M1079 Improving Adherence to Guidelines When Managing Non-Variceal Upper Gastrointestinal Bleeding: A National Cluster Randomized Trial of a Multifaceted Strategy

system in 74/76 (97%) of cases.Grading correlated weakly with self-reported caecal intubation rates and multiple choice question (MCQ) scores (r=0.24 and 0.27, p<0.01).Overall 27/30 candidates felt the DOPS assessment was fair/very fair, while 27/32 felt the MCQ was fair/very fair.Of the assessors, 12/16 felt the DOPS was valid/very valid, while 17/17 felt the overall process was fair/very fair.It is possible for candidates to fail the accreditation process repeatedly and yet be able to continue their routine National Health Service colonoscopy practice without sanctions.In countries that do not adopt the "driving test", e.g.USA, Canada, there is no evidence that the quality of colonoscopy in these countries is inferior.Concerns about a two-tier service, and roll out of similar tests in other aspects of clinical practice have not been adequately addressed.CONCLUSION: For trained colonoscopists with proven satisfactory performance outcomes, it is not clear if the addition of a "driving test" is necessary to select screening colonoscopists.