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NHS Western Isles will launch an innovative new service this month which will transform the way many patients undergo investigation for bowel problems. 

NHS WI is introducing Colon Capsule Endoscopy (CCE) – a small capsule with a camera at either end, which is swallowed by the patient and takes tens of thousands of pictures as it travels through the bowel, before being passed and flushed away. 

During a visit to Stornoway yesterday (Friday August 12), Health Secretary Humza Yousaf, heard from NHS WI clinicians about how this impressive new technology will be used in patients' own homes as part of a pilot project within the Health Board's Hospital at Home service.  

Mr Yousaf said: "It has been inspiring to hear from the team and learn more about this innovative service, Colon Capsule Endoscopy. This ground-breaking technology is one of the ways we can adapt to make procedures less invasive and quicker for patients, improving the overall outcome for patients. This is an excellent example of adjusting services to meet local needs while our NHS is recovering from the pandemic."

Traditionally, patients who present with symptoms affecting the lower gastrointestinal tract ('large bowel' or 'colon') would have to undergo a colonoscopy to visualise the inside of the bowel to check for abnormalities.

"Whilst this is a highly effective investigation which, as well as allowing visualisation of the colon, also allows biopsies (samples) to be taken, the procedure itself can be unpleasant and throughout NHS Scotland there is a shortage of surgical time to match the demand, which has been made worse by the inevitable loss of activity through the pandemic. 

Western Isles GP, Dr Dave Rigby, explained: "The Colon Capsule Endoscopy (CCE) is ground-breaking technology which will mean that those at highest risk will gain access to colonoscopy quicker, and others will not require colonoscopy at all.

"After taking suitable bowel preparation to clear the bowel (as is done for colonoscopy) the patient is fitted with a belt (the recording belt) and asked to swallow the capsule along with a fluid to help push it through the bowel.

"The camera takes tens of thousands of pictures as it travels through the bowel before being passed and flushed away. The images are all stored on the recording belt and analysed in a national centre with a report being generated for the referring clinician within the next few days.

"The success rate of the test has been found to be as good as that for the traditional colonoscopy. With appropriate patient selection, most patients will not require any further investigation or intervention. If a significant abnormality is found appropriate, further investigation will be arranged, such as a colonoscopy." 

Patients suitable for CCE will largely avoid the need for an 'invasive' investigation like a colonoscopy and even those that do after their CCE will often need a very small investigation as the location of any polyps or other abnormalities will be known from the CCE pictures. 

NHS Western Isles Chief Executive, Gordon Jamieson, said: "For NHS Western Isles there are two 'First for Scotland' achievements with the roll out of the service. Firstly, patients can be directly referred for the test by their GP. This will streamline the process for the patient and save time for the surgical team as they will not need to see these patients prior to their test.

"Secondly, a pilot in underway in Lewis and Harris for the service to be delivered entirely in the patients' own homes. This will avoid the need for travel for patients after they have taken bowel preparation and will increase the number of patients suitable for this type of test and they will be able to remain in the comfort of their own home. This pilot will be delivered by the Hospital at Home team based in Western Isles Hospital.  

"I would like to congratulate and commend the staff involved in planning and establishing this ground-breaking new service, which has the potential to deliver a significantly improved service for patients."