Demand for gastroenterology services is on the rise, putting pressure on capacity and resulting in an increase in waiting times.
From 2008 - 2016 there has been a 104% growth in new attendances for gastroenterology services - The Modern Outpatient: A Collaborative Approach 2017-2020
Current processes for investigating potential problems are often time and resource intensive for both patients and services. For example, using traditional colonoscopy for inspection typically involves the patient attending an outpatient hospital appointment and having to manage what they eat and drink the day before.
A further option to conventional endoscopy being explored is a camera contained in a pill that can be swallowed, avoiding the need for more invasive procedures and allowing for the timing of any investigations to be more flexible.
Whether from conventional or new cameras, there is an opportunity for improvements in how images are interpreted. This is a specialist skill that is usually carried out but this option allows those images to be interpreted remotely, potentially negating the need to attend hospital outpatient appointment for this service. This work is being evaluated in a remote and rural setting and in an urban environment to address potential waiting list initiatives.
This work is in using video conferencing, via a typical PC web browser in the Highlands and Islands area to carry out consultations with patients and GPs, to avoid the time and travel involved in such outpatient appointments.
We are working with our partners to combine these approaches into a comprehensive service that will allow for more localised provision of gastroenterology services, supported by central virtual analysis and specialist consultation service.
The first phase of this will be to assess the experience in the NHS Highlands and Islands area against needs across the rest of Scotland to develop a model that could be adopted nationally.
There has been a sustained increase of people having to wait over 6 weeks between 2016 and 2017 from 2563 to 8362, showing that the services are becoming overloaded.
36% of people are not taking part in the national bowel cancer screening programme
The partners include NHS Highland, NHS Scotland and the Scottish Government. We are also working with Highlands and Islands Enterprise on identifying commercial opportunities. Private sector partners include: video-conferencing provider Attend Anywhere; Corporate Health International, an SME based in Inverness and Open Brolly, an Elgin-based enterprise that has supported secure data exchange.
We have facilitated and funded the evaluation of an NHS Highlands and Islands project that used an external analysis service to streamline the process of assessing these images to improve service and patient outcomes.
Separately, some GP practices have experimented with remote consultation using video conferencing, supported by NHS Highlands and Islands.
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