The British Society of Gastroenterology welcomes the second Atlas of Variation in NHS Diagnostic Services in England; it is clear that unwarranted variation in endoscopy quality and access needs to be addressed. It is vital also that we keep our focus on outcomes rather than levels per se.

Integral to high quality diagnostic services is the workforce and this cannot be underestimated in the current environment. Not only is this important for endoscopists but also for the wider team, who increasingly play a fundamental role in the delivery of high quality care.

It is important that endoscopy resources are used in an impactful way and the right types of procedures are better deployed for the patient, such as colonoscopy, capsule endoscopy, flexible sigmoidoscopy and CT colonoscopy whilst procedures such as barium enema, that have no place in modern gastroenterology, are phased out by NHS England.

Professor Martin Lombard President, British Society of Gastroenterology