Emergency services for patients with gastrointestinal bleeding are seriously wanting, a survey of more than 150 acute NHS hospitals suggests.
Some 64% of hospitals questioned by the British Society of Gastroenterology (BSG) said their emergency endoscopy service was unsatisfactory.
And nearly 40% believed their services to be unsafe, the survey in the journal Clinical Medicine suggested.
Acute gastrointestinal (GI) bleeding can result in death.
Just over half of the hospitals questioned said they had no formal rota for covering emergency endoscopy services, while just under half of those who worked in the service said they received no remuneration for being there out-of-hours.
"The provision of a safe service should not be viewed as an aspiration"
Dr Pranab Gyawali said: "The finding that 64% of endoscopy leads rate their provision as unsatisfactory is worrying. The fact that 38% view services as unsafe is alarming.
"The provision of a safe service should not be viewed as an aspiration. A planned system for managing emergency GI bleeds is essential for all areas."
Finding answers
The article called for the creation of regional centres where GI emergencies can be admitted, and also suggests that hospitals could share staff.
"In this model, the on-call endoscopist and GI nurse travel to the hospital that admits the patient.
"Different solutions are possible depending on local circumstances but they all require serious engagement by senior management with the consultant staff delivering them."
Professor Ian Gilmore, a consultant gastroenterologist at Royal Liverpool University Hospitals and President of the Royal College of Physicians, urged action.
"There is strong evidence that emergency endoscopy reduces blood transfusion requirements, surgery rates, length of hospital stay and mortality.
"It is essential that gastrointestinal rotas for consultants are formally established and effective out-of-hours GI serrvices are properly resourced in order to provide the best and most timely care possible for patients."
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