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

2. 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

3. 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

4. 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

5. 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 

6. 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’

7. 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

8. Recommended data outputs
Please refer to separate charts summary document