TTP5.05 Improving diagnostic endoscopy pathways: an audit of inpatient referrals and outcomes

Aims Inpatient endoscopy referrals are made for various indications; however, delays in performing these procedures can extend hospital stays, often with normal outcomes. With increasing pressure on NHS resources, inpatient endoscopy slots and hospital beds are critical assets. This audit aimed to evaluate referral patterns and diagnostic endoscopic procedures within a single health board in Wales. Methods A retrospective analysis of an electronic inpatient endoscopy database reviewed referrals within a single Welsh health board over two months (August–October 2024). The analysis included referrals from a large teaching hospital, focusing on diagnostic oesophagogastroduodenoscopy (OGD) and flexible sigmoidoscopy (FS). Results Of 297 inpatient referrals, 175 (59%) were for OGD, including 137 diagnostic and 38 therapeutic procedures. Forty-two (14%) referrals were for FS, 21 (7%) for colonoscopy, and 21 (7%) redirected to outpatient care. Thirty-eight (13%) cases were cancelled due to withdrawal, being unfit, no longer requiring the procedure, or death. The analysis included 179 cases: 137 OGDs and 42 FS. Of these, 71 (40%) of OGDs and 19 (11%) of FS referrals were priority 1 (1–24 hours). Sixty-seven (49%) OGD and 24 (57%) FS inpatients waited over one day for their procedure. Additionally, 46 (34%) of OGD and 14 (33%) of FS patients were discharged within two days post-procedure, suggesting they might have been discharged earlier if scoped sooner. Conclusion Delays in inpatient endoscopy may unnecessarily extend hospital stays. Redirecting suitable referrals to outpatient pathways could improve resource efficiency and support timely discharges.