Sheffield Endoscopy
World Endoscopy Organization Centre of Excellence
Sheffield Gastroenterology is only one of two UK centres to have been recognised as a World Endoscopy Organization Centre of Excellence. In total, there are only 20 centres across the globe. The WEO Centers of Excellence program identifies and gathers a group of endoscopic centres with an outstanding international reputation in the performance of endoscopic procedures, education and research within digestive endoscopy.
Overview of Sheffield Teaching Hospitals (STH) Endoscopy
STH is now the largest UK GI Unit with 30 Consultants (6 Professors) and 9 endoscopy rooms. We serve a regional population of >1.5 million people. On 2 hospital sites per year we undertake more than 10,000 gastroscopies, 7,500 colonoscopies, 6500 flexible sigmoidoscopies, 1200 ERCPs, 560 EUS, 800 capsule endoscopies, 100 double balloon enteroscopies (DBE) & 100 gastrostomies.
Royal Hallamshire Hospital Endoscopy Unit
Northern General Hospital Endoscopy Unit
Uniquely we are the only UK centre to have won our National Endoscopy Prize, the British Society of Gastroenterology (BSG) Hopkins Prize 3 times in its history (2012, 2017 & 2019). Since 2005 our unit has published more than 300 PubMed endoscopy-based papers.
Live Endoscopic Meetings
We have been running the BSG Yorkshire Bardhan Live Endoscopy Symposium annually since 2003 with a half day live interactive endoscopy session involving regional and national invited experts. Of 460 delegates 95% rated as good/excellent (Likert scale 1-5).
Right: Hands-on patient-based course
European Capsule Course (annually since 2005):
We conceived and run this annual live small bowel endoscopy course with a regular international faculty. Up to 30% of delegates are from abroad and over 90% of 700 delegates (doctors and nurse readers) have appraised the course as good or excellent. Our live, interactive course conducted from the UK to Croatia won the Medipex Telemedicine Award in 2016.
Flagship Annual symposium
The International BSG Sheffield Gastroenterology Symposium (annually since 2009): The largest UK meeting outside of our annual National BSG meeting >300 delegates (>95% good to excellent rating) and >30% of the content is endoscopic. The faculty of 10-20 is always 40% internationally recognised.
Find out about the latest Symposium
National/International Hands on Training Courses
One of the ten original BSG/Joint Advisory Group(JAG) Training Centres (since 2001): the UK is internationally recognised for our JAG accredited training. Led by Dr Mark Donnelly and Dr Stuart Riley we were in the first wave of centres and provide basic hands on gastroscopy courses (3 courses per year>250 delegates to date), basic hands on colonoscopy courses (6 courses per year, >500 delegates to date). We also run a range of other courses, including Training the Colonoscopy Trainer (TCT) and Training the Gastroscopy Trainer (TGT) courses – essential to spread the practice of effective endoscopy training. We provide preparation days for aspirant Bowel Cancer Screening Programme (BCSP) colonoscopists as well as being one of a handful of centres to conduct the BCSP Accreditation exam itself. We also deliver hands on polypectomy training on porcine models. In total, we deliver a minimum of 12-15 hands on courses per year with delegates and observers from throughout the UK, Europe and elsewhere. All courses are consistently evaluated as good or excellent by national/international delegates, visiting observers and faculty.
Our programme provides the full spectrum of teaching including observational, diagnostic teaching and hands–on teaching, using modern 4 way split screen audio-visual links This includes individualized training programmes on computer models, device simulation, animal models and one to one hands on training on patients.
BSG National Endoscopy Quality Improvement Training Programme (EQIP) Upper GI bleed training course run by Dr Mo Thoufeeq (annually since 2018): Interactive hands on Pig Models essential training for all final year trainees.
Fuji International DBE Training course (annually since 2005): as the first UK centre to adopt DBE (along with St Mark’s) we trained most of the other UK centres through visiting fellowships for consultants from Manchester, the North East, Leeds, Birmingham, Cardiff, Liverpool & East Midlands. We have also trained Consultant colleagues from Jordan, Malta, Turkey and Italy.
As a result of our International small bowel training course Prof Sidhu is the first author of the Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement Endoscopy 2020
Fellowships
Endoscopy International/National Training Fellowships (since 2005): We provide endoscopy fellowships for trainees (1-3 years) from the UK, USA, Italy, Malta, Jordan, Turkey, Spain and Greece (N>25 Frontline Gastroenterology 2018). We were the first centre in the UK to achieve Royal College of Physicians post-CCT Fellowship accreditation in 2014. As a result of these internationally recognised training fellowships Prof D Sanders is co-author of the ESGE curricula development for postgraduate training in advanced endoscopic procedures: rationale and methodology (Endoscopy 2019).
Areas of International Endoscopic Recognition for STH
Small Bowel Endoscopy
We are the largest small bowel centre in Europe (>800 capsules and >100 DBE per annum). Lowest reported international DBE complication rate (0.4% EJGH 2012). The service we provide won the inaugural British Society of Gastroenterology National GI Care awards (2011).
