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March 22, 2021

Endoscopy backlog at half a million and rising in England, report finds

A backlog in England of nearly half a million endoscopy procedures has built up during the Covid-19 pandemic, according to a new analysis of NHS England data from University College London (UCL).

By Chloe Kent

A backlog in England of nearly half a million endoscopy procedures has built up during the Covid-19 pandemic, according to a new analysis of NHS England data from University College London (UCL).

The study, published in The Lancet Gastroenterology and Hepatology, shows that the number of endoscopies performed in England in April 2020, the month following the first lockdown, fell by over 90%.

To estimate the potential backlog, UCL researchers compared the number of colonoscopies, flexible sigmoidoscopies and gastroscopies performed every month from 1 January 2018 to 31 October 2020 in 125 different NHS England trusts.

The researchers concluded that even if endoscopy procedures fully returned to their usual pre-pandemic monthly totals in November 2020, the January 2021 backlog would still be 476,000.

This figure could potentially rise to over 870,000 should there be a further full or partial lockdown or slow relaxing of restrictions.

A further two-month interruption would add an extra 15.4% to the backlog total, a four-month interruption would add an extra 43.8%, and a six-month interruption would add an extra 82.5% to the potential backlog.

The researchers then modelled the backlog from January 2021 to January 2023, estimating the backlog recovery at 90% of capacity through to 130%.

The study estimated that procedures would need to be performed at 130% capacity to clear the backlog by January 2023.

Clinicians are now calling on the UK government and NHS to implement a mitigation plan to prioritise patients in urgent need of an endoscopy to help reduce the health consequences of the delays.

UCL Division of Surgery and Interventional Science Professor Laurence Lovat said: “Our study highlights the scale the Covid-19 pandemic has had on endoscopic services on the NHS in England. Even with mitigation measures, such as FIT [fecal immunochemical test] triaging, it could take much longer than a year to eliminate the pandemic-related backlog.

“Urgent action is required by key stakeholders, including individual NHS trusts, Clinical Commissioning Groups, British Society of Gastroenterology, and NHS England, to tackle the backlog and prevent delays to patient management.”

Gastrointestinal cancers, which are routinely diagnosed via endoscopy, remain some of the UK’s most prevalent and deadly forms of cancer.

Bowel cancer is the second-biggest cancer killer in the UK, while oesophageal cancer comes in 7th and stomach cancer is 15th.

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