Impact of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) on endoscopy services in the UK and beyond

Keith Siau, John T Green, Neil D Hawkes, Raphael Broughton, Mark Feeney, Paul Dunckley, John Roger Barton, John Stebbing, Siwan Thomas-Gibson, Keith Siau, John T Green, Neil D Hawkes, Raphael Broughton, Mark Feeney, Paul Dunckley, John Roger Barton, John Stebbing, Siwan Thomas-Gibson

Abstract

The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) was initially established in 1994 to standardise endoscopy training across specialties. Over the last two decades, the position of JAG has evolved to meet its current role of quality assuring all aspects of endoscopy in the UK to provide the highest quality, patient-centred care. Drivers such as changes to healthcare agenda, national audits, advances in research and technology and the advent of population-based cancer screening have underpinned this shift in priority. Over this period, JAG has spearheaded various quality assurance initiatives with support from national stakeholders. These have led to the achievement of notable milestones in endoscopy quality assurance, particularly in the three major areas of: (1) endoscopy training, (2) accreditation of endoscopy services (including the Global Rating Scale), and (3) accreditation of screening endoscopists. These developments have changed the landscape of UK practice, serving as a model to promote excellence in endoscopy. This review provides a summary of JAG initiatives and assesses the impact of JAG on training and endoscopy services within the UK and beyond.

Keywords: diagnostic and therapeutic endoscopy; gastrointesinal endoscopy; health service research.

Conflict of interest statement

Competing interests: All authors have either held a position on JAG or worked on behalf of JAG

Figures

Figure 1
Figure 1
The role of JAG. Courtesy of Dr John Anderson. BCSP, Bowel Cancer Screening Programme.
Figure 2
Figure 2
JAG trainee certification pathway. Courtesy of Dr John Anderson. DOPS, direct observation of procedural skills; JAG, Joint Advisory Group on Gastrointestinal Endoscopy; KPIs, key performance indicators; QA, quality assurance.
Figure 3
Figure 3
JAG unit accreditation pathway. GRS, Global Rating Scale; JAG, Joint Advisory Group on Gastrointestinal Endoscopy; KMS, Knowledge Management System; QA, quality assurance.
Figure 4
Figure 4
BCSP accreditation pathway. Courtesy of Dr John Anderson. BCSP, Bowel Cancer Screening Programme; DOPS, direct observation of procedural skills; DOPyS, direct observation of polypectomy skills; JAG, Joint Advisory Group on Gastrointestinal Endoscopy; MCQ, Multiple Choice Questionnaire; NHS, National Health Service.
Figure 5
Figure 5
Results from the literature search.

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