n = number of cases where information was provided
THE ENDOSCOPIST
Key point
A consultant was the senior endoscopist for 97% of ERCPs.
From the data available it could be seen that a consultant was the senior endoscopist for 97% (226/233) of ERCPs performed (Table 45).
Table 45. Specialty and grade of endoscopist for ERCP
Specialty
Grade
Total
(%)
Physician
Consultant
154
(66)
Associate specialist
1
(<1)
Staff grade
2
(<1)
SpR of three years or more
1
(<1)
Surgeon
Consultant
57
(24)
Associate specialist
1
(<1)
SpR - post CCT
1
(<1)
Not answered
1
(<1)
Radiologist
Consultant
15
(6)
Sub-total
233
Not answered
4
(2)
Total
237
Where the data were available, in 11% (23/202) of cases the senior endoscopist
performed less than 50 ERCPs a year. The exacting nature of this procedure, with its high complication rate, suggests that when an individual or unit is performing few ERCPs the advisability of them undertaking these procedures should be considered. However, there
is no evidence on the number required to maintain competency and departments and individuals should be reviewing their own perfomance. Rationalising the service with
internal referral to lead endoscopists for ERCP or inter-hospital referral may be indicated.
(For a more detailed discussion on training and the problems of assessing competency,
please refer to the chapter entitled ‘Training and Education’).