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Background This audit measures the extent to which in hospital end of life care is meeting the Five Priorities of Care for the Dying Person. 1) Recognise 2) Communicate 3) Involve 4) Support 5) Plan & Do. Aims To assess the impact of the Covid–19 pandemic on end of life care. To provide trust wide feedback in preparation for increasing rates of Covid–19. Methods Cases were audited retrospectively using quality measures based on the 2016 National End of Life Care Audit. Thirty deaths from November/December 2019 were compared with forty deaths from April 2020 (first peak of Covid-19) Results Median age was similar pre and during pandemic (81.5 vs 80.3). During the pandemic 70% of patients audited tested positive for covid 19. Pre pandemic 13% of patients died without a Treatment Escalation Plan (TEP) compared to 2% during the pandemic. Pre pandemic 27% of patients received active treatment in the last days of life compared 48% during the pandemic. Involvement of the patient and next of (NOK) in decisions remained >90% pre and during pandemic. During the pandemic spiritual/cultural needs assessments fell by 25% and discussions around place of death fell by 36%. Conclusions The increased likelihood of active treatment in the last days of life during the pandemic may reflect the rapid disease trajectory of covid-19. The consistent high level of communication with patients and NOKs reflects efforts to communicate via telephone due to visiting restrictions. TEP completion improved during the pandemic in keeping with national drives to establish ceilings of care and the transfer to electronic TEPs in the Trust during the pandemic. Prioritisation of communication and medical intervention during the pandemic may have adversely impacted holistic needs assessment. Learning points from this audit have been publicised in the Trust in preparation for the second wave of the pandemic.

Background and study aims Detecting colorectal neoplasia is the goal of high-quality screening and surveillance colonoscopy, as reflected by high adenoma detection rate (ADR) and adenomas per colonoscopy (APC). The aim of our study was to evaluate the performance of a novel artificial intelligence (AI)-aided polyp detection device, Skout, with the primary endpoints of ADR and APC in routine colonoscopy. Patients and methods We compared ADR and APC in a cohort of outpatients undergoing routine high-resolution colonoscopy with and without the use of a real-time, AI-aided polyp detection device. Patients undergoing colonoscopy with Skout were enrolled in a single-arm, unblinded, prospective trial and the results were compared with a historical cohort. All resected polyps were examined histologically. Results Eighty-three patients undergoing screening and surveillance colonoscopy at an outpatient endoscopy center were enrolled and outcomes compared with 283 historical control patients. Overall, ADR with and without Skout was 54.2 % and 40.6 % respectively (P = 0.028) and 53.6 % and 30.8 %, respectively, in screening exams (P = 0.024). Overall, APC rate with and without Skout was 1.46 and 1.01, respectively, (P = 0.104) and 1.18 and 0.50, respectively, in screening exams (P = 0.002). Overall, true histology rate (THR) with and without Skout was 73.8 % and 78.4 %, respectively, (P = 0.463) and 75.0 % and 71.0 %, respectively, in screening exams (P = 0.731). Conclusion We have demonstrated that our novel AI-aided polyp detection device increased the ADR in a cohort of patients undergoing screening and surveillance colonoscopy without a significant concomitant increase in hyperplastic polyp resection. AI-aided colonoscopy has the potential for improving the outcomes of patients undergoing colonoscopy.