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Clinical Pathway
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Recommended Action
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Routine New Patients
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Moved to telephone when possible. Some clinics cancelled so longer wait times.
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Urgent New Patients
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Moved to telephone, unless requiring F2F, will be prioritised.
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Routine Follow up patients
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Telephone were possible, unless clinical need.
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Endoscopy - Acute Upper GI bleeding
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Continue
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Endoscopy - Acute oesophageal obstruction – foreign bodies, food bolus, pinhole stricture/cancer where stenting is considered essential.
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Continue
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Endoscopy - Endoscopic vacuum therapy for perorations/leaks.
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Continue
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Endoscopy - Acute cholangitis/jaundice secondary to malignant/benign biliary obstruction
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Continue
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Endoscopy - Acute biliary pancreatitic and/or cholangitis with stone and jaundice
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Continue
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Endoscopy - infected pancreatic collections/WON
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Continue
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Endoscopy - Urgent inpatient nutrition support – PEG/NJ tube
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Continue
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Endoscopy - All routine symptomatic referrals
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Defer until further notice
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Endoscopy - Planned POEM, pneumatic dilatation for achalasia
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Defer until further notice
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Endoscopy - Other elective therapy/intervention –PEG, stricture dilatation, APC for GAVE, RFA, pneumatic dilatation, ampullectomy etc
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Defer until further notice
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Endoscopy - Low-risk follow-up and repeat scopes – oesophagitis healing, gastric ulcer healing, ‘poor views’, check post therapy e.g. EMR/RFA/polypectomy (unless felt to be clinically high risk neoplasia still present)
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Defer until further notice
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Endoscopy - Surveillance
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Defer until further notice
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Endoscopy - Other ERCP cases – stones where there has been no recent cholangitis and a stent is in place; therapy for chronic pancreatitis; metal stent removal/change; ampullectomy follow up.
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Defer until further notice
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2 Week Wait cancer referrals
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Original recommendation from JAG as follows - Consultants reviews and triage these referrals, reserving endoscopic procedures for those judged to be highest priority
New guidance 24/03 – suggests stopping all activity that is not emergency – waiting for clinical decision
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Planned EMR/ESD for complex polyps/ high risk lesions
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To continue but will need to have clinical case by case review
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New suspected IBD – acute colitis
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To continue but will need to have clinical case by case review
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