We have co-written the BSG Guidelines (Gut 2008), Small Bowel Endoscopy in IBD (Endoscopy 2009), ESGE Guidelines (Endoscopy 2015 and 2019) and lead the UK Small Bowel Endoscopy Quality Improvement Programme (Frontline Gastroenterol 2019, Endoscopy 2019). Small bowel endoscopy >150 pub med papers. Prof R Sidhu was the first female doctor to win the BSG Hopkins prize for her work in this field in 2012.
Endoscopic Coeliac Disease
Sheffield is the NHS England National Centre for Refractory Coeliac Disease (incorporating capsule and DBE assessment also). The service won the National Patient Charity Coeliac UK service award in 2010.
We have published the largest studies of I-Scan and Magniview as well as writing the BSG Guidelines (Gut 2014) and European Guidelines (UEJ 2019). We are the most published unit in the world in the area of the endoscopic diagnosis of coeliac disease (> 60 pub med papers). BSG Hopkins Prize 2019
Gastrostomy Feeding
We are one of the largest UK centres undertaking PEG and have pioneered endoscopic techniques and the role of scoring systems to avoid inappropriate selection and reduce mortality. The comprehensive endoscopic PEG service we provide has resulted in us winning National Health Service Journal Award in 2012. We are authors of BSG Guidelines (Gut 2010) and the forthcoming ESGE guidelines (currently in writing). Pub Med >30 publications.
Upper GI Bleeding
We provide one of the most comprehensive GI Bleed services in the UK with a dedicated unit and 24 hour Consultant Endoscopy cover. We demonstrated the lowest 30-day mortality (8%) in the UK (EJGH 2004) subsequently recognised by a BSG SAGE (Shire Awards for Gastrointestinal Excellence 2014) award. We co-authored the ESGE Guidelines (Endoscopy 2015) and have published >30 medline publications.
Endoscopic Tolerability & Remote Endoscopy
We have contributed significantly to the field of endoscopic tolerability and sedation practices, including the recent UK guidelines on deep sedation and anaesthesia in complex gastrointestinal endoscopy: a joint position statement endorsed by the BSG, Joint Advisory Group (JAG) and Royal College of Anaesthetists (RCoA) (Frontline Gastroenterology 2019). (>10 pub med papers) Prof M McAlindon has studied the use of capsule endoscopy in the upper GI tract. This began using simple patient position change to move a capsule in the flow of swallowed water (World J Gastroenterol 2018). Simple handheld magnet control was equivalent to conventional upper GI endoscopy in lesion detection in an ex-vivo porcine model (Endoscopy 2015), the same device demonstrating the value of external control in human subjects (Endosc Int Open 2016) and subsequently shown to outperform conventional upper GI endoscopy in patients with anaemia (Endoscopy 2019) and suspected acute upper GI bleeding (Gastrointest Endosc 2019). Most recently, he was the first outside China to study the clinical utility of magnet controlled capsule endoscopy using the Ankon robot arm magnet, funded by the British Medical Association Dawkins and Strutt award. He has collaborated with colleagues in Shanghai (Zhu SG et al Dig Liver Dis 2018 & Qian YY et al Dig Liver Dis 2018), where two Sheffield research fellows were trained to use the system and is the chief investigator of an international multicentre study using the system to investigate anaemia. He has a collaboration with paediatric colleagues to perform the first study in children and was awarded the BSG International Award (2020) to develop a Training And Research in MAgnet-controlled Capsule endoscopy international working group (TARMAC). The recent Lancet Gastroenterology Hepatology review (2019) creates a road map for the future of non-invasive endoscopy particularly in this post-covid era (>20 pub med papers). (BSG Hopkins Prize 2017)
Promoting International Education, Training and Collaboration
We have well-established links with the international endoscopic community.
A group from our centre has been visiting the WGO Centre at Ibn Sina Hospital, Khartoum, Sudan annually since 2015. We deliver TCT courses to local consultants, porcine model polypectomy and upper GI bleeding courses to trainees as well as taking part in the annual meeting of the Sudanese Gastroenterology Society (SGS). We were recently (2019) recipients of an award from the BSG International Committee to help fund this acitivity going forwards. Most recently, we took two Sheffield trainees with us, recognising that the workload and skills around the endoscopic management of oesophago-gastric varices at Ibn Sina provided a valuable learning experience for UK trainees. A report of this visit is currently in press (Frontline Gastroenterology). This demonstrates that endoscopic learning and training is assuredly a two-way street.
Other activities include departmental members acting as faculty on courses in Ireland (2010 to current), Denmark (2017) and Mauritius (2018) in addition to regularly acting as external faculty on a range of courses throughout the UK.
Most recently, we have delivered the first ever TCT courses to be held in India (in Chennai, 2020) – a report of this is currently in press (Journal of Digestive Endoscopy).
First Training the Colonoscopy Trainer Chennai (India) 2019
In 2019, we delivered a pilot Training the Robotic Trainer (TRT) course, the first of its kind, under the auspices of the European Society of Coloproctology (ECSP) in Orsi, Ghent, Belgium. A report of this is in press (Colorectal Diseases).