The Growing Importance of ODPs in Endoscopy: A Nursing and Pre-Assessment Perspective
- May 3
- 7 min read
by Sabrina Cox
Acknowledgements
A sincere thank you to Sally West, Endoscopy ODP at the Royal Gwent Hospital, Aneurin Bevan University Health Board, and Lee Jonitson, Senior ODP in Endoscopy at Prince Charles Hospital, Cwm Taf Morgannwg University Health Board, for taking the time to share their experiences and perspectives for this article.
Their insight has helped give a genuine reflection of what the ODP role in endoscopy looks like day to day — from supporting patients through anxious moments to managing complex procedures and maintaining safety within a busy clinical environment.
Both Sally and Lee spoke openly about the challenges, responsibility, and teamwork involved in the role, and their contributions help highlight how important ODPs have become within modern endoscopy services. Sharing real experiences from clinical practice gives a far better understanding of the profession and the impact ODPs have on both patients and the wider multidisciplinary team.
Their passion for patient care and commitment to the specialty is clear throughout their stories, and their willingness to contribute to this discussion is greatly appreciated.
Endoscopy services across the UK are changing rapidly. Patients are presenting with more complex medical conditions, procedures are becoming increasingly advanced, and services are under constant pressure to meet growing demand. Within this environment, Operating Department Practitioners (ODPs) are becoming an increasingly important part of the endoscopy workforce.
From a nursing and pre-assessment perspective, the contribution of ODPs extends far beyond technical support. Their skills in airway management, sedation, patient monitoring, and peri-operative care help strengthen patient safety throughout the endoscopy pathway. As services continue to evolve, the role of the ODP is becoming more visible and increasingly valued within multidisciplinary teams.
British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidance emphasise the importance of safe sedation practice, effective patient assessment, physiological monitoring, and early recognition of deterioration. In many units, ODPs play a key role in supporting these standards while helping services manage increasingly complex patient groups.
A Changing Endoscopy Environment
Modern endoscopy is no longer limited to straightforward diagnostic procedures. Patients attending for endoscopy are often older, have multiple comorbidities, and may require deeper sedation or more advanced therapeutic procedures. Interventions such as ERCP, ESD, and bronchoscopy can be lengthy and technically demanding, requiring close monitoring and a coordinated multidisciplinary approach.
For nursing and pre-assessment teams, this has highlighted the need for clinicians with additional expertise in airway management, sedation, and acute patient care. ODPs bring these skills from their peri-operative and anaesthetic backgrounds, helping teams manage higher-risk patients more safely.
The Day-to-Day Role of an ODP in Endoscopy
No two days in endoscopy are ever quite the same. The role of the ODP is varied, fast-paced, and heavily focused on patient safety and teamwork.
Sally West, Endoscopy ODP at the Royal Gwent Hospital, describes starting the day by either admitting patients or preparing the clinical area:
“Checking equipment, ensuring everything is safe and ready. In the procedure room, I am either assisting the endoscopist or maintaining the patient’s airway.”
Throughout the list, ODPs support sedation, airway management, physiological monitoring, and troubleshooting equipment, while also reassuring anxious patients before procedures. Sally highlights that although the pace can be challenging, remaining organised and calm is essential.
Similarly, Lee Jonitson, Senior ODP in Endoscopy at Prince Charles Hospital, describes the role as “fast-paced, highly technical, and patient-focused.” He explains that emotional support is just as important as technical skills:
“Many patients arrive anxious, and reassurance and clear communication are key parts of my role.”
For both practitioners, seeing a patient safely through admission, procedure, and recovery is one of the most rewarding aspects of the job.
Why ODPs Are Drawn to Endoscopy
Both Sally and Lee describe endoscopy as a specialty that combines technical skill with direct patient impact.
Sally explains that she was drawn to endoscopy because of the variety within the role and the opportunity to support patients who are often anxious or uncertain about procedures.
As the only ODP in her unit, she is responsible for supporting general anaesthetic lists and anaesthetic-led propofol lists, adding further complexity and challenge to her role within a remote endoscopy environment.
Lee shares a similar view, describing endoscopy as an area where “early detection and intervention genuinely change outcomes, particularly in cancer pathways.” He also values the continuity of care within the specialty, allowing ODPs to remain involved throughout the patient journey.
The Importance of Pre-Assessment
From a pre-assessment perspective, ODP involvement can significantly improve patient planning and risk identification before the procedure takes place.
Patients with obesity, respiratory disease, cardiac conditions, obstructive sleep apnoea, or previous sedation complications often require additional planning. Collaborative discussions between nurses, ODPs, endoscopists, and anaesthetic teams help ensure the safest sedation approach is selected and that escalation plans are in place if needed.
Sally also explains that pre-assessing patients has become an important extension of her role:
“Being able to reassure and answer questions to hopefully ease their journey through our unit makes such a difference.”
This early involvement reflects BSG guidance, which stresses that patient safety begins before the patient even enters the procedure room.
Supporting Patient Safety During Procedures
Patient safety remains central to the ODP role within endoscopy. During procedures, ODPs focus on sedation, airway management, monitoring vital signs, and recognising early signs of deterioration.
