Improving upper GI triage and endoscopy capacity with the GastroPanel® Quick Test

Rising demand for upper gastrointestinal (GI) endoscopy is placing increasing pressure on NHS capacity, with higher-risk patients potentially facing longer waits as a result. The gastroenterology department of Oxford University Hospitals (OUH) NHS Foundation Trust has introduced a service improvement initiative to assess whether the GastroPanel^® Quick Test could more effectively triage patients and help to focus gastroscopy capacity on those most likely to benefit. In this blog, Dr Jan Bornschein, a Consultant Gastroenterologist, and Dr Simona Fourie, Clinical Research Facility Operational Lead at the trust, explain how the new pathway works as well as the hurdles involved in introducing it and its potential to improve referral decisions and patient care.

Testing a new approach to triage

OUH is one of the largest NHS teaching trusts in England and a world-renowned centre of clinical excellence. The John Radcliffe Hospital is the trust’s largest hospital and Oxfordshire’s main accident and emergency site. It provides a wide range of acute medical and surgical services including trauma, intensive care and cardiothoracic services. The hospital’s comprehensive GI department encompasses endoscopy, gastroenterology, hepatology and an intestinal failure unit. The Horton General Hospital in Banbury provides a wide range of services to the north of Oxfordshire and surrounding areas, including inpatient and outpatient GI clinics.

Rising demand for these services is placing increasing pressure on the trust’s existing GI triage pathways, endoscopy capacity, waiting times and costs. For instance, many younger patients present to the GI departments with persistent symptoms such as heartburn or indigestion but have no alarm features or other clear indication of serious disease. Although gastroscopy may identify mild inflammation or a hiatus hernia in some of these patients, the findings often do not alter their management. At the same time, referrals of lower-risk patients can increase waiting times and delay investigation for those with more concerning symptoms. This problem is not unique however, with the NHS as a whole struggling to manage growing patient volumes. An effective alternative is clearly needed to identify those who require invasive investigation, while avoiding unnecessary procedures for those who don’t.

To address these pressures, gastroenterology services at the John Radcliffe and Horton General hospitals have launched a service improvement initiative to assess whether the GastroPanel Quick Test could support a more effective triage pathway for patients with upper GI symptoms. The finger-prick test provides results in 15 minutes, helping clinicians to assess risk at the point of care without sending samples to a laboratory. The trust’s new protocol aims to identify patients at greater risk of stomach pathology who are likely to benefit from gastroscopy, while providing greater reassurance to lower-risk patients for whom the procedure is unlikely to be helpful.

To assess the feasibility of future implementation, GastroPanel is being performed alongside the existing pathway, with patients continuing to undergo a gastroscopy as planned. Firstly, junior doctors identify eligible patients, particularly symptomatic people under approximately 55 years old who are not in established gastric cancer risk groups. After admission, patients are invited to have the finger-prick test while waiting for gastroscopy, with around 75 per cent agreeing to participate. The endoscopist remains unaware of the GastroPanel result, allowing the test and gastroscopy findings to be compared without influencing normal care. Comparing the results will help the team to estimate how many gastroscopies might safely have been avoided and the potential cost savings, had GastroPanel been implemented prior to endoscopy referral. Discrepant cases may also identify training opportunities, while the overall findings could inform future use in either gastroenterology clinics or primary care to relieve pressures on hospital endoscopy services.

Overcoming hurdles to adoption

Introducing a new pathway like this requires evidence, clinical engagement and careful operational planning. Jan and Simona involved the endoscopy management team, gastroenterologists and governance colleagues from an early stage, while BIOHIT’s data and a published baseline study helped to build the case for change. Simona’s research delivery team also resolved the key staffing question by agreeing to identify patients, perform the tests and record the results. Without that support, further discussions about staffing, responsibilities and clinical processes would have potentially delayed the project considerably.

Since its start in April 2026, the initiative has recruited approximately 125 of its target 250 patients. Completion is now expected to take 12 to 18 months, partly because the British Society of Gastroenterology’s strict referral criteria reduce the number of eligible patients reaching endoscopy in the first place.¹ Although these criteria are helpful for decreasing the strain on endoscopy, they also present a limitation that highlights the practical challenges of evaluating a pathway at the endoscopy stage rather than earlier on in primary care.

Collaboration as a foundation for more effective triage

The OUH trust’s experience of rolling out this initiative demonstrates that successful adoption depends not only on the strength of the proposed pathway, but also on early engagement, credible evidence and operational support. The process has highlighted the need for sustained collaboration between research and clinical teams, demonstrating how this close communication can turn an evidence-based proposal into a tangible service improvement. If the project delivers promising results, the team will explore adopting GastroPanel in satellite gastroenterology clinics to enable earlier triage during primary care appointments. It also hopes to share the findings through the local primary care network and the Primary Care Society for Gastroenterology. Ultimately, the ambition is to improve referral confidence and focus gastroscopy capacity on the patients most likely to benefit.

References

1. Banks, M., et al. (2019). British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut, 68(9), 1545-1575.