BSG, ACPGBI and AUGIS guidance on the scope of professional practice for clinical endoscopists

Background This document focuses on the scope of professional practice for clinical endoscopists (previously known as non-medical endoscopists/nurse endoscopists). Clinical endoscopists not only contribute significantly to diagnostic gastrointestinal (GI) endoscopy services, performing upper GI endoscopy, flexible sigmoidoscopy and colonoscopy, but are extending their scope of practice to include more complex procedures such as bowel cancer screening colonoscopy and complex polypectomy. Aim The previous British Society of Gastroenterology (BSG) Working Party Report on this issue was published in 2005. This revised document aims to provide updated guidance on professional aspects of the clinical endoscopist roles and responsibilities, ensuring safe, high-quality care for patients. Methods The present document was produced by a guidance development group (GDG) including nurse consultants, clinical endoscopists and gastroenterologists, with experience in training and leading teams of clinical endoscopists. The first draft was developed by clinical endoscopists within the GDG, based on a comprehensive literature review. The wider GDG was then invited to review and contribute to the document and its recommendations. It was recognised that there was a paucity of high-quality evidence and the recommendations have been developed based on the best evidence available and consensus. Consensus was achieved through anonymised electronic voting among the GDG, with at least 80% agreement required for statements to be included. Results 23 recommendations achieved consensus outlining the roles and responsibilities of clinical endoscopists and encompassing three key components regarding the scope of professional practice: medicolegal aspects of professional practice; training, education and continued professional development; and care of the patient pre, peri and post endoscopy. Conclusions Clinical endoscopists make a vital contribution to endoscopy, gastroenterology and colorectal services. The present document offers guidance concerning best practice for clinical endoscopists, outlining a path from training to independent practice, management and expansion of practice. The implementation of these recommendations will lead to safer and more effective use of clinical endoscopists within our services, with continuous support and mentorship to promote the expansion of their practice, while ensuring the appropriate governance protocols are in place to provide patients with excellent care in endoscopy.