Endoscopy is an essential tool in treating, diagnosing, and prognosticating patients with acute upper gastrointestinal bleeds (UGIB). NICE recommend all patients presenting with Acute UGIB should be risk stratified using the Glasgow Blatchford Score, must have an endoscopy within 24 hours of admission if haemodynamically stable, and within 2 hours of resuscitation in patients with a severe AUGIB. The Joint Advisory Groups in GI endoscopy (JAGS) expects hospitals to offer endoscopy to least 75% of all patients presenting with AUGIB within 24 hours. They also recommend daily GI-bleed list for any hospital seeing more than 330 cases of AUGIB a year. Our audit was focused on analysing if the above recommendations are being met at our DGH hospital, and if changes suggested improve overall patient care.

A total of 341 referrals were collated from July 2019 - February 2020, from these the data for 262 endoscopies were retrieved and analysed.

The results showed on average, 63% of the endoscopies were done within 24 hrs overall. 100% of the referrals from the emergency department and the wards had a Glasgow-Blatchford Score completed pre-endoscopy. The most common symptom for referral was melaena. However in unstable patients, the commonest symptom was haematemesis.

In summary, we found out that our local DGH is short of the gold standard target of 75% endoscopy within 24 hrs of UGIB presentation. From the data gathered, this audit projects that in a 12-month period up to 450 UGIB endoscopies will be performed. As a result of this, we should be offering 7 days a week UGIB endoscopy service.

From this audit, we have been able to initiate the use of the Acute UGIB bundle in our emergency department. We have also presented the result at departmental meetings, to educate the junior doctors on the important of prompt referral to endoscopy as a means to ensure patients are getting their endoscopy within 24 hrs of presentation.