Keeping The Endoscopy Ship Afloat Against The First Wave Of Covid -19 -The Utilisation Of A Private Institution To Bolster Mmuh Gi Services During Covid-19

Aims During COVID-19, guidelines for performance of endoscopy meant procedure numbers were significantly curtailed.From April-June 2020, the Health Authorities in Ireland procured private hospitals for public use. The aims of this study were 1. to determine if additional private hospital capacity was utilised effectively for endoscopy, as this model is oftenemployed to deal with long waiting lists in Ireland. 2. to compare pathology and follow up rates between the two institutions. Methods We analysed all documentation relating to 242 endoscopy procedures outsourced to the private institution (MPH). For the period of June 2020 we compared indications, follow up rates and pathology for outpatient endoscopy proceduresperformed in our public institution, MMUH (n = 111) and MPH (n = 104). Results 197/242 (81.4 %) procedures in 167 patients were completed. Non-completion was due to refusal or failure toattend (32) and illness (6). 102 patients (61 %) were subsequently discharged to the GP and 39 % of patients requiredhospital follow up. There was no significant difference between indications in both institutions (p = 0.843). As shown in Table 1, rates ofsignificant pathology in MPH vs MMUH were not statistically significant, 4 % vs 7 %;p = 0.315. There was no difference infollow up rates in MPH vs MMUH, 62 % vs 51 %, p = 0.849. Conclusions The use of private capacity in MPH during the first wave of COVID19 significantly reduced the burden on thepublic system for GI procedures. However arranging the necessary follow up for the 39 % of patients from the MPHgenerated a substantial clinical and administrative workload on the public system. Although the endoscopy procedures performed in both institutions were deemed 'urgent', significant pathology was rare, between 4-7 %, suggesting more stringent criteria for endoscopy should be considered in the future.