The Royal College of Physicians of London recently published a survey of out-of-hours services for gastrointestinal emergencies.1 The British Society of Gastroenterology surveyed 188 acute National Health Service (NHS) hospitals in England, particularly focusing on the management of gastrointestinal haemorrhage. The key findings from the 167 (89%) hospitals that responded are that 64% had an unsatisfactory emergency endoscopy service, 38% thought their service unsafe, 51% had no formal roster to cover emergency endoscopy services and 44% doctors who perform such a service are not paid for it or have it specified in their contract. The Clinical Services and Standards Committee of the Society comments that service innovation across organisational boundaries is needed plus the development of clinical networks, regional centres and finding local solutions for local circumstances.
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