Celtic Workshop Wales Feb 2008

1. Celtic WorkshopWales Feb 2008 Mr Kourosh Khosraviani Dr Colin Rodgers Northern Ireland

2. Celtic Workshop Joined up Endoscopy Services Bowel Cancer Screening Catalyst Appointment of three people Hopefully a fourth person

3. Celtic Workshop Endoscopy Clinical Lead Mr Kourosh Khosraviani Endoscopy Training Lead Dr Colin Rodgers Clinical Network Coordinator Ms Sarah Liddle

4. The Beginning Department of Health involvement Development of Modernising Endoscopy Team (Sept 2007) Appointment of Clinical and Training Lead for the region Trusts invited to appoint local leads

5. Demographics Population 1.7 M 5 Trusts 17 individual units for Endoscopy Majority single rooms Only three dedicated endoscopy units remainder DPU�s Bowel Cancer Screening Proposed 2009

6. Global Rating Scale No unit has complete data Specific aspects have been audited GRS purchased for region Timeliness domain biggest issue 1st run to be completed end July 2008

7. Capacity audit 8000 Colonoscopies per annum 15,000 OGD 900 ERCP Pooled lists being introduced Straight to test policy wide spread for OGD

8. Workforce

9. Capacity Audit 21 week wait target has been met by trusts 13 weeks target to be achieved April 2008 Bottlenecks Endoscopy staff Scopes Processors

10. Reporting Units using up to 3 different reporting system Plan for unified system (web linked) to incorporate GRS data

11. Action Plan GRS first run July 2008 Application of KMS for 2nd run end 2008 Improvements in bottlenecks (Early 2009) JAG accreditation of units (2009) Unified reporting tool Introduction Bowel Cancer Screening (End 2009)

12. Celtic Workshop Colonoscopy Audit Prospective audit All colonoscopies in NHS endoscopy units Four month period

13. Colonoscopy Audit Endoscopist (Trainee and if trainer had to take over) Time for procedure Terminal ileum Caecum Landmarks identified Sedation Complications Comments Polyps Reasons for failure Patient comfort score (1-5)

14. Celtic Workshop Colonoscopy audit Identify areas that need addressing Governance issues Trusts Education All staff Skills improvement courses

15. Celtic Workshop Endoscopy Training Most training occurs in the units Foster good training atmosphere Training Lists Managers vs Waiting lists Training Domain GRS Endoscopy Training the Trainers All trainers whether on faculty or not Upper ETTT

16. Celtic Workshop The JAG Standards All trainees to meet these standards Performance DOPS All endoscopists to meet these standards

17. Celtic Workshop JAG approved courses Whiteabbey Hospital (Northern Trust) Altnagelvin Hospital (Western Trust) Basic skills in colonoscopy Basic skills in endoscopy Endoscopy Training the Trainers Hopefully a new ETTT for Upper GI Endoscopists

18. Celtic Workshop Newer ideas on training Endoscopy Training Leads All trainees Gastroenterologists training surgical trainees Vice versa? Time to acquire the skills (EWTD) Upper GI surgical trainees Therapeutic training Courses, not planned as yet for NI. Standard for therapeutic endoscopy

19. Celtic Workshop Equipment Scopeguide Plan to see one in each training unit Mannequins Simulators

20. Celtic Workshop Training of the whole workforce Endoscopy Nurses NIENG Gastrointestinal Nursing Courses University based endoscopy course Meeting with the NIENG

21. Celtic Workshop Nurse Endoscopists Training Colonoscopy Therapeutic colonoscopy PEG tube placement Dyspepsia out-patient clinics Coeliac nurse lead clinics Support Supervisors Management

22. Celtic Workshop Nurse Endoscopists NEP in Northern Ireland No funding specifically for this Meeting with Nurse Endoscopists Similar to the questionnaire for the NEP

23. Celtic Workshop JAG visitation Training Bowel cancer screening Local visitors Two in training Endoscopy Nurse Lead

24. Celtic Workshop Endoscopy is recognised now Waiting times Hine Report Bowel Cancer Screening Build on this Quality service One tier Clock is ticking

25. Celtic Workshop

26. Celtic Workshop

27. Celtic Workshop