Access and booking Productivity advice JAG Access and booking Productivity advice Debbie Johnston-Head of Assessors April 2017

The current situation There is a large and consistent challenge with waiting times in endoscopy; this is evident from different information sources This impacts on Services’ ability to achieve and sustain accreditation (all nations) Pressure on rollout plans for FS screening programme (England) Patients being offered variable care, e.g. being outsourced to non accredited facilities Patients suspected of having cancer waiting beyond acceptable limits for an endoscopy (urgent and surveillance breaches) FS, flexible sigmoidoscopy

Endoscopy services must ensure: Endoscopy leads work collaboratively with their colleagues, team and organisation to achieve joint understanding and responsibility for the service Work to known processes Pooling (view JAG advice) Vetting (view Rapid review advice) Booking systems (view Rapid review advice) Pre-assessment Consent Have appropriate facilities (view JAG advice) Leadership Best practices Physical capacity JAG, Joint Advisory Group on gastrointestinal endoscopy

Endoscopy services must ensure: Systems for collection of data Demand Capacity Utilisation of lists Utilisation of points Skilled workforce that supports the total management of waiting times effectively Clear plans: the service knows where it is going and how its going to respond Balance training demands Data focus Flexible workforce Capacity plans

Waits tolerance: National tolerance for diagnostic waits is that Trusts are allowed a 2% breach of their 6 week target at month end.  This does not apply to cancer OR urgent waits 

Waits tolerance: As a minimum we would expect to see a clear statement provided by all trusts about diagnostic waits as follows: ‘Diagnostic waits over 6 weeks, 19 patients waited over 6 weeks at the end of March, achieving the standard of no more than 2% waiting over 6 weeks’  

Patient choice: Is not included in the 2% tolerance.  These are the exceptions for 18 weeks including diagnostics if a patient chooses to wait longer if delaying the start of their treatment is in the best clinical interests, if it is clinically appropriate for their condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage if they fail to attend appointments that they had chosen from a set of reasonable options, or if the treatment is no longer necessary

Recommended data outputs Please refer to separate charts summary document