Login

Routine Upper and Lower GI Endoscopy

 

Introduction

Community Diagnostic Centres provide diagnostic services for adults in the community, reducing the need for patients to travel long distances. Cornwall and the Isles of Scilly now benefit from an additional endoscopy suite based at the Camborne and Redruth Community Diagnostic Centre.


 

Tests Available

  • Routine upper GI endoscopy
     
  • Routine lower GI endoscopy

 

Please note that this service is not for urgent or emergency need such as acute dysphagia or acute upper or lower GI bleeds.


Please note this service is not for fast track for suspected cancer or fast track direct access upper endoscopy. 


Please follow the Acute GP guidelines for urgent GI bleeds and urgent endoscopy or arrange emergency medical treatment as clinically appropriate.


Please refer via the fast-track referral pathways, on the fast-track forms, for any suspected cancer.

 

Please follow the RMS Gastroenterology and Colorectal guidelines in all cases


 

Duodenal Biopsy

If duodenal biopsy is required to confirm a diagnosis of Coeliac disease, then refer via eRS for endoscopy.


Patients must be eating a diet containing gluten.


For patients who do not meet criteria or are excluded from a direct access service, then please consider referral to secondary care.


 

Exclusion criteria for endoscopy at the CDC

  • Requiring immediate referral to secondary care
  • Medically unfit or unstable
  • Myocardial infarction in the last 3 months
  • Severe heart failure
  • Unstable angina
  • Severe COPD
  • Weight over 220kg (34 stone)
  • Lynch Syndrome
  • Therapeutics such as Variceal banding
  • Patient unable to consent
  • Requires screening for a family history of colorectal cancer, please follow the family history of colorectal carcinoma guidelines
  • Age under 18 years
  • Referred for Capsule Endoscopy
  • Patients under treatment for suspected diverticulitis and on a course of antibiotics should not be referred until course has been completed (patients will not be seen until 6 weeks’ post antibiotic course). This MUST be noted clearly on the referral
  • Pacemaker/ICD DIAGNOSTIC colonoscopy ONLY without scope guide, diagnostic gastroscopy
  • Mobility - Patient must be able to transfer from chair to trolley and turn 180 degrees (left to right hand side on trolley)
  • Barrett’s Surveillance– long segment Barrett’s (ie 3cm or more) is for secondary care surveillance
  • Large Polyps - these will be clinically assessed if safe for removal in a community site according to size, site and type of polyp
  • Patients requiring a general anaesthetic such as for complex therapeutic procedures or for patients where ability to co-operate during a procedure is in doubt such as with severe learning disabilities.

 

For community colonoscopy patients should also:

  • be able to tolerate the bowel preparation
  • not have severe renal impairment - cut off for eGFR <30 ml/min. If eGFR is below 30 then seek advice and guidance or refer to secondary care
  • be reasonably fit to tolerate the sedation. Beware for significant cardio-respiratory disease
  • be relatively mobile - during colonoscopy patients turn several times to facilitate onward movement of the scope.

 

Sedation

Discussions around sedation are best had with the patient and an endoscopy nurse or endoscopist and not with the GP.  Patients requesting sedation for endoscopy should be advised that this will be discussed with the endoscopist prior to their procedure.

 

The InHealth community diagnostic centre (CDC) also advises the following:

'Some patients may be able to tolerate a trans nasal endoscopy better than a traditional OGD which could be done with or without sedation at the CDC. For some patients who are frail, it is unsafe to give any sedation and always ultimately down to the endoscopist to decide (with discussion with the patient). This would be true wherever they attend for endoscopy.'

 

Referrers should therefore refer in the usual way and avoid stating that a patient needs deep sedation as this can cause confusion.


 

Referral Instructions and Information

Refer via eRS to RMS

  • InHealth triage the referral and if accepted will organise an Endoscopy telephone preassessment
  • Following this if all satisfactory, InHealth will send an appointment instruction pack and bowel prep if needed
  • Referrals that do not meet the criteria will be returned to the referrer with details.
  • The endoscopy report is sent to the GP on the day of the appointment, and a supplementary report is sent including the histology results if samples are taken.
  • Onward referrals to RCHT services are initiated by InHealth as required.

 

Page review information

Review date

17 April 2026

Next review date

17 April 2028

Clinical editor

Dr Rebecca Hopkins

Contributors

Planned Care Commissioning Team, Cornwall and IoS ICB