| JOINT ADVISORY GROUP
ON GASTROINTESTINAL ENDOSCOPY (JAG) 86% of acute units have been JAG visited in the past 4-5 years – the first round of accreditation (5 year cycles) for all acute sector units will be completed by June 2011. The proposed future accreditation will consist of ‘in depth’ JAG visit every 5 years and ‘maintenance of accreditation’ review every year. The yearly review will involve self-complete assessment using key performance indicators JAG QA Working group for trainees Currently therapeutic certification is suspended and the work is in progress to develop assessment tools for therapeutic endoscopy. Polypectomy assessment tool (DoPyS) have now been developed and mostly validated and will appear on the JAG website shortly. Although it will be difficult to train all assessors in person, detailed guidance will be provided on the website giving guidance on how to assess trainees. Polypectomy assessments will become mandatory for JAG certification. At the recent JAG committee meeting, it was proposed that there should be a change in the way that summative DOPS for endoscopy are done. The JAG recognises that it can be extremely difficult for trainees to have a 2x2 assessment performed (ie 2 assessors watching 2 consecutive procedures, neither of whom must be the indivual's training supervisor). Report of key items from JAG Committee meeting, 22.4.08 Increasing representation by all endoscopy groups has led to regular committee attendance by 20-30 people over the last few meetings. This reflects what are interesting times for all endoscopic practices. The main activity of JAG currently is the development and maintenance of agreed standards for endoscopy and endoscopy units. This has been driven by funding for the bowel cancer screening project(BCSP) and the national endoscopy(NET) project. That funding is soon coming to an end. In the near future revalidation seems a certainty and endoscopy will undoubtedly be included within this. I think at the least, agreed JAG standards will define this and with the expertise gained through the above programmes it would seem logical to harness JAG for this. Whether this will be through JAG or not does remain to be seen, and this will be perhaps the single most important issue for all endoscopists in the coming months. Foreseeable problems with current endoscopic practice and training in specialties where endoscopy is both difficult, but vital, are leading discussions amongst the different bodies as endoscopy approaches professional revalidation. Away from this, work in the BCSP continues with a paper being produced on the colonoscopist’s “driving test” assessment . It is proving to be a highly robust process. From 150 tests the pass mark is 75%, and re-test pass mark 67%. From only 6-7 appeals, 2 have been upheld because of process difficulties. Guidelines on large polyp therapy are being drawn up, and will shortly be circulated for comment. These will probably suggest levels of competency for attempts at differing polyp types and size. This and guidelines on EUS and ERCP training will be of particular interest to trainees as the momentum gathers towards training of specialised endoscopists. The way that these specialist techniques are bundled will probably dictate the future practice of advanced endoscopic techniques, and those able to undertake non-diagnostic endoscopic sessions. JAG will look to review these ideas in light of best practice for patient outcome. EUS DOP’s and guidelines are being discussed and hopefully agreed by the BSG and EUS groups for release soon. A big project around e-learning for health, will start in June this year. JAG have been awarded a grant to provide an endoscopic programme. In light of this and other projects I wonder how much training will change in the near future? Finally everyone will have an opportunity to receive regular e-mail letter and contact from JAG, in an effort to increase communication around these difficult and interesting times. Report of key items from JAG Committee meeting, 08.01.08 Much of the meeting was dominated by ongoing JAG business with BCSP (Bowel Cancer Screening Programme) centre accreditation. The visits are proceeding at 5-6 a month, with further refinements to the administration of the visits by website support and standardization through increased JAG assessor training. Scotland will accredit centres but not endoscopists currently; Wales and Northern Ireland will follow the pattern set in England for the BCSP. The private sector seems keen to follow JAG guidelines, which should really drive up standards throughout the whole NHS. JAG continues to pursue representation by all endoscopy workforce groups, and welcomed Pauline Hudson a nurse representing the Endoscopy Associates Group. JAG wishes to set standards for all endoscopists, not just trainees. It continues to talk to surgical colleagues to gain their confidence and support. Competency based curriculum seems agreed as the way forward endoscopists. New polyp guidelines will be released soon. A grant has been obtained for e-health curriculum, and this will be developed. Universal support was voiced for the efforts of the paediatric gastroenterologists to meet JAG guidelines. This is ongoing. The next meeting was agreed for April 2008. |