Career intentions of the UK endoscopy workforce: results from the 2023 UK-wide pan-workforce survey

Objective The career intentions of the endoscopy workforce within the UK are unclear. We performed the first UK-wide, multi-society, pan-workforce endoscopy survey with the primary aim of estimating attrition rates of the workforce over time to forecast training and recruitment needs. Design An electronic questionnaire was developed by the British Society of Gastroenterology and National Health Service (NHS) England with representation from major UK endoscopy societies and distributed to members between November and December 2023. The survey covered: demographics, service provision, career intentions and reasons for leaving. Attrition rates were plotted on Kaplan-Meier curves and comparisons made using the log-rank test. Results 3564 respondents from 149 UK NHS Trusts were included (consultants 924, endoscopy nurses 837, clinical endoscopists 373, trainees 183). The response rate was 35% for gastroenterology consultants and 57% for clinical endoscopists. Consultants (gastroenterologist 64.0%, colorectal surgeon 19.3%, hepatologist 10.1%, upper gastrointestinal (GI) surgeon 6.1%) delivered a median of 11.5 weekly programmed activities (PAs) with 2.0 hands-on endoscopy PAs. 26.4% of consultants had PAs for Bowel Cancer Screening (BCS), 19.0% endoscopic retrograde cholangiopancreatography (ERCP) and 7.9% endoscopic ultrasound. Clinical endoscopists delivered more weekly endoscopy sessions than consultants (mean 4.04 vs 2.27, p<0.001). The reported 5-year intention to leave endoscopy rate was 23.7% for consultants, 26.5% nurses, 31.5% clinical endoscopists and 10% specialist trainees. For those aged 55+, this outcome was reported by 62.0% of consultants, 70.7% BCS endoscopists, 76.6% ERCP practitioners and 84.0% clinical endoscopists. The most common reason for workforce attrition was retirement in non-trainees and emigration in trainee respondents. Conclusion As many as 23.7% of consultants and 31.5% of clinical endoscopists are thinking of leaving endoscopy within 5 years. Immediate action should be taken to develop a future endoscopy workforce strategy.