Endoscopy
Harmonising availability, sterility, and sustainability
Jennifer Gregory argues that investment in single-use endoscopes could help tackle issues around meeting demand, in the wake of the backlog, as well as addressing concerns over infection transmission. She tackles potential concerns around sustainability and highlights some recycling pilot projects that are due to begin this year.
In an NHS struggling with patient backlogs it is hard to imagine that issues as simple as supply of endoscopes can negatively impact busy procedural lists but, unfortunately, they do. The impact this has on delivering patient care is concerning. Despite efforts to improve waiting times, the fact remains that they are still far higher than pre-COVID.1 The NHS faces a substantial backlog in completing patient treatments within the recommended 18-week period but, unfortunately, many patients in need fall short of the NHS’s own operational standard. Bed capacity management for inpatients is a key challenge, with delays in endoscopy procedures contributing to the issue. Patients on wards often wait for weekly endoscopy lists, increasing length of stay and aggravating cost burdens related to transportation, administration, and other operational requirements. The use of reusable endoscopes in the
Endoscopy Unit relies on complex infrastructure, resource-intensive staffing, and costly maintenance contracts. However, demand
surpasses the capacity - prompting a need for innovative solutions to alleviate diagnostic and therapeutic backlogs. It is important to recognise that the NHS,
like any healthcare system, faces challenges – such as resource constraints, unexpected emergencies, and fluctuations in demand; and this doesn’t always sit well in a setting with a fixed number of endoscopes in their fleet. Advocacy for improvements in these areas is crucial, which is why single-use endoscopy solutions can offer some relief as part of an integrated solution that improves workflow and productivity. Single-use solutions offer a reliable and
consistent solution to the issues reusable scopes present, as they have no requirements with regard to repair or reprocessing. It is possible to increase procedures and move with fluidity in times of crisis, such as the pandemic, without a sizeable investment in new equipment. The cost and effort of maintenance and repairs - not only for the endoscopes – but the machines that clean them too, service contracts,
and resources spent on transportation, administration, training, and cleaning supplies are not applicable with single-use endoscopes; therefore, planning and managing patient throughput should be improved. The operational demands of reusable scopes,
including pre- and post-procedural set-ups, cleaning, and room allocation, consume valuable time, staff resources and space, which means fewer patients are seen per list, hindering efforts to clear backlogs. For inpatients, waiting for endoscopy procedures in the Endoscopy Unit causes a delay, increasing length of stay, consequently reducing available bed spaces, and impacting the overall cost of patient care. Issues with reusable scopes, including delays
due to cleaning and fragility of the scopes, further complicate the situation and delay patient pathways. Purchasing more scopes to satisfy demand is a costly solution that does not address the underlying timeframe challenges. The NHS faces increased pressure beyond its current infrastructure and endoscopy capabilities. Single-use endoscopes provide an effective solution to challenges recognised in NHS England’s Long Term Plan, which outlines plans for earlier diagnosis of cancer. Single-use endoscopes can help upscale services, through one-stop clinics, weekend clinics or community clinics to achieve streamlined care and more convenient access to diagnostic procedures simply because single-use scopes remove the need for reprocessing and have guaranteed availability. From the outside, it seems the NHS are stuck in a vicious cycle – with increasing demand in endoscopy services and insufficient scopes to satisfy it - leading to heightened waiting times and potential costly cancellations due to decontamination demands.
Infection control & sterility Furthermore, the cleaning process for reusable scopes raises infection control concerns. It has been proven that scopes can be sterilised
August 2024 I
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