Innovation clears endoscopy waiting lists

A potentially life-saving diagnostic test has cleared backlogs of patients waiting for endoscopy services in Cheshire, Merseyside, Lancashire and South Cumbria.

The ‘sponge on a thread’ test, known as Cytosponge, helps identify people most at risk of oesophageal cancer and has been offered in community settings, diverting patients away from hard-pressed hospital endoscopy teams.

The test involves the patient swallowing a capsule attached to a thread. The capsule dissolves after a few minutes to release a sponge that gathers oesophagus cells for analysis as it is pulled out.

Health Innovation North West Coast was a key partner in a consortium bid that secured £500,000 of SBRI Healthcare funding (an Accelerated Access Collaborative initiative) for the pilot of a diagnostic test, known as Cytoprime, that included partners from primary and secondary care and Cambridge artificial intelligence specialists Cyted, who developed the test.

The project took place in Lancashire, South Cumbria, Cheshire and Merseyside, where the test was offered to patients suffering from reflux and Barrett’s oesophagus, a condition in which the lining of the gullet becomes inflamed, and which can lead to cancer.

Interim findings from the pilot show that the backlog of patients under surveillance for Barrett’s oesophagus at three trusts in Lancashire has been cleared.

The pilot was also able to prioritise more urgent cases, while there were fewer instances of patients not attending appointments.

Tanis Barnett from the Lancashire and South Cumbria Cancer Alliance managed the project which covered East Lancashire Hospitals NHS Trust, University Hospitals of Morecambe Bay NHS FT and Blackpool Teaching Hospitals NHS Foundations Trust. The Lancashire primary care sites involved in the project were Oswald medical practice in Accrington, Burnley group practice, Morecambe Bay Primary Care Collaborative and Fylde Coast Medical Services.

She said: “It’s been a highly successful project, and nothing demonstrates that better than the fact we’ve cleared the backlog of patients under Barrett’s surveillance at all three hospital trusts.

“We’ve had nothing but positive feedback from all the clinical teams and patients involved.”

Stephanie Driver is practice manager at Oswald medical centre. She said: “Our first reaction was Why hasn’t anyone thought of this before? Our patients’ reaction was overwhelmingly positive when we offered Cytosponge as an alternative procedure.

“We came together with a group of people from a number of organisations who were equally committed, and once you have that commitment everything else follows from it.”

The Cytosponge test is minimally invasive and generally more comfortable for patients, needs no sedation and can be delivered in a nurse-led clinic in around 15 minutes.

By contrast, an endoscopy or gastroscopy requires a team of specialists in secondary care and can take several hours of preparation.

St Helens and Knowsley Teaching Hospitals NHS Trust took part in a separate, national trial of Cytosponge. Consultant gastroenterologist Dr David McClements said the test had helped clear a backlog of 300 patients who were overdue tests for Barrett’s oesophagus.

He added: “We’ve not only cleared the backlog we are bringing patients forward. It’s had an amazing impact on our backlog and future lists.

“I’m sure the test will become part of standard guidelines and the more we increase the evidence base the more widely accepted it will become.

“It’s much better tolerated by patients than a gastroscopy and provides a really good alternative for those with dyspeptic symptoms and those who would have had a lifetime of gastroscopy tests previously.”

Ed Millensted, Head of Programmes for the Innovation Agency’s System Partnerships Team, said the project was an excellent example of collaboration between the health service and industry.

“It’s a national priority to divert demand away from endoscopy and this project has able to reduce waiting times from referral to diagnosis, prioritise those individuals most at risk of cancer and generally improve patients’ experience of care.”

You can read our Cytoprime case study here.