Diagnostic fibreoptic endoscopic examination – Criteria Led Commissioning Statement

Scope

This commissioning statement refers to:

  • Diagnostic fibreoptic endoscopic examination of the colon, and diagnostic fibreoptic sigmoidoscope examination of the lower bowel with or without biopsy in patients under 45 years of age

This commissioning statement does not refer to:

  • Patients with HIV who have an increased risk of anal cancer, emergency care patients with suspected cancer
  • Patients under the age of 45 years with any of the following symptoms over a period of six weeks should be urgently and appropriately investigated:
    • rectal bleeding with a change in bowel habit to looseness or increased
    • frequency
    • rectal bleeding without anal symptoms
    • palpable abdominal or rectal mass
    • intestinal obstruction.
  • All patients with iron-deficiency anaemia (Hb<11g/dl in men or<10g/dl in postmenopausal women) without overt cause should be thoroughly investigated for colorectal cancer. Source: SIGN 67 (2003).

Status

Eligibility Criteria

Diagnostic fibreoptic endoscopic examination of the colon, and diagnostic fibreoptic sigmoidoscope examination of the lower bowel with or without biopsy are NOT routinely commissioned where patients are under 45 years of age

Lifestyle Factors - Best Practice

Obesity

  • Patients with a BMI >30 should be encouraged by their Clinician to lose weight prior to surgery and signposted to appropriate support to address lifestyle factors that would improve their fitness for surgery and recovery afterwards.
  • There is a clinical balance between risk of surgical complications with obesity and the risk to delaying any surgery.
  • See Weight Management Care Pathways

Smoking

  • In line with 'Healthy Lives, Healthy People; a tobacco control plan for England', local authorities and health professionals are committed to encourage more smokers to quit.
  • Smoking remains the leading cause of preventable morbidity and premature death in England.
  • There is sufficient evidence to suggest that people who smoke have a considerably increased risk of intra- and post-operative complications such as chest infections, lung disorders, wound complications and impaired healing.
  • See Smoking Cessation Care Pathways
Please Note: The life style factors above are not a restriction to the commissioning statements unless otherwise stated

References

Supporting Polices

  • NHS North Kirklees and NHS Wakefield CCG Commissioning Policy

Assurance & Governance

  • This policy was developed on: 05.2017
  • This policy was approved by: Clinical Strategy Group (NK) and Clinical Cabinet (WK)
  • Date approved: 05.2017
  • Publication Date: 05.2017
  • Review Date: 04.2018
  • Ref No: PA2 - 05.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document

 

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