Accreditation
JAG accreditation provides a framework for the quality improvement and assurance of endoscopy services
Assessments and the accreditation pathway
- Does the service need to be functioning as normal during the assessment?
- What are the mandatory templates required for annual review?
- What is the five-year accreditation cycle?
- When will I need to submit the annual review?
- Can we book an assessment if we are having building works?
- Can you send me a template for a specific criteria?
Annual Reviews and the GRS
- How do I complete the GRS?
- Transition to updated GRS standards 2021
- My service is accredited. When is the GRS due for submission?
- How do I register my service for JAG accreditation?
- What are the effects of outsourcing and insourcing on JAG accreditation?
- How has the self-assessment pathway changed?
JAG website and Evidence
- My login/ password is not working. What should I do?
- How do I get a login to the JAG website and update our service contacts?
- Where can I locate the PPAT?
- Where do we find the assessor comments and how do we respond?
- How do I complete the conflict of interest declaration for my JAG assessment?
- How can I send a message to the JAG office and the assessment team?
Clinical quality
- What observations should be made during endoscopy?
- Can endoscopists perform less than 100 upper GI endoscopies per year?
- Do all patients have to have supplementary oxygen, or is this only recommended?
- Do endoscopy services need to audit the comfort levels of all patients, or only patients that have been sedated?
- Does JAG have any guidance on general anaesthetic?
- Does JAG have any guidance on safe sedation and best practice for the frequency of documenting clinical observations?
Environment
- Can an endoscopy unit be used as an inpatients' facility?
- Can JAG review proposed building layouts and designs for endoscopy services, or provide consultancy?
- Does the gas in the recovery area need to be piped, or will portable gas suffice?
- How many diathermy units should be available in an endoscopy service?
- How often should a procedure room be deep-cleaned?
- Is it mandatory to have doors on the recovery room?
Decontamination
- What is JAG's guidance on completing the IHEEM and IPS audits?
- The decontamination of endoscopes for my service is undertaken off-site. Do I still need to provide an IHEEM report?
- My decontamination facility has just opened - do we need to provide an IHEEM report?
- Should our decontamination lead be accountable to the theatre manager or an executive board member?
- Can my unit be accredited if an external person supports our decontamination team?
- Can Infacol be used through the biopsy channel in an Endogator pump?
Access and booking
- Can I remove unresponsive surveillance patients from the list?
- How can efficiency be improved in endoscopy services?
- What is an acceptable level for DNA rates?
- What is the expected percentage growth in endoscopy procedures each year?
- My trust is on the border of England and Wales. What wait times should my service adhere to, given we have both English and Welsh patients?
- Do planned elective therapeutic endoscopic procedures such as EMR or HALO still fit 6 week JAG targets given completion of diagnostic endoscopy within schedule?
Patient experience
- What comfort level descriptors should an endoscopy service use?
- Can ODPs take patient consent?
- Does JAG have any guidance on transgender patients?
- Is it mandatory to provide a hearing loop system?
- Is it appropriate to ask patients and endoscopists to sign more than one copy of a consent form?
- Is postal consent a valid form of consent?
Workforce
- Does JAG have any guidance to support safe staffing for GA lists?
- Can endoscopy nurses remove gastronomy PEG tubes if they are not trained as first assistants?
- Why does JAG need to know the names of all staff at my service?
- Do management leads need to be healthcare professionals who have completed a recognised endoscopy course?
- Can we offer the role of training lead to a nurse endoscopist?
- How much time should clinical leads and training leads be given in their job planning?