The Covid pandemic resulted in a significant reduction in endoscopy training opportunities for our regional trainees in 2020. Despite the resultant training deficit, the 2021 SWETA SpR endoscopy training survey highlighted a number of challenges that our trainees face in accessing sufficient numbers of endoscopy training lists. Having a resilient future endoscopy workforce is dependent on endoscopy training prioritisation. The importance of a focus on endoscopy training has been emphasized in the Mike Richard’s report on diagnostic recovery  and the NHS’s 2021/22 priorities and operational planning guidance .
This SW endoscopy training guidance has been written to support the region’s endoscopy training centres by providing recommendations for endoscopy training delivery.
Responsibilities of SWETA
- In collaboration with the region’s endoscopy training centres, ensure that there is sufficient course capacity for the region’s trainees
- Ensure that trainees can access appropriate courses at the appropriate time in their training, specifically
- SPRINT (simulation) courses
- Basic skills courses
- Human factors (Endoscopic non-technical skills) courses
- Increase provision of simulation courses including polypectomy and Upper GI Bleeding courses in the region
- Support the development and quality assure immersion training at the region’s academy centres (Cheltenham and Torbay) - expected to come on line 2022
- Co-ordinate immersion training blocks with academy centres, TPDs and trainees.
- Work closely with the surgical and gastroenterology TPDs to identify and support any trainees in need of additional support
- Promote the national HEE clinical endoscopist programme within the SW region
- Audit training delivery at base training units through the annual SpR survey.
- Ensure increased opportunities for human factors training in the region
- Support trainers through provision of TxT courses, faculty development courses and outreach
Organisation of endoscopy training at endoscopy units
- Training lists are coordinated by a dedicated member of staff (JAG GRS standard 17.2) 
- A nominated local training lead has overall responsibility for ensuring the induction of trainees and has oversight of training list allocations (with recognised time in their job plan). (JAG GRS standard 18.2)
- Each trainee should have a virtual appraisal with the upcoming training lead one month before start date to assess training needs and proactively organise training lists tailored for that trainee
- There is an endoscopy induction programme for all new endoscopy trainees which references all key quality indicators. This is reviewed and updated annually (JAG GRS standard 17.3)
- There is an assessment of endoscopic skills conducted by the local training lead (or nominated deputy) for trainees seeking to perform procedures independently. (JAG GRS standard 19.4)
- There is a policy for defining and monitoring independent practice of endoscopy trainees. (JAG GRS standard 19.5)
- When the Academy Centres have been fully established, training should continue at the base endoscopy units without reductions in training list numbers
- Endoscopy training provision should be discussed as a recurring agenda item at the endoscopy user group and governance meetings. There should be trainee representation at those meetings. (JAG GRS standard 17.6)
- Trainees should be released to attend their mandatory Basic Skills courses.
Training list opportunities
- Endoscopy trainees have at least 20 dedicated training lists annually which are planned at least 6 weeks in advance in addition to ad hoc training opportunities. (JAG GRS standard 17.7)
- Endoscopy trainees should have access to a minimum of one endoscopy list per week (training list or service list)
- Trainees should have access to ad hoc lists within the units as well as dedicated training lists as long as the list is with one of the named trainers in the unit and as long as the trainer agrees (JAG GRS standard 17.7)
- Gastroenterology, surgical and clinical endoscopy trainees should have equal access to both dedicated training lists and ad-hoc training lists
- Trainees who are on a surgical GI placement and who have not yet declared their subspecialty interest can attend endoscopy lists with a named supervisor in their department to observe endoscopy however hands on endoscopy training should only commence when a trainee has declared a GI sub-speciality interest
- Trainees who are on a surgical rotation and have declared a GI sub-speciality interest but are working on a non-GI firm, e.g. vascular, should still be offered access to the endoscopy units for endoscopy training lists
- Trainees on a surgical rotation who have declared a non-GI sub-speciality interest, eg vascular or breast, should not be offered endoscopy training.
- Dedicated training lists should either have reduced number of points on the list and/or be segmented (defined cases allocated to the list - e.g., variceal banding) to ensure trainee learning needs are met.
- In units where there are more than 1 gastro or surgical trainees, one week immersion blocks of endoscopy training (e.g., 5 endoscopy lists - training or service) should be considered if cross-cover of other trainee commitments can be arranged
- Training units should consider additional training opportunities for trainees including access to weekend lists, waiting list initiatives, community hospital endoscopy lists etc
- Where trainees have defined rotas, endoscopy training should be scheduled alongside other commitments
- Each unit should have a list of designated trainers who are willing to train. This list should be shared with endoscopy trainees at induction
- Endoscopy trainers’ performance is reviewed, and actions taken to develop trainers. (JAG GRS standard 18.4)
- At least one trainer participates as training faculty on a JAG-approved training course annually. (JAG GRS standard 18.7)
- All endoscopy trainee activity is recorded on JETS. (JAG GRS standard 19.2)
- If a trainee achieves JAG certification, they should be encouraged to deliver service lists as long as they and the training lead is happy that they are ready to do so and that they have immediate access to support/supervision
- All trainees should complete the annual endoscopy training survey
This document has been reviewed and approved by:
Dr Geoff Smith, Regional Postgraduate Dean, HEE-SW
Mr Mark Coleman, Colorectal surgeon and JAG Chair
Mr Tim Cook, Colorectal surgeon and ex SAC chair
Dr Paul Dunckley, Consultant Gastroenterologist, Director SW Endoscopy Training Academy, HEE-SW
Richards, M. Diagnostics: Recovery and Renewal. Report of the Independent Review of Diagnostic Services for NHS England.