Direct Access Endoscopy Restarting

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  • Direct Access Endoscopy Services will resume at the Homerton in November 2020.
  • Flexible Sigmoidoscopy (DAFS) and Colonoscopy (DACS) will resume from 1st November 2020.
  • Gastroscopy (DAE) will resume from 9th November 2020.

There are a few changes to be aware of:-

Direct access colonoscopy: With the availability of FIT for the investigation of patients who are lower risk for bowel cancer, it is anticipated that there will be a reduced need for this service. It has been decided to continue this service for the time being for patients who require a colonoscopy for a strong family history of colorectal cancer (see BSG guidelines) or those who require polyp surveillance (note new guidelines for who requires surveillance, as some patients told in the past that they’d need a follow-up procedure may no longer require this).

Dysphagia: The new Edinburgh Dysphagia score (EDS) is to help guide which patients with dysphagia symptoms require an urgent OGD (at higher risk of malignancy) and which can be referred for routine OGD. The DA OGD referral forms (and the dyspepsia pathway) have been amended to include this.

Patient pathway: All patients attending the Endoscopy Unit at Homerton Hospital will require a telephone pre-screening appointment and a COVID-19 swab (both of which will be arranged by the unit),  In light of this, all Direct Access Endoscopy Services will no longer be ‘directly bookable’ with an appointment date, but will be changed to a RAS (Referral Assessment System) on e-RS. This can still be found in the same place under ‘Diagnostic Endoscopy', but you will click ‘Send for Triage’, and this will only be visible to the hospital team once the referral forms are attached. The endoscopy booking staff will contact the patients on receipt of the referral to arrange the pre-screening and swab testing and to give them a date for the Endoscopy appointment afterwards.  Please continue to provide the information leaflets to the patient for DA OGD, DAFS and DACS, reminding patients for an OGD to fast for 6hrs before the procedure and prescribing Moviprep 2 sachets for DACS patients.

Expiry date: Nov 5th, 2021