716 Analysis of Routine Endoscopy Referrals in NHS Greater Glasgow and Clyde

Aim Routine (category 3/4) upper gastrointestinal endoscopies (UGIE) constitute a significant proportion of endoscopy workload in NHS Greater Glasgow and Clyde (GGC). Referrals are varied and there are opportunities for service improvement to reduce clinician burden and patient outcomes. This is with particular relevance to early detection and prevention of cancer. This work aimed to analyse routine UGIE referrals and subsequent scopes within GGC to identify quality improvement opportunities, potentially including endoscopy-saving alternatives such as Cytosponge. Method Referral indications for 299 males over 50 years awaiting routine UGIE in GGC on 02/03/2023 were reviewed. Referrals were categorised into 6 groups based on primary presentation. Data on findings, biopsy and follow-up were gathered where UGIE was subsequently performed. Results 299 patients were analysed; 197 received UGIE (4 had no available scope report), 77 remained waiting, 25 had died/not attended/declined UGIE. Primary referral presentations were 13% Oesophageal; 29% Gastric; 10% Anaemia; 28% Liver/variceal; 14% Dysphagia; 6% other (n=299). At UGIE, 10% (n=193) identified pre-/malignancy across all groups; there were 3 cases of new malignancy. 75% (n=193) received medical/conservative management following their scope and 22 cases could have been reassured using Cytosponge. Conclusions There are opportunities for improved routine UGIE delivery in GGC which may reflect nationally. These include altered vetting practices and potential UGIE-saving procedures. Notably, there was no Barrett’s oesophagus rich group within this cohort.