A survey of endoscopy units by the BSG in 2003 revealed that less than 50% of hospitals have twenty four hour/seven days/week access for patients requiring diagnostic/interventional endoscopy for GI bleeding. A more recent comprehensive survey of 161 endoscopy units showed a further small decline in the availability of out of hours cover.

The introduction of the new consultant contract and the increasing numbers of acute medical admissions have led to consultant gastroenterologists being expected to provide an out of hours(OOH) GI bleeding service whilst their ward-based responsibilities inexorably rise. Financial pressures have also led to a reduction in the numbers of units having specialist endoscopy nurses working out of hours.