In some instances (eg a sabbatical) a break in service may exceed 12 months and the required number of BCSA procedures may not be achieved.

If this occurs, the screening endoscopists undertaking colonoscopy assessments outside the BCSA should continue to audit their practice in detail including polyp detection, retrieval rates, and complication rates and submit returns. If they continue to meet the current BCSA QA endoscopist criteria they may resume screening on their return to the BCSA, with agreement of the local Professional Clinical Advisor (PCA) for Colonoscopy and service lead. Endoscopists are also required to have a substantive NHS contract. 

It is the responsibility of the local screening and PCA to ensure that any screening endoscopist is up to date with current guidance and competent to re-enter the programme following a break in service. If a period of re-training or mentorship is required, this should be completed before rejoining the screening programme. 

Once an individual has returned to the screening programme they will be subjected to the exact same QA measures as those without any service break.

Provided their period outside the BCSA does not exceed 6 months, BCSA endoscopists who do not maintain their colonoscopy practice (e.g. maternity leave) may resume screening immediately on their return to the BCSA after local agreement with local PCA and service lead. An individual may be advised to undertake further training or initial list(s) with a mentor if deemed appropriate.

If the time outside the BCSA is 6 months or longer, at least the first list of BCSA procedures should be performed with a mentor, along with any other measures deemed necessary by local QA and service lead.