54934Remote community-based digital rectoscopy for patients with rectal disease during Covid-19 PandemicClosedFeasibility StudiesInnovate UKThe COVID-19 pandemic has exerted significant pressure on all elective and emergency NHS resources and capacity. This has been so significant that operations and treatments for planned care have been cancelled and it is now likely that many millions of patients will come to harm as a direct result of delayed diagnoses. New technologies may present a range of flexible and adaptable solutions that can also help widen accessibility to care and alleviate physician burden during and after the pandemic. Indeed, the need for rapid innovation and new ways of increasing capacity within the NHS have been identified as key to tackling the COVID-19 challenge. Each year the NHS sees nearly 6.7 million patients with gastrointestinal complaints as outpatients, and it performed over 900,000 telescopic procedures of the gut. Nearly all of this activity has stopped during the pandemic. Endoscopy in particular is thought to pose a risk of covid-19 transmission to doctors and nurses. This means that during the pandemic many patients with chronic conditions are not able to receive care and rates of new cancer diagnoses are falling. This will cause a large and second "peak" of deaths from covid 19\. This project will deploy a new, state of the art tele-endoscopy platform into the primary care setting so that patients are able to undergo endoscopic procedures during the pandemic and access specialist opinions. This will also serve to reduce the demand for formal endoscopy in hospitals after the pandemic. We will target two types of patients: 1) Patients with rectal bleeding or symptoms of bowel cancer presenting to primary care. 2) Patients with inflammatory bowel disease. The goal is to commence treatment in the community and protect patients from exposure to Covid-19 by keeping them out of hospital. This highly innovative project will establish and pilot a novel primary care service that uses this platform at the point of care supported by specialist "virtual" clinics in secondary care hospitals. This pilot will be run in two sites in London. Primary end-points will be completion of 100 appointments using the platform and digital endoscope. Secondary end-points will be patient and user satisfaction, safety, utility and identify barriers to support the scaling up of the technology throughout the UK.