Work is underway in Skye which is set to revolutionise diagnostic endoscopy services across the Highland are.
Capsule endoscopy or PillCam is being piloted in Skye, and aims to provide easy access to diagnostic endoscopy. Instead of having to travel to hospital for an invasive procedure, a pill - which includes a tiny camera - can now be taken. As well as being less invasive, the capsule can be taken at home with the results discussed at home or the Medical Centre.
Commenting on the new development Dr Steve McCabe, who met the research team and proposed the local trial, said: “This is really exciting for our patients. It puts Skye and NHS Highland at the forefront of the development of Gastro Intestinal investigations. With the new technology, diagnostic endoscopy can be organised and supported locally from local practices without having to travel for an invasive procedure.”
He added: “It is a fantastic development and good example of how technology developed for other fields can and should be used to deliver high quality clinical care to remote communities.”
Dr Will Nel, clinical lead for the locality, and an endoscopist, said: “The pilot, which is also taking place in Ullapool practice, and being co-ordinated by senior clinicians from Raigmore Hospital, is going well. It will hopefully demonstrate that this approach will work in any practice irrespective of the locality.”
The test is for diagnostic scopes only. Anyone requiring biopsies or treatment scopes would still have to travel to Belford or Raigmore Hospital, as currently happens.
The endoscopy service in Dr Mackinnon Memorial Hospital was stopped several years ago due to health and safety concerns. At that time, NHS Highland was of the view that the service could be resumed in the new facility. Now the Board has confirmed that the Endoscopy unit will not be included in the specification for the new hospital.
A review conducted by Mr James Docherty, colorectal surgeon and NHS Highland’s clinical lead for Endoscopy, highlighted a number of reasons why this would no longer be appropriate.
He said: “The low level of activity would mean the service would only run for one session per week. This alone would mean it would not be sustainable including staff not able to maintain skills.”
In addition the report concluded that the low levels do not warrant the significant investment required to build an endoscopy suite, purchase the necessary equipment as well as the annual cost to run such a service. The capital costs alone would be in the region of £1.5m.
Mr Docherty said: “Having carried out a review and given careful consideration to the various local issues, it was my recommendation that endoscopy facilities should not be carried out on Skye. It does not make clinical or financial sense and we would be guilty of planning a service that would not be sustainable from the outset.
“Instead, it was my strong view that we must look to the future and I am confident that the current trial of capsule endoscopy in Skye, and in Ullapool, will be successful. This offers the best solution to allow more patients with Gastro Intestinal symptoms to be investigated locally. Unfortunately, a minority of patients who require a biopsy or treatment will still have to travel to Fort William or Inverness. However, more patients will benefit and overall fewer will have to travel once the PillCam is rolled out.”
The trial is part of an international collaboration and with further work it is envisaged that the whole of the gut (from gullet to anus) will be able to be examined adequately by capsule endoscopy. The trial includes monitoring both clinical and cost effectiveness.
Clinical pathway events to demonstrate the PillCam technology and to allow people from Skye, Lochalsh and Wester Ross to discuss this and other Gastro Intestinal issues with specialists, are being planned for later in the year.
Pictured above is an example of the PillCam to be used to revolutionise diagnostic endoscopy services on Skye.