Iniative to make sigificant in-roads into gastro waiting list nears

Monday 09 January 2023

Action to tackle a growing gastroenterology waiting list should begin within the next two months - nearly a year after a solution was first identified.

Latest figures from the start of January show that there were 450 people on the waiting list, up from 411 in November.

An initiative to bring in off-island providers to run weekend endoscopy clinics is seen as the only way to make significant inroads, which itself would allow the bowel cancer screening programme to start again.

Today was the closing date for providers to tender process for the Waiting List Initiative, which is expected to be implemented by the end of March.

"HSC and the Medical Specialist Group identified the need to introduce a Waiting List Initiative using off-island providers in April 2022, but this has been challenging to implement with NHS Trusts chasing the same providers," a joint statement issued by Health and Social Care and the Medical Specialist Group said.

Pictured: A joint statement was issued by HSC and the MSG.

The plans to reduce the waiting list for those who require endoscopy procedures centres around off-island providers coming to Guernsey on a regular basis over four-day weekends.

The routine service is not staffed to deal with the unexpected backlog which has been attributed to the Covid-19 pandemic when only urgent endoscopy procedures could be booked.

"The proposed waiting list initiative for endoscopy procedures will make significant inroads into the waiting list for these symptomatic patients.

"It is hoped that the bowel cancer screening programme will recommence once the symptomatic waiting list has been reduced."

The bowel cancer screening programme has been repeatedly paused over the past two years and, most recently, in the last quarter of 2022 when a locum who was due to start working in Guernsey changed their mind.

"A screening programme for a healthy population should not be run when there is no means of diagnosing a condition found from a screening test. This is because there are many other conditions which can require follow up investigations, such as piles, and while a person has no symptoms and is otherwise healthy a screening test can cause more harm than benefit.

"Once the symptomatic waiting list has reduced, and extra capacity is available in our gastroenterology teams, the screening programme will be reviewed and reintroduced."

When the screening programme is running routinely around 5,500 kits are sent out to those aged 60 and above every two years until they are 70.

The Medical Specialist Group is still trying to recruit a full time gastroenterologist to replace the two part-time specialists who were in post.

It is now advertising in two specialist publications to reach more potential candidates.

"In the meantime, we were able to employ two full-time locum gastroenterologists during December which helped with the backlog. It is a very fluid situation, but we are hoping we can continue to double up on locums for at least this month and the next."

In response to official written questions posed to the Health and Social Care President Deputy Al Brouard by Deputy Gavin St Pier about the waiting list, the committee said that it has not taken any action against the MSG under the secondary healthcare contract.

"The Committee is assured that appropriate steps would be taken if the MSG was not seen to make the reasonable efforts to address the situation. For example, the Client Team could issue a Contract Performance Notice which would then be followed by a remedial action plan. To date, it has not been necessary to issue such a Notice.

"It is important to note that the MSG have maintained, using locums, the sessional commitment that would be provided by a full-time gastroenterologist during 2022."

HSC and MSG said it was important to remember that the screening programme is only for people who do not have any bowel symptoms.

Anyone experiencing the following symptoms should make an appointment to see their doctor as soon as possible:

• Bleeding from your bottom or blood in your poo

• A change in your bowel habit such as looser poo, pooing more often or constipation

• A lump that you can feel in your bottom or tummy

• Unexplained weight loss or

• Pain in your abdomen or back passage

Further information on signs and symptoms can be found at https://www.cancerresearchuk.org/about-cancer/bowel-cancer.