{"id":3240,"date":"2020-10-22T10:27:21","date_gmt":"2020-10-22T10:27:21","guid":{"rendered":"\/?p=3240"},"modified":"2020-10-22T10:27:21","modified_gmt":"2020-10-22T10:27:21","slug":"diagnostic-reform-the-impact-on-endoscopy","status":"publish","type":"post","link":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/diagnostic-reform-the-impact-on-endoscopy\/","title":{"rendered":"Reforma diagn\u00f3stica: o impacto na endoscopia"},"content":{"rendered":"

O ac\u00famulo de pacientes esperando mais de seis semanas por uma endoscopia aumentou substancialmente desde o in\u00edcio da pandemia de Covid-19, e as listas de espera agora precisam ser abordadas com urg\u00eancia.\n\n relat\u00f3rio publicado recentemente\n<\/a>\npelo NHS England, pede reformas e prop\u00f5e a introdu\u00e7\u00e3o de uma rede de centros de diagn\u00f3stico na comunidade, alguns dos quais conter\u00e3o instala\u00e7\u00f5es de endoscopia.<\/p>\n

A\n\n endoscopia m\u00f3vel ou modular\n<\/a>\na unidade pode ser usada provisoriamente, ou junto com um centro comunit\u00e1rio, para criar uma instala\u00e7\u00e3o independente que forne\u00e7a um caminho distinto para servi\u00e7os de endoscopia eletiva.\n\n Uma necessidade urgente de abordar os tempos de espera\n<\/strong>\nA demanda por endoscopia cresceu substancialmente nos \u00faltimos cinco anos e, embora a atividade tenha aumentado, os tempos de espera aumentaram mais rapidamente, causando um ac\u00famulo. Os procedimentos flex\u00edveis de sigmoidoscopia tiveram as maiores taxas de crescimento, em grande parte devido \u00e0 implementa\u00e7\u00e3o do programa de triagem intestinal.<\/p>\n

Durante a Covid-19, a necessidade de limpeza profunda de equipamentos e instala\u00e7\u00f5es entre pacientes levou a uma queda na produtividade e procedimentos cancelados e, como resultado, esperas maiores e mais longas. No geral, os n\u00edveis de atividade de endoscopia reduziram em mais de 90% no pico da pandemia.<\/p>\n

Procedimentos endosc\u00f3picos de emerg\u00eancia no pico da pandemia foram realizados sempre que poss\u00edvel em salas de cirurgia com press\u00e3o de ar negativa. A gastroscopia tamb\u00e9m foi inicialmente designada como um procedimento gerador de aerossol (AGP), o que traz um risco para os endoscopistas se os pacientes forem positivos para Covid-19 ou incertos sobre Covid-19, mas a gastroscopia n\u00e3o \u00e9 mais considerada um AGP sob a orienta\u00e7\u00e3o do PHE.\n\"\"\nOs n\u00fameros mais recentes do NHS England mostram que, embora a atividade de endoscopia tenha aumentado substancialmente desde abril, a taxa de recupera\u00e7\u00e3o diminuiu significativamente. A atividade em agosto foi cerca de dois ter\u00e7os daquela de um m\u00eas normal. Isso, em combina\u00e7\u00e3o com o fato de que as listas de espera n\u00e3o aumentaram substancialmente em agosto, apesar do baixo n\u00edvel de atividade, sugere que ainda h\u00e1 um consider\u00e1vel ac\u00famulo "oculto" de pessoas que ainda n\u00e3o entraram nas listas de espera.\n\n A necessidade de prepara\u00e7\u00e3o para o futuro\n<\/strong>\nAgora h\u00e1 uma necessidade urgente de estabelecer instala\u00e7\u00f5es m\u00ednimas de endoscopia para a Covid-19 para auxiliar na recupera\u00e7\u00e3o. O relat\u00f3rio reconhece que o acesso a equipamentos e instala\u00e7\u00f5es de endoscopia, em particular aqueles para colonoscopia, j\u00e1 estavam sob press\u00e3o consider\u00e1vel antes da pandemia. Al\u00e9m das restri\u00e7\u00f5es de for\u00e7a de trabalho, o programa Get it Right First Time (GIRFT) tamb\u00e9m revelou que cerca de 20 trusts do NHS provavelmente precisar\u00e3o de uma reconstru\u00e7\u00e3o completa de suas instala\u00e7\u00f5es de endoscopia, com outras precisando de melhorias.<\/p>\n

No relat\u00f3rio do NHS England, estima-se que cerca de 200 novas salas de endoscopia sejam necess\u00e1rias nos NHS Trusts para cobrir o crescimento atual em endoscopia e permitir as extens\u00f5es planejadas para o programa de triagem intestinal. Novas unidades de descontamina\u00e7\u00e3o de endoscopia tamb\u00e9m s\u00e3o necess\u00e1rias, e o relat\u00f3rio tamb\u00e9m recomenda que todos os equipamentos de imagem existentes com mais de 10 anos sejam substitu\u00eddos.<\/p>\n

Infelizmente, n\u00e3o h\u00e1 um registro nacional de ativos para instala\u00e7\u00f5es de endoscopia, e o relat\u00f3rio recomenda que pesquisas de equipamentos\/instala\u00e7\u00f5es e pessoal sejam realizadas urgentemente para facilitar o planejamento de curto e longo prazo. O relat\u00f3rio sugere a participa\u00e7\u00e3o no National Endoscopy Database (NED) pelo 20% de NHS Trusts que ainda n\u00e3o o estejam fazendo.<\/p>\n

