PTH-55 Next available please: real world waiting times and availability of endoscopy for lower gastrointestinal bleeding

Published Date: 07th November 2021

Publication Authors: Baig D

Introduction
Current British Society of Gastroenterology (BSG) guidelines recommend all patients admitted to hospital with lower gastrointestinal bleeding (LGIB) undergo an inpatient colonoscopy on the next available list as part of providing a 7-day endoscopy service. The real-world availability of a 7-day service and adherence to this guidance is unknown.

Methods
Patients aged ≥16 years admitted with LGIB to 7 hospital trusts from June 1st–Aug 31st 2019 were included. Data on presentation, endoscopy, time to procedure and outcomes were recorded. We established data from participating Trusts on their current endoscopy services in relation to BSG guidance.

Results
407 patients across 7 NHS Trusts presenting with LGIB were included. Mean age was 59.8 (17-96), with a mean Oakland score of 14.5 (SD 6.78). 14.7% received a LGI endoscopic investigation during admission (3.4% colonoscopy, 11.8% flexible sigmoidoscopy), with 25.7% of admitted patients undergoing their LGI endoscopy as an outpatient. Median time from admission to inpatient flexible sigmoidoscopy and colonoscopy was 2.5 days (58 hours) and >3 days (80 hours) respectively. 43% (3/7) of Trusts provided daily inpatient endoscopy lists able to accommodate inpatient colonoscopies, with colonoscopies being ad hoc/no regular slots in a further 43% of Trusts. At weekends, 86% (6/7) of hospitals provided endoscopy lists, however of these, 83% stated colonoscopies were not routinely performed at weekends.

Conclusion
Current real-world practice is not in keeping with BSG guidelines. The majority of patients admitted with LGIB do not undergo inpatient LGI endoscopy (colonoscopy or flexible sigmoidoscopy) and the waiting time for a ‘next available’ slot can be several days. LGI endoscopic assessment for LGIB is more commonly performed as an outpatient. Most Trusts do not currently provide a 7-day endoscopy service, the majority with no regular weekend or weekday colonoscopy slots for patients with LGIB.

Davies, M; Baig, D et al. (2021). PTH-55 Next available please: real world waiting times and availability of endoscopy for lower gastrointestinal bleeding . Gut. 70 (4), A200

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