UK Endoscopy Quality: Insights from the National Endoscopy Database (NEDi2)

Aims This study aimed to utilise data from the second iteration of the National Endoscopy Database (NEDi2) to assess endoscopy quality across the UK.

Methods Data uploads to NEDi2 for endoscopic procedures (Gastroscopy, ERCP, Colonoscopy) conducted over a one-month period (November 2023) were analysed. Quality was assessed by calculating key performance indicators (KPIs) according to British Society of Gastroenterology (BSG) guidelines.

Results A total of 46,042 endoscopies were analysed: 23,107 gastroscopies (50.2%), 1,001 ERCPs (2.2%), and 21,934 colonoscopies (47.6%). The 23,107 gastroscopies were performed across 173 sites by 1,905 endoscopists. Most (57.0%) were conducted under conscious sedation, with 40.5% without sedation, and 2.5% using deep sedation or general anesthesia. Patient discomfort was reported as moderate or severe in 3.1% of cases. Intubation to the second part of the duodenum was achieved in 93.4%, and the J-maneuver was completed in 92.2% of procedures. The 1,001 ERCPs were performed across 65 sites by 187 endoscopists. Cannulation at first ERCP was successful in 89.0% of cases, with an initial stone clearance rate of 83.9%. The majority (81.2%) of ERCPs were performed under conscious sedation, 16.9% under deep sedation or general anesthesia, and 1.9% without sedation. Discomfort was recorded as moderate to severe in 3.6% of cases. The 21,934 colonoscopies were performed across 173 units by 1,880 endoscopists. Caecal intubation was achieved in 94.4% of cases, rectal retroversion in 91.8%, and the polyp detection rate was 44.1%. Mean withdrawal time in completed negative colonoscopies was 8.7 minutes. Most procedures (66.6%) were performed under conscious sedation, with 31.9% conducted without sedation and 1.4% under deep sedation or general anesthesia. Intubation methods included water alone (22.7%), a combination of gas and water (33.2%), and gas alone (44.0%). Discomfort was rated as moderate or severe in 4.5% of cases.

Conclusions The NEDi2 enables near real-time monitoring of endoscopy quality across the UK, providing valuable insights into performance and identifying areas for improvement. November 2023 data highlights an increased use of deep sedation for ERCPs compared to 2020, combined with reduction in discomfort rates. It also revealed that nearly half of colonoscopies still used gas insufflation, despite the documented benefits of water-assisted techniques.

Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025