Table 2.

Service requirements for oesophageal dilatation

Service requirement	Details	Option
The endoscopy unit must have the ability to offer conscious sedation
The endoscopy unit can offer GA or propofol sedation for selected cases		Agreed link with a referral centre
The endoscopy unit has ready access to surgical expertise		Agreed link with a referral centre
The endoscopy unit has ready access to fluoroscopy	Discussion with clinician experienced in fluoroscopic procedures to decide cases appropriate for this	Agreed link with a referral centre
Procedures to be performed by clinicians experienced in managing oesophageal strictures	Consider limiting to reduced numbers of endoscopists on dedicated lists
Arrangements for clinical audit	Success rates, timeliness of procedure, complications—data for unit and individual endoscopists
Appropriate protocols	Recovery and discharge protocol including recognition and management of complications; written discharge information for patient including on call contact details
Access to repeat procedures within 1–2 weeks	Endoscopist to make necessary referral after procedure Patient should ideally have next appointment on discharge from hospital
Appropriate management of complications with rapid access to CT scanning and surgical expertise where required	To be included in recovery/discharge protocol	Access to surgical and further endoscopic expertise can be via an agreed link with a referral centre
Management strategies in place for refractory strictures		Agreed link with a referral centre