Quality Improvements in Endoscopy in England

The British experience of improving endoscopy shows that it is possible to achieve a transformation in quality, safety, and patient experience with a strategic, centrally led, and modestly resourced approach. There continue to be obstacles to sustaining change and some significant challenges, particularly in increasing the volume of endoscopy and in more rapid adoption of new technologies. The context of health care is varied across the world and it has often been commented to me that duplicating the British approach is either not necessary (particularly in the United States and Germany) or just not feasible. However, the basic principles—having a clear goal, a strategic approach, alignment of agendas, robust quality assurance, and effective leadership at all levels—hold true for all. The challenge to those aspiring to provide equitable, high-quality, and patient-centered endoscopy will be how to apply these principles in their own setting.