1. ENDOSCOPY 2006 A NEW WORLD BEGINS

2. www.thejag.org.uk PMETB PMETB JCHMT, JCHST JCHMT, JCHST RCP, RCPed RCP, RCPed RCPSglas RCPSglas RCS, RCSed RCS, RCSed RCPGP RCPGP RCN RCN BSG BSG ACP, AUGIS ACP, AUGIS

3. TRAINING SITES 3 NATIONAL CENTRES 3 NATIONAL CENTRES POLICY DECISION POLICY DECISION COURSE DEVELOPMENT COURSE DEVELOPMENT 7 REGIONAL CENTRES 7 REGIONAL CENTRES TRAINING DELIVERY TRAINING DELIVERY JAG APPROVED UNITS JAG APPROVED UNITS NOWHERE ELSE CAN TRAIN NOWHERE ELSE CAN TRAIN

4. COURSES JAG APPROVED JAG APPROVED JAG COMPLIANT JAG COMPLIANT MUST DO SPECIFIC COURSES MUST DO SPECIFIC COURSES APPLIES TO ALL ENDOSCOPISTS APPLIES TO ALL ENDOSCOPISTS

5. COURSES BASIC ENDOSCOPY BASIC ENDOSCOPY UPPER GI DIAGNOSTIC UPPER GI DIAGNOSTIC FLEXIBLE SIGMOIDOSCOPY FLEXIBLE SIGMOIDOSCOPY COLONOSCOPY COLONOSCOPY ERCP ERCP THERAPEUTIC UPPER THERAPEUTIC UPPER EUS EUS TTE / STT TTE / STT

6. TRAINEES SpR AND ABOVE – NOT SHO SpR AND ABOVE – NOT SHO NURSES NURSES PERMANENT STAFF PERMANENT STAFF GP’S GP’S OTHERS OTHERS

7. TRAINEES START WITH BASIC COURSE (Sp1) START WITH BASIC COURSE (Sp1) MORE SPECIALIST COURSES LATER MORE SPECIALIST COURSES LATER Sp2/3 gastro trainees Sp2/3 gastro trainees At sub-specialisation – surgical (Sp3/4) At sub-specialisation – surgical (Sp3/4) Only appropriate courses Only appropriate courses No tick boxing No tick boxing

8. TRAINEES BASIC COURSE BASIC COURSE COMPLETE CONSOLIDATION COMPLETE CONSOLIDATION DECLARATION OF COMPETENCE DECLARATION OF COMPETENCE ONLY THEN - MOVE ON TO NEXT ONLY THEN - MOVE ON TO NEXT

9. TRAINERS ON COURSES – TTT / TTE ON COURSES – TTT / TTE AT BASE – TTT/TTE or STT AT BASE – TTT/TTE or STT AIM AIM LOCAL TTT RESPONSIBLE LOCAL TTT RESPONSIBLE LOCAL TTT / STT DELIVERY LOCAL TTT / STT DELIVERY

10. TRAINERS MAJOR CHANGES IMMINENT MAJOR CHANGES IMMINENT NO TTT/TTE/STT NO TTT/TTE/STT = NO TRAINEES = NO TRAINEES TRAINERS MUST BE IN ROOM AT ALL TIMES TRAINERS MUST BE IN ROOM AT ALL TIMES TRAINING COLONOSCOPY COUNTS IN TRAINERS FIGURES TRAINING COLONOSCOPY COUNTS IN TRAINERS FIGURES

11. ASSESSMENT MEDICAL/SURGICAL MEDICAL/SURGICAL VIA RITA PROCESS VIA RITA PROCESS ? CERTFICATION ? CERTFICATION TRAINING LOG TRAINING LOG DOPS FORMS DOPS FORMS CONSOLIDATION FORMS CONSOLIDATION FORMS www.thejag.org.uk www.thejag.org.uk

12. ASSESSMENT OTHER MEDICAL OTHER MEDICAL NURSES NURSES OTHER ENDOSCOPISTS OTHER ENDOSCOPISTS REGISTER WITH JAG REGISTER WITH JAG PROVIDE LOG/DOPS EVIDENCE PROVIDE LOG/DOPS EVIDENCE ?CERTIFICATION ?CERTIFICATION

