Sussex Hospitals NHS Trust said:
The non-medical endoscopist role is an extension to my current job and it has been a really enjoyable challenge to learn a new skill set.
Mr Neil Cripps, colorectal surgeon and clinical supervisor at Western Sussex Hospitals NHS Trust said:
Jane has become a very competent safe and comfortable flexible sigmoidoscopist. She is aware of the pressures on newly qualified non-medical endoscopists and we will ensure that she has continuous mentorship to support her through any early difficulties.
Competence Assessment Portfolio
Working with major national endoscopy stakeholders* we’ve developed the ‘Competence Assessment Portfolio for Non-Medical Endoscopists’ (now known as clinical endoscopists).
The portfolio provides a framework for clinical endoscopists - ensuring a consistent basis for education and training, optimising patient safety and supporting high quality standards of care.
Trainee clinical endoscopists, their clinical supervisors, mentors and managers can use the portfolio to demonstrate achievement of the skills and knowledge required to deliver safe and effective quality care through core and specific competencies, and to identify and manage risks.
* Stakeholders include the Joint Advisory Group on GI Endoscopy (JAG), the British Society of Gastroenterology, NHS Improving Quality, Royal College of Nursing, Council of Deans and higher education institutions.