Transforming Trans-nasal Endoscopy Services: A multicentre service evaluation pilot project.

Objectives: To assess the impact of pilot Transnasal endoscopy (TNE) services on workforce efficiency, allocated procedure times and patient tolerance of procedures. The aim was to also understand the challenges of setting up a TNE service.

Methods: Six-month data was collected from ten sites. Data captured included productivity, performance, workforce numbers, facilities and quality metrics. A patient survey was done to capture patient's experience. An eight likert-style and open question survey was designed and used. Pilot sites were visited using a semi-structured interview process.

Results: 30% of the pilot sites carried out the TNE service outside of the endoscopy unit. There is an overall 25% improvement in workforce efficiency with TNE. Of those patients that had both a TNE and OGD 78% of patients reported that having the TNE procedure was a better experience. All sites reported that they will continue providing TNE beyond the pilot period. Sites carrying out TNE reported a high satisfaction with the services. Overall satisfaction with the quality of TNE imaging was very high.

Conclusions: This multicentre pilot project shows evidence that the integration of TNE services has a positive impact in increasing capacity and patient satisfaction. This should set the scene for scaling this up on a wider capacity. TNE services particularly with an introduction into outpatients will improve service capacity in endoscopy, patients will tolerate the procedures more, national two week wait, and Faster Diagnostic Standard targets will improve, and it is potentially more cost efficient overall.