13. ENDOSCOPY QA ENDOSCOPY UNITS ENDOSCOPY UNITS GLOBAL RATING SCALE GLOBAL RATING SCALE JAG VISITS / REGISTRATION JAG VISITS / REGISTRATION ENDOSCOPISTS ENDOSCOPISTS ALL ENDOSCOPISTS ARE EQUAL ALL ENDOSCOPISTS ARE EQUAL PERSONAL QA – BEGINS NOW PERSONAL QA – BEGINS NOW

14. ENDOSCOPY QA STARTING WITH COLONOSCOPY STARTING WITH COLONOSCOPY PRECIPITATED BY BSG AUDIT PRECIPITATED BY BSG AUDIT MADE ESSENTIAL BY SCREENING MADE ESSENTIAL BY SCREENING SCREENING QA (screen bar) DECIDED SCREENING QA (screen bar) DECIDED TWO TIER SERVICE INCONCEIVABLE TWO TIER SERVICE INCONCEIVABLE

15. THE SCREEN BAR MINIMUM OF 150 PER YEAR MINIMUM OF 150 PER YEAR LIFETIME PERF RATE < 1:1000 LIFETIME PERF RATE < 1:1000 ADENOMA DETECTION >15% ADENOMA DETECTION >15% BASED ON PRIMARY DIAGNOSTIC SCOPE BASED ON PRIMARY DIAGNOSTIC SCOPE 85% CAECAL INTUBATION RATE 85% CAECAL INTUBATION RATE BASED ON LIST DESCRIPTOR BASED ON LIST DESCRIPTOR NO DISCOUNTING ALLOWED NO DISCOUNTING ALLOWED 90% IF YOU DISCOUNT 90% IF YOU DISCOUNT

16. THE SCREEN BAR MCQ BASED ON LESION RECOGNITION MCQ BASED ON LESION RECOGNITION HANDS ON ASSESSMENT – RECORDED LIST OF 4 WITH IMAGER AND TRI- SCREEN HANDS ON ASSESSMENT – RECORDED LIST OF 4 WITH IMAGER AND TRI- SCREEN APPEALS POSSIBLE APPEALS POSSIBLE

17. THE SCREEN 10 – 15% NON NHS DELIVERY 10 – 15% NON NHS DELIVERY SAME ASSESSMENT WILL APPLY SAME ASSESSMENT WILL APPLY

18. THE SCREEN BAR WILL EVENTUALLY APPLY TO ALL COLONOSCOPISTS: WILL EVENTUALLY APPLY TO ALL COLONOSCOPISTS: IN NHS UNITS IN NHS UNITS IN DIAGNOSTIC CENTRES IN DIAGNOSTIC CENTRES IN PRIVATE HOSPITALS IN PRIVATE HOSPITALS

19. WELCOME TO THE FUTURE QA IS ESSENTIAL QA IS ESSENTIAL QA IS HERE TO STAY QA IS HERE TO STAY UPDATE YOUR PRACTICE NOW UPDATE YOUR PRACTICE NOW DEMAND MASTERCLASSES/UPDATES DEMAND MASTERCLASSES/UPDATES MAKE SURE YOUR UNIT IS JAG’d MAKE SURE YOUR UNIT IS JAG’d MAKE SURE YOU CAN TRAIN MAKE SURE YOU CAN TRAIN

20. TRAINING IN THE FUTURE DIDACTIC SESSIONS – ELECTRONIC DIDACTIC SESSIONS – ELECTRONIC CENTRALIZED SIMULATED TRAINING CENTRALIZED SIMULATED TRAINING UNIT BASED PRACTICE (TTE/STT) UNIT BASED PRACTICE (TTE/STT) LESS TIME AWAY FROM BASE LESS TIME AWAY FROM BASE RITA / JAG CERTIFICATION RITA / JAG CERTIFICATION CENTRAL FUNDING ENDS CENTRAL FUNDING ENDS LOCAL FUNDING BEGINS 2007 (WDD/WDC or DEANERY) LOCAL FUNDING BEGINS 2007 (WDD/WDC or DEANERY)

21. TRAINING IN THE FUTURE TRAINING MEANS TRAINING TRAINING MEANS TRAINING IN THE ROOM IN THE ROOM HANDS ON HANDS ON NOT JUST “available” NOT JUST “available” UNTIL CERTIFIED UNTIL CERTIFIED