Related Experiment Video
Updated: Oct 15, 2025

Author Spotlight: Advancing Biopsy Techniques with Transesophageal Ultrasound
Published on: November 21, 2023
National census of UK endoscopy services in 2019
Srivathsan Ravindran1,2, Paul Bassett3, Tim Shaw1
1Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK.
Insights
UK endoscopy services face increasing demand and workforce pressures. Despite efforts to expand capacity and staffing, fewer services met waiting time targets in 2019 compared to 2017.
Area of Science:
- Gastroenterology
- Health Services Research
- Public Health
Background:
- The 2017 Joint Advisory Group on Gastrointestinal (GI) Endoscopy (JAG) census revealed significant pressures on endoscopy services.
- A follow-up census in 2019 was conducted to assess trends in activity, workforce, and waiting times.
Purpose of the Study:
- To evaluate changes in UK endoscopy service activity, workforce, and adherence to waiting time targets between 2017 and 2019.
- To identify factors contributing to challenges in meeting national endoscopy targets.
Main Methods:
- A national census of JAG-registered endoscopy services was conducted in April 2019.
- Data were statistically analyzed, with a comparative dataset created using matched 2017 submissions.
- A 68% response rate was achieved from 322 services.
Main Results:
- Gastrointestinal (GI) procedure activity increased by 12%-15%, with notable growth in bowel cancer screening.
- Fewer services met waiting time targets in 2019 versus 2017, attributed to endoscopist, nursing, and physical capacity limitations.
- Workforce numbers increased: endoscopists by 15%, nurses/allied health professionals by 14%, and clerical staff by 30%.
Conclusions:
- The 2019 JAG census indicates rising endoscopy activity but a decline in meeting waiting time targets.
- Endoscopy services are enhancing workforce and planning to manage increased demand.
- The COVID-19 pandemic is expected to worsen these pressures, necessitating adjustments to waiting time targets.
Introduction:
The 2017 Joint Advisory Group on Gastrointestinal (GI) Endoscopy (JAG) census highlighted the pressure endoscopy services were under in meeting national targets and the factors behind this. In 2019, JAG conducted a further national census of endoscopy services to understand trends in activity, workforce and waiting time targets.
Methods:
In April 2019, the census was sent to all eligible JAG-registered services. Collated data were analysed through various statistical methods. A further comparative dataset was created using available submissions from the 2017 census matched to services in the current census.
Results:
There was a 68% response rate (322/471). There has been a 12%-15% increase in activity across all GI procedures with largest increases in bowel cancer screening. Fewer services are meeting waiting time targets compared with 2017, with endoscopist, nursing and physical capacity cited as the main reasons. Services are striving to improve capacity: 80% of services have an agreed business plan to meet capacity and the number using insourcing has increased from 13% to 20%. The workforce has increased, with endoscopist numbers increasing by 15%, nurses and allied health professionals by 14% and clerical staff by 30%.
Conclusions:
The 2019 JAG census is the most recent and extensive survey of UK endoscopy services. There is a clear trend of increasing activity with fewer services able to meet national waiting time targets than 2 years ago. Services have increased their workforce and improved planning to stem the tide but there remains a continued pressure to deliver high quality, safe endoscopy. In light of the COVID-19 pandemic, JAG recognises that these pressures will be severely exacerbated and waiting time targets for accreditation will need adjustment and tolerance during the evolution and recovery from the pandemic.
Related Concept Videos
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
Endoscopic Procedures II: Colonoscopy
Endoscopic Procedures V: ERCP
Patient...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Endoscopic Procedures III: Video Capsule Endoscopy

