Endoscopy Services

Following its capacity survey, the Network, in collaboration with the NSW Department of Health's Clinical Services Redesign Program, carried out a six week comparison study into the efficiency of colonoscopy provision across six public hospitals and two private hospitals between November - December 2006. The purpose of the Colonoscopy Study was to compare identified models of care in terms of their standard of care, level of throughput efficiency and demand-capacity matching.

In 2007 a joint NSW Health / GMCT Gastroenterology Network's Colonoscopy Study Implementation Committee was established to implement the main findings of the Colonoscopy Study. This committee included NSW Health, clinicians, Area Health Service representatives, the Clinical Excellence Commission and consumer participation.

In 2007 the Colonoscopy Study Implementation Committee developed new advice on the appropriate clinical priority categories for elective colonoscopy procedures for referring and treating doctors managing elective patients and waiting lists in NSW public hospitals. These were developed following extensive consultation with a wide variety of stakeholders including gastroenterologists, surgeons, Area Health Service representatives, the NSW National Bowel Cancer Screening Program Advisory Group and the NSW Health Surgical Services Taskforce. This advice was included in the revised guidance to accompany the next edition of the NSW Health "Waiting Time and Elective Patient Management Policy" which was published in 2009.  The overall aims of the new advice are to clarify the appropriate clinical priority categories for colonoscopies and to promote the National Health and Medical Research Council's 2005 clinical practice guidelines for the prevention, early detection and management of colorectal cancer.  Increasing awareness about the appropriate surveillance intervals for repeat procedures should help to avoid excessive or unnecessary surveillance procedures being conducted, with subsequent benefits in terms of increasing capacity and cost savings and improvements in the quality and safety of procedures provided.

In 2006, the Gastroenterology Network identified that there was a lack of data on the number of endoscopy procedures undertaken in NSW public hospitals. These issues were examined by the Gastroenterology Network’s Colonoscopy Study Group, whose 2007 report emphasised that any changes to address deficiencies in endoscopy services in NSW needed to be underpinned by information systems.

In 2008, the NSW Health Director General gave funding approval for the purchase of a statewide information system, similar to that being implemented in Queensland.  The ACI has worked consistently with NSW Health on the purchase of a State-wide Endoscopy Information System (EIS) in NSW. A trial of the Program was run at Concord Hospital in November 2009.

In June 2010, NSW Health finalised the purchase of the EIS licence agreement from ProVation Medical.  The implementation order is now being finalised and then implementation will commence across NSW. The implementation process is being supported by the Gastroenterology Network’s EIS Implementation Working Group, which includes membership from:

• EIS Executive
• Concord clinical trial
• Area Health Service clinical representatives
• NSW Health
• Health Support Services Project Manager