National census of UK endoscopy services in 2023

Background The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) conducts a biennial census of UK endoscopy services. The 2023 census aimed to assess the current status of endoscopy services and compare them with pre-pandemic census benchmark data. Methods An electronic survey was sent to all JAG participating services in April 2023. Key domains included activity, waiting times, workforce and safety. Whole census and service level paired comparison was made with 2019 census data. Results There were 334 census responses representing 443 JAG-participating services (86.7% response rate). NHS services were operating at 110% of pre-pandemic activity levels. In the first 3 months of 2023, 53.6% of NHS services met urgent suspected cancer waiting time targets, 26.5% met routine waits and 26.2% met surveillance waits. The proportion of NHS services meeting all three targets decreased from 40.9% to 21.9% between 2019 and 2023. Compared with 2019, the proportion of independent sector activity has significantly increased. Insourcing activity has significantly increased and is being used by 57.9% of NHS services. Staff shortages were the most cited reasons for services not meeting waiting time targets or providing training. Absence through sickness rates for Band 2–6 nursing and healthcare support workers were significantly higher in 2023 compared with 2019 (p<0.001). Conclusion The 2023 census presents a system under strain. While overall activity is above pre-pandemic levels, this is set against workforce concerns, increasing staff absences and reliance on insourcing for additional activity. This census re-emphasises the need to proactively plan for rising demand, while maximising all current available resources.