New consensus guidelines have been published which provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging. JAG strongly recommends that services review the guidelines and implement them with immediate effect.

The new guidelines are expected to reduce demand for surveillance procedures by up to 70% and are a positive development in reducing demand on services. Clinical resource will be needed to safely identify patients who can have their surveillance period extended or who can be discharged, and JAG expects services to be given resource to undertake this. JAG recognises that implementation of FIT with the bowel cancer screening service has increased demand and continues to work with stakeholders on this issue. NHS England and Improvement has written to stakeholders including Cancer Alliance chairs encouraging symptomatic services to implement the guidance and appoint a consultant as a surveillance lead with time in their job plan. PHE has sent a separate communication about the guidance to screening services.

The JAG tolerance regarding the accreditation standards relating to waiting times targets, relevant to services aiming to gain or maintain accreditation, is due to finish at the end of November 2019. While the new guidelines are implemented services can continue to apply for accreditation if they are outside of national waiting times targets providing that they show robust plans for retrospectively and prospectively implementing the new guidelines. All services will be expected to be compliant with waiting times targets by 1 April 2020.

The guidelines were jointly commissioned by the British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland and Public Health England and can be accessed ​on the BSG website. JAG has also provided an updated briefing on ensuring efficiency in services, available in our knowledgebase and has example guidelines for a nurse-led virtual polyp clinic.