Lee explains:
“ODPs in endoscopy are often the first to recognise subtle changes in airway, breathing, or circulation, particularly during sedation.”
This vigilance becomes especially important during complex procedures such as ERCP, ESD, or bronchoscopy, where patients may become unstable or require deeper sedation.
Sally describes these situations as some of the most challenging parts of the role:
“Managing sedation, recognising early signs of deterioration, and responding effectively requires both experience and confidence.”
ESGE and ESGENA guidance highlight the importance of continuous physiological monitoring, safety checklists, and early recognition of deterioration during endoscopy procedures. The skills ODPs bring from anaesthetic and peri-operative practice help strengthen the team’s ability to respond quickly and effectively.
Teamwork Within the Endoscopy Unit
Both practitioners emphasise that endoscopy relies heavily on teamwork and communication.
Sally explains:
“Teamwork is essential to endoscopy. I work closely with gastroenterologists, nurses, and support staff to ensure each procedure runs smoothly.”
Lee also describes ODPs as acting as a bridge between medical and nursing teams during complex or rapidly changing situations.
From a nursing perspective, ODP support also allows clearer role allocation within the procedure room. Nurses can focus on assisting the endoscopist, maintaining documentation, managing equipment, and supporting patient comfort, while ODPs concentrate on sedation and patient monitoring. This shared approach aligns with UK guidance on competency-based staffing and safe delegation within endoscopy services.
Managing Difficult Situations
One of the most important aspects of the ODP role is remaining calm during emergencies or unexpected complications.
Lee recalls a situation where a patient developed vasovagal syncope following Entonox use during a procedure. By maintaining a calm environment, supporting structured teamwork, and closely monitoring the patient’s condition, the team managed the episode safely without requiring further escalation.
He reflects:
“Creating a composed environment allowed the team to work efficiently and confidently, reinforcing the value of ODP expertise and non-technical skills in managing acute events within the endoscopy setting.”
These situations highlight how technical knowledge, communication, and leadership all contribute to patient safety.
Technology and the Future of the Role
Advances in endoscopic technology have significantly changed the role of the ODP in recent years. Improved imaging systems, advanced therapeutic equipment, digital reporting systems, and AI-assisted detection tools all require ongoing training and adaptability.
Sally describes the specialty as “interesting, varied and progressive,” while Lee notes that the increasing complexity of therapeutic endoscopy requires ODPs to continually expand their knowledge and technical competence.
Both practitioners also recognise growing opportunities for ODPs within endoscopy, particularly in leadership, education, advanced practice, and service development.
Lee believes there is increasing potential for experienced ODPs to progress into advanced clinical pathways, including roles that may eventually lead towards clinical endoscopist positions. He argues that developing structured career frameworks in Wales could help strengthen workforce resilience, improve service sustainability, and support reductions in waiting times.
Recognition of the ODP Role
Both Sally and Lee strongly advocate for greater recognition of ODPs within endoscopy services.
Sally highlights the growing demand for deeper sedation and advanced patient monitoring, stating that ODP skills are highly transferable and increasingly valuable within modern endoscopy.
Lee adds:
“ODPs are not simply support staff — we are integral to the endoscopy team, and investing in our development directly benefits patients and the wider healthcare system.”
As endoscopy services continue to expand and patient complexity increases, the contribution of ODPs is becoming increasingly difficult to overlook.
Conclusion
The role of the ODP within endoscopy has developed significantly over recent years. What was once seen as a supportive role has evolved into a highly skilled position that contributes directly to patient safety, procedural success, and service resilience.
From pre-assessment and sedation planning to airway management, recovery support, and emergency response, ODPs now play an essential part in the multidisciplinary endoscopy team. The experiences shared by Sally West and Lee Jonitson demonstrate not only the technical expertise required within the role, but also the importance of communication, reassurance, teamwork, and patient-centred care.
As endoscopy services continue to face increasing demand and complexity, investing in ODP development, recognition, and advanced career pathways will be important in supporting the future sustainability of endoscopy services across Wales and the wider UK.
References
British Society of Gastroenterology. British Society of Gastroenterology Guidelines on Sedation in Gastrointestinal Endoscopy. Gut, 2024.
Dunkley, Irene, et al. “UK Consensus on Non-Medical Staffing Required to Deliver Safe, Quality-Assured Care for Adult Patients Undergoing Gastrointestinal Endoscopy.” Frontline Gastroenterology, vol. 10, no. 1, 2019, pp. 24–34.
Gralnek, Ian M., et al. “Guidance for the Implementation of a Safety Checklist for Gastrointestinal Endoscopic Procedures: ESGE and ESGENA Position Statement.” Endoscopy, vol. 54, 2022, pp. 206–210.
Sidhu, Reena, et al. British Society of Gastroenterology Guidelines on Sedation in Gastrointestinal Endoscopy. British Society of Gastroenterology, 2023.
European Society of Gastrointestinal Endoscopy. ESGE–ESGENA Guidelines and Position Statements. ESGE.
