National guidance and ongoing training of staff are needed to improve the selection and care of patients who undergo therapeutic gastrointestinal endoscopy, says a critical appraisal of UK practice that was published last week.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD), an independent body that audits anonymised data on deaths of patients, examined 1818 deaths of inpatients that occurred within 30 days of therapeutic endoscopy.

The authors of the report of the audit found that in about 3% of the 136 000 endoscopies performed in 2002-3 the patient died within 30 days of the procedure. However, the report considered that the procedure had been performed inappropriately in 14% of these deaths. Of these 14%, more than half the procedures were considered “futile,” where the NCEPOD assessors found it impossible to see any potential benefit of performing endoscopy. The …