Irene Dunkley, Helen Griffiths, Rachael Follows, Alison Ball, Mandy Collins, Phedra Dodds, Richard Gardner, Victoria Jackson, Claire Rodgers, Barbara Simpson, Nicky Taggart, Tony Tham, Vivienne Wilkin, Andrew Veitch
Patients undergoing endoscopy procedures expect support and care from a competent healthcare team. The original endoscopy guidance on workforce was published in Gut in 1987; since then there have been significant developments in endoscopy techniques and the way endoscopy services are delivered in all the home nations of the UK. JAG does not state the numbers of staff required for an endoscopy unit as there are variations in the environment, procedure types and patients’ health status. This document makes a number of recommendations to guide managers’ decision-making on safe staffing levels.
Summary of recommendations
- We recommend that all registered nursing and allied healthcare professionals work within their code of conduct at all times.
- We recommend that all patients receive care supervised by a registered nurse who is accountable for their care throughout their time in the endoscopy department.
- We recommend that delegation of responsibilities is considered, and only delegated to an individual deemed competent to undertake the task. All staff competencies should be clearly displayed in the endoscopy unit.
- We recommend that thorough assessments of patient health status are undertaken before, during and after endoscopy procedures by a competent registered practitioner.
- We recommend that staff who assist with complex procedures, or manage the care of patients with complex needs, should demonstrate a high level of relevant competence. This should be both in the technical aspects of endoscopic procedures, and the higher levels of assessment and monitoring required in patients at greater risk of deterioration or complications.
- We recommend that pre-procedure checklists are undertaken, and all aspects of care throughout the procedure, including any changes in health status, must be documented and reported to the endoscopist.
- We recommend that all staff have access to education and training, in line with endoscopy national frameworks, to meet professional standards, with regular appraisals of performance and competence to support staff development and professional revalidation.
- We recommend that all staff actively participate in their own educational and skill development.
- We recommend that all staff have a portfolio of competencies reflecting their education and training. This includes assessments of their competencies by senior registered staff, and evidence to support to their learning and revalidation. All endoscopy services must have an education, mentorship and supervision programme for all staff.
- We recommend that due consideration is given to the endoscopy environment. All areas where patients are cared for must have the appropriate staffing skill mix to support patients’ needs.
- We recommend that managers consider the numbers of staff, their qualifications, skill mix and competencies. There must be registered staff responsible for the supervision and direction of appropriate care at each step of the patient journey.
- We recommend that service managers, endoscopy nursing leads and clinical leads are responsible for planning future service delivery collaboratively. This should include workforce requirements to meet national guidance and local requirements.