Open access fundholding endoscopy in the private sector.

We conducted a comparative study of 150 patients referred for endoscopy to an NHS hospital and 150 patients referred to an open access scheme in the private sector for fundholding GPs. The concept of consultoscopy, whereby a consultant gastroenterologist gives an opinion at the same visit as the endoscopy is performed, is introduced. Results showed a similar number of normal studies (about 40%) were performed in each group, although the number of examinations showing serious pathology was significantly higher in the fundholding group (p < 0.01). Patients seen in the fundholding scheme had less sedation, required fewer outpatient appointments, and the GPs were given more advice on further management than those seen in the non-fundholding group. We conclude that open access endoscopy in the private sector is a workable option and may result in work being transferred from NHS hospitals to the private sector unless NHS hospitals review their working practices. The concept of consultoscopy is a useful development on traditional open access systems.