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In mid-2016, the Gastroenterology Unit at NNUH was facing an increase in demand for endoscopy services due in part to the growing elderly population in Norfolk. Another contributing factor is the fact that the unit is a national centre of excellence and is the provider of choice for the over 800,000 residents of Norfolk and over 100 referring GPs. The unit is a regional bowel screening centre and has been declared by the JAG as being the largest endoscopy service in the UK. There were staffing challenges which limited the unit’s ability to increase capacity by running a 7-day service.

The Work

18 Week Support Gastroenterology (18WS) led by Dr Matthew Banks visited the trust to meet with the operational managers as well as the clinical and nurse leads. This initial meeting allowed both parties to undertake a thorough capacity review, agree inclusion and exclusion criteria, approve governance arrangements, agree key performance indicators and finalise details of a bespoke service specification. The weekend service commenced in July 2016 and involves the provision of clinical services delivered by expert teams of JAG accredited clinicians and specialist endoscopy nurses.

The Output
  • Provision of services for up to 5 endoscopy rooms per weekend
  • Service flexed to meet variations in demand and regularly involved bank holiday services
  • On average 24.5 JAG points completed per list
  • Two-week wait and surveillance cases routinely managed within the service
The Outcomes
  • Our work enabled the trust to increase capacity in the face of ever-increasing demand
  • As at Feb 2018, over 10,363 patient episodes were registered. This included 2798 colonoscopy procedures, 2464 flexible sigmoidoscopies and 3363 gastroscopy procedures
  • Local clinicians have greater capacity to develop more specialised services
  • Trust able to avoid patient breaches and avoid prolonged waiting times for routine appointments
"We are extremely positive about the services delivered by 18 Week Support, indeed we have extended their services to other specialties across the Trust and renewed existing contracts, which will give you a good indication of the confidence we have in the organisation to mobilise and deliver high-quality services in a way which is responsive to our needs "
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