JAG’s guidance for quality and safety indicators is currently being reviewed, and the current guidance can be downloaded here.
At present JAG does not expect to see a full audit of a service’s Post Colonoscopy Colorectal Cancer Rates (PCCRC). An assessment (root cause analysis) should be performed of any patient the service is made aware of who has been diagnosed with a colon cancer up to 3 years after a colonoscopy and the findings should be discussed at their endoscopy user’s group (EUG) / governance meeting.
A similar process should happen for the other parameters in the table on page 2, which should be recorded and investigated as clinical incidents i.e. use of flumazenil / naloxone; sustained drop in O2 saturations <90%; need for ventilation; perforation/bleeding by procedure; and unplanned operations within 8 days. There are also outcomes listed on pages 3, 4 and 5 for which we do not ask to see audit data e.g. perforation rates after colonic stenting etc.
It is envisaged that this PCCRC data will be released on a national basis in the future, and services are likely to then be expected to undertake a full audit/analysis.
JAG expects all services to be linked to the National Endoscopy Database (NED) as soon as possible and will use its outputs for accreditation and annual reviews. One advantage to NED is the ability to easily perform assessments of the KPI’s for operators in a service and compare them to national performance data / the BSG audit standards. NED will in time be able to produce a wider range of datasets including those that relate to many of the new KPI’s within the Quality Standards for Gastroscopy from the BSG, 2017. In the meantime JAG will not expect these standards to be routinely audited.