Quality and Clinical Governance

1. Endoscopy Global rating Scale (GRS)

This is a well established, web-based tool to enable endoscopy units to assess how well they provide patient-centred care. This provides a standard for accreditation and a quality framework for service improvement. Scores are calculated based on statements requiring yes/no answers, covering patient experiences, clinical quality and processes for monitoring the facility. Scores range from D (basic) to A (excellent). There has recently been an addition of an A* rating too.

The A* score is the highest standard a facility can attain, and means that these units are able and willing to help others achieve level A in specific areas. The GRS has effectively elevated the standards for endoscopic procedures and allowed a uniform assessment of overall quality of various units.

Currently, our community units in Essex score all A and B’s which exceeds that of the local District General Hospital units. We aspire to make all our units an A* standard as we continue to expand our services. GRS is now used as the quality standard for the Joint Advisory Group for Gastrointestinal endoscopy (www.thejag.org.uk)

2. Joint Advisory Group for endoscopy (JAG)

This group has existed since 1994 and was set up to define the standards of training of endoscopists regardless of professional background (i.e. hospital specialists and PwSI’s- both GP’s and Nurse Endoscopists). Despite this initial remit, the JAG is now focussed on new areas such as validating the assessment and competence of endoscopists (mandatory by 2009) along with accreditation and ongoing re-accreditation of endoscopy units. JAG also will be assessing quality of the endoscopy trainers and setting standards for endoscopy courses.

All of our Endoscopists have completed the current training requirements of the British Society of Gastroenterology (BSG). We aim to have all our present and future units, and endoscopists JAG accredited in the not too distant future as JAG rolls out to the community units.
We aim to be the first community JAG accredited unit in the UK, and feel well placed to achieve such a status.

For ongoing training validation we shall be making use of the various JAG lead courses, especially ensuring continuing competence of all endoscopists, planning Endoscopy Personal Development Plans (PDP's), and ongoing Direct Observation of Practical Skills(DOPS) for all our providers .