Leith, Damien

Orpen-Palmer, Josh

Siddhi, Sandeep

Stanley, Adrian J.

Enlighten

Leith, D., Orpen-Palmer, J., Stanley, A. J.  and Siddhi, S. (2024) Developing a sustainable endoscopy network in Scotland - in response to Tavabie et al. Frontline Gastroenterology, (doi: 10.1136/flgastro-2023-102620)This is the author version of the work. There may be differences between this version and the published version. You are advised to consult the published version if you wish to cite from it: https://doi.org/10.1136/flgastro-2023-102620https://eprints.gla.ac.uk/323132/ Deposited on 22 March 2024 Enlighten – Research publications by members of the University of Glasgow http://eprints.gla.ac.uk Confidential: For Review OnlyTo the Editor,It is with great interest that we read the timely article by Tavabie and colleagues detailing the environmental impact of gastroenterology and hepatology services and outlining the unique position of trainee research networks to facilitate sustainable transformation of endoscopy services and share best practice approaches between units.(1) The recent COP28 summit and Global Tipping Points Report reiterated in stark terms, time is of the essence.(2) It is critical we all act. The Scottish Trainees' Research in Gastroenterology and Hepatology network [ScotRIGHT],(3) in collaboration with the Scottish Society of Gastroenterology [SSG], have already taken a lead on this in Scotland.Utilising the ScotRIGHT network of Scottish trainees and Allied Healthcare Professionals [AHP], we have begun work identifying trainee, consultant and nurse/AHP “Green Endoscopy Champions” in every Scottish endoscopy unit. We recognise the need to involve a cross-section of specialities and professions to instigate meaningful and sustained change. These Green Endoscopy Champions have converged across the country to form a Scottish Sustainable Endoscopy working group. In 6 weeks we have identified interested individuals representing 17 endoscopy units across 10/14 Scottish Health Boards and held the inaugural meeting. We have completed an audit of practice across Scotland with responses from 16 hospitals across 9 Health Boards (see Figure 1) providing crucial data on the current position of sustainable endoscopy. This data was presented at the SSG Winter meeting 2023. The working group will share ideas of easily replicable sustainable practice and working with all stakeholders lobby for the most sustainable endoscopy possible in Scotland utilising the most up to date guidance and position statements.(4) Challenges are anticipated. Endoscopy units across Scotland serve heterogenous populations with differing service requirements and are starting from differing baselines of sustainability therefore a flexibility of approach will be needed. In addition, to facilitate sustained change clinical endoscopy leads and managerial input will be required - especially when tackling issues of procurement and waste management. Finally, smaller district hospitals and community endoscopy units which do not have medical trainees will be more challenging to reach (particularly represented in Scotland by rural areas in the Highlands and Islands) but engagement will be essential to prevent the development of a two-tier sustainability standard. Despite these and unforeseen obstacles there is clear enthusiasm and we hope to report success In conclusion, we feel our work to date confirms the assertion of Tavabie and colleagues that trainee research networks are well placed to initiate, disseminate and drive sustainability, an   essential area, not just in endoscopy or gastroenterology but across medicine. We are keen to collaborate and share learning with other trainee networks or sustainable endoscopy groups and encourage any who are interested to contact us at committee@scotright.comDamien LeithJosh Orpen-PalmerAdrian StanleySandeep SiddhiOn behalf of ScotRIGHTCompeting interests: No competing interests Figure 1: Health Boards with members of Scottish Sustainable Endoscopy working group indicated with green squares. Locations of endoscopy units returning the initial survey to indicate geographical spread - indicted with green circles.Page 2 of 3https://mc.manuscriptcentral.com/fgFrontline Gastroenterology123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960Confidential: For Review OnlyReferences1. Tavabie O, Clough J, King J, Nicholas V, Kumar A. Challenges of developing a greengastroenterology evidence base and how trainee research networks can fill the gapsProfessional matters. Gastroenterology [Internet]. 2023 [cited 2023 Dec 6];0:1–12. Availablefrom: http://fg.bmj.com/2. McKay DIA, Staal A, Abrams JF, Winkelmann R, Sakschewski B, Loriani S, et al. Exceeding1.5°C global warming could trigger multiple climate tipping points. Science [Internet]. 2022 Sep9 [cited 2023 Dec 6];377(6611). Available from: https://pubmed.ncbi.nlm.nih.gov/36074831/3. Moffat V EL, Brennan PN, Gaya DR, Hayes PC, Din S, ScotRIGHT OB of. The evolution ofScotRIGHT: The first pan-Scotland physician trainee research network.https://doi.org/101177/14782715231197240 [Internet]. 2023 Aug 31 [cited 2023 Dec 6];Available from: https://journals.sagepub.com/doi/10.1177/147827152311972404. Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG)and Centre for Sustainable Health (CSH) joint consensus on practical measures forenvironmental sustainability in endoscopy | Gut [Internet]. [cited 2023 Dec 6]. Available from:https://gut.bmj.com/content/72/1/12Page 3 of 3https://mc.manuscriptcentral.com/fgFrontline Gastroenterology123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960Confidential: For Review OnlyPage 4 of 3https://mc.manuscriptcentral.com/fgFrontline Gastroenterology123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960

Developing a sustainable endoscopy network in Scotland - in response to Tavabie et al

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Developing a sustainable endoscopy network in Scotland - in response to Tavabie et al

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