Quantifying the Economic Impact of Flexible Endoscope-Related Procedure Rescheduling in NHS Endoscopy Services: A Retrospective Analysis and Survey-Based Model
Author(s)
Joshua Hicks, BSc1, Philip Skinner, BSc (Hons)2.
1Olympus Medical Systems, Southend-On-Sea, United Kingdom, 2Health Economics Market Access, Olympus Medical Systems, Southend-On-Sea, United Kingdom.
1Olympus Medical Systems, Southend-On-Sea, United Kingdom, 2Health Economics Market Access, Olympus Medical Systems, Southend-On-Sea, United Kingdom.
OBJECTIVES: To estimate the operational and financial impact of procedure rescheduling due to flexible endoscope failures across NHS endoscopy services, using provider-level activity data and survey-based incident reporting to model delays, lost procedure time, and unrealised tariff income at both the local and national levels.
METHODS: A retrospective analysis utilized two years of procedural and tariff data from 126 NHS Trusts, from April 2023 to March 2025. In April 2025, a targeted survey of endoscopy staff achieved 60 responses (88% clinical roles), in line with the study’s sampling objective. The survey gathered estimates on flexible endoscope failures, the number of procedures impacted, and typical postponement durations.
Participants were from various NHS regions in England, Scotland, and Wales, with the highest representation from London and the East of England. Responses were aggregated by role type and combined with national activity and costing data to model the operational and financial impact of rescheduled procedures due to endoscope malfunctions.
RESULTS: NHS providers reported an average of 1.94 monthly incidents related to flexible endoscope failures, each affecting 2.0 procedures, resulting in 3.9 rescheduled procedures per provider per month. Nationally, this equates to 489 procedures rescheduled monthly and a cumulative delay of 1,080 procedure-days, based on a weighted average postponement of 2.21 days. The estimated financial impact is £552,112 per month, and £6.6 million per year nationally, in unrealized tariff income.
CONCLUSIONS: Damaged flexible endoscopes that require repair result in delays, rescheduled procedures, and substantial unrealized tariff income across NHS endoscopy services. Though modest at the provider level, the cumulative national impact is considerable. These findings underscore the need for reliable equipment and regular maintenance. Although this analysis did not assess specific causes of equipment failure, variation in service contract providers and other operational factors may play a role, warranting further investigation.
METHODS: A retrospective analysis utilized two years of procedural and tariff data from 126 NHS Trusts, from April 2023 to March 2025. In April 2025, a targeted survey of endoscopy staff achieved 60 responses (88% clinical roles), in line with the study’s sampling objective. The survey gathered estimates on flexible endoscope failures, the number of procedures impacted, and typical postponement durations.
Participants were from various NHS regions in England, Scotland, and Wales, with the highest representation from London and the East of England. Responses were aggregated by role type and combined with national activity and costing data to model the operational and financial impact of rescheduled procedures due to endoscope malfunctions.
RESULTS: NHS providers reported an average of 1.94 monthly incidents related to flexible endoscope failures, each affecting 2.0 procedures, resulting in 3.9 rescheduled procedures per provider per month. Nationally, this equates to 489 procedures rescheduled monthly and a cumulative delay of 1,080 procedure-days, based on a weighted average postponement of 2.21 days. The estimated financial impact is £552,112 per month, and £6.6 million per year nationally, in unrealized tariff income.
CONCLUSIONS: Damaged flexible endoscopes that require repair result in delays, rescheduled procedures, and substantial unrealized tariff income across NHS endoscopy services. Though modest at the provider level, the cumulative national impact is considerable. These findings underscore the need for reliable equipment and regular maintenance. Although this analysis did not assess specific causes of equipment failure, variation in service contract providers and other operational factors may play a role, warranting further investigation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE626
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas