The aim of this document is to provide an evidence- base according to which good quality secondary care services should be commissioned for patients with symptoms and conditions related to the gastrointestinal tract and liver.

Adherence to this should facilitate care that is:

  • appropriate
  • good quality

  • cost effective

  • coordinated across primary and secondary care


It is expected that implementation of these recommendations should:

  • re-align resources to improve outcomes and provide better value

  • reduce inequalities in care

    The guidance given here focuses on provision of medical gastroenterology and hepatology services, including endoscopy, but does not cover emergency or elective surgery. It also does not
    cover the essential high quality support services that include specialist GI/liver pathology, diagnostic and interventional radiology, and microbiology, all of which need to be commissioned to ensure a good GI/hepatology service.

    The new commissioning framework represents a great opportunity for colleagues in primary and secondary care to work together to re-evaluate patient needs, reduce activity that is outdated or
    of limited value, invest in high value services that meet patient needs and thereby achieve the overall objectives of improving value whilst modernising the service to meet the goals of the Outcomes Framework as it applies to gastrointestinal and liver diseases.


Access the full commissioning report here.