Proposal

It is recognised that the current Bowel Cancer Screening Programme in England is regarded as one of the best, if not the best in the world. This is based on the high quality outcomes seen in the programme, which is a reflection of the workforce which supports this. Integral to this is the performance of the individual colonoscopists.

The current assessment process is robust and validated and has been proven to be highly effective. It is accepted that any proposal suggesting a modification or changes to this process will need to at least perform as well as the existing accreditation system.

Despite the success of the accreditation process in enabling a high quality screening workforce, the process does have some issues:

• Lack of assessment opportunities for candidates
• Need for urgent expansion of BCSP screening workforce
• Relatively time consuming nature of current assessment process, in relation to organisation and actual assessing
• Relative expense - direct and indirect in setting up and hosting BCSP assessments
• Difficulty in some individual reaching existing thresholds for application (e.g. min 1000 colonoscopies performed)

The pilot aims to enable an accelerated process for accreditation, utilising National Endoscopy Database (NED) data without the
need for a formal face to face DOPS assessment.

Application process

Individuals looking to apply will need the support of their screening centre who will be required to fill out a new screener request form on their behalf. The new screener request form can be found here. 

Once the form has been through a regional QA and PHE approval process it will be sent to JAG who will check the individuals KPI data using NED. Should the KPI data meet the pilot criteria the individual will be invited to join the pilot. Should the individual's KPI data not meet the pilot specific criteria they will continue down the standard BCSA DOPS assessment application route.  

Requirements for BCSA NED pilot:

•      Conventional BCSA application (candidate to fill in standard BCSA online application form after invite email)

•      Named mentor

•      Mentorship/training must be a minimum of 1 list per week and a minimum duration of 4 weeks

•      Successful completion of BCSA MCQ

•      Applicant to start independent screening after a minimum of 6 lists if the mentor assessors the individual sufficiently competent for this. The mentorship period may last up to maximum of 6 months

 

KPI criteria for NED/BCSA pilot (base level)

1. Minimum of 200 independent colonoscopies per annum
2. Caecal intubation rate (CIR) of >95%
3. Polyp detection rate of >40%

Lifetime numbers threshold

The majority of trainees currently need 250-300 colonoscopies to gain basic competence and JAG certification. A further
200 independent cases increases lifetime experience to about 500 cases. If individuals were performing >200 cases
per year it would take until the end of their second year of independent practice before they would be eligible for screener accreditation application. For this reason, it is suggested that a min of 2 years data with >200 cases per year becomes part of this NED application criteria

To assess and validate the effectiveness of the BCSA NED pilot, participants must also agree to the following:

Completion and submission of 360 multi-source feedback (MSF) from training lists (minimum of 20 assessments over 6 lists -            360 MSF to be completed by patient, mentor, nursing staff, SSPs)

More information will be provided to successful candidates on invitation to the pilot programme