Um relat\u00f3rio publicado pela Public Policy Projects em parceria com\n\n Vanguard\n<\/a>\nh\u00e1 dois anos, mostrou que mais de um ter\u00e7o dos hospitais est\u00e3o operando su\u00edtes de descontamina\u00e7\u00e3o endosc\u00f3pica com equipamentos que se aproximam ou excedem as recomenda\u00e7\u00f5es do fabricante, e que cerca de 251% dos hospitais t\u00eam su\u00edtes de descontamina\u00e7\u00e3o endosc\u00f3pica com mais de dez anos.\n\n Uma solu\u00e7\u00e3o pr\u00e1tica para endoscopia\n<\/strong>\nEspera-se que a cria\u00e7\u00e3o de instala\u00e7\u00f5es de endoscopia livres de Covid em alguns dos centros comunit\u00e1rios de diagn\u00f3stico propostos ou\n\n balc\u00f5es \u00fanicos\n<\/a>\n, juntamente com testes de pacientes e equipe antes de todos os procedimentos, pode significar que a necessidade de limpeza profunda entre os pacientes ser\u00e1 bastante reduzida, permitindo que o rendimento aumente para n\u00edveis mais pr\u00f3ximos do normal. Pacientes que s\u00e3o positivos para Covid-19 e aqueles que precisam de uma endoscopia de emerg\u00eancia antes que o status da Covid-19 possa ser determinado devem continuar a ter seus procedimentos feitos em instala\u00e7\u00f5es com press\u00e3o de ar negativa (geralmente salas de cirurgia).<\/p>\n

Com rela\u00e7\u00e3o \u00e0 for\u00e7a de trabalho, o relat\u00f3rio recomenda o estabelecimento de academias de treinamento para aumentar a quantidade de colonoscopistas n\u00e3o m\u00e9dicos e para permitir que os colonoscopistas existentes assumam a colonoscopia de triagem. Mais enfermeiros de endoscopia tamb\u00e9m ser\u00e3o necess\u00e1rios para atender \u00e0 demanda adicional.<\/p>\n

Sem investimento ou presta\u00e7\u00e3o de servi\u00e7os reformada, por sua pr\u00f3pria admiss\u00e3o, o NHS corre o risco de n\u00e3o conseguir atingir metas, incluindo a ambi\u00e7\u00e3o de diagnosticar 75% de pessoas com c\u00e2ncer em est\u00e1gio inicial e melhorar os resultados dos pacientes. Mesmo que os planos sejam aprovados rapidamente, as recomenda\u00e7\u00f5es no relat\u00f3rio levar\u00e3o tempo para serem implementadas. Mas com o ac\u00famulo crescendo a cada m\u00eas, esperar \u00e9 uma op\u00e7\u00e3o?<\/p>\n

Para cada m\u00eas em que a produtividade \u00e9 comprometida, a lista de espera cresce al\u00e9m de um n\u00edvel que pode ser facilmente recuperado sem ultrapassar 100% da capacidade existente. Uma solu\u00e7\u00e3o provis\u00f3ria \u00e9 necess\u00e1ria, e\n\n infraestrutura cl\u00ednica flex\u00edvel\n<\/a>\npoderia fornecer a resposta. Unidades de endoscopia m\u00f3veis e modulares podem ser combinadas com unidades de contamina\u00e7\u00e3o de endoscopia flex\u00edveis e instaladas em quase qualquer local \u2013 adjacente a um centro de diagn\u00f3stico ou em outro lugar da comunidade \u2013 para criar um local aut\u00f4nomo e livre de Covid para endoscopia eletiva.<\/p>\n

Leia o relat\u00f3rio, que inclui uma revis\u00e3o detalhada da atividade endosc\u00f3pica,\n\n aqui\n<\/a>\n.<\/p>\n

Uma c\u00f3pia do relat\u00f3rio\n\n 'Olhando para dentro: o estado da endoscopia na Inglaterra'\n<\/em>\n, produzido pela Public Policy Projects em parceria com o Vanguard, pode ser solicitado por\n\n contatando-nos\n<\/a>\n.<\/p>","protected":false},"excerpt":{"rendered":"

O n\u00famero de pacientes que esperam mais de seis semanas por uma endoscopia aumentou substancialmente desde o in\u00edcio da pandemia de Covid-19, e as listas de espera agora precisam ser resolvidas com urg\u00eancia.<\/p>","protected":false},"author":1,"featured_media":1347,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,119,115],"tags":[131,137,5,4],"class_list":["post-3240","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-procedures","category-products-and-services","tag-endoscope-decontamination","tag-endoscopy-suite","tag-mobile","tag-modular"],"acf":[],"yoast_head":"\nDiagnostic reform: the impact on endoscopy - Vanguard Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"The impact of diagnostic reform in reducing patient backlog for endoscopy treatment using mobile or modular Vanguard facility\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/diagnostic-reform-the-impact-on-endoscopy\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diagnostic reform: the impact on endoscopy - Vanguard Healthcare Solutions\" \/>\n<meta property=\"og:description\" content=\"The impact of diagnostic reform in reducing patient backlog for endoscopy treatment using mobile or modular Vanguard facility\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/diagnostic-reform-the-impact-on-endoscopy\/\" \/>\n<meta property=\"og:site_name\" content=\"Vanguard Healthcare Solutions\" \/>\n<meta property=\"article:published_time\" content=\"2020-10-22T10:27:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1771\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Vanguard Healthcare Solutions\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Vanguard Healthcare Solutions\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo estimado de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/\"},\"author\":{\"name\":\"Vanguard Healthcare Solutions\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/#\\\/schema\\\/person\\\/426decd65e2d39321705e63d5ea4394b\"},\"headline\":\"Diagnostic reform: the impact on endoscopy\",\"datePublished\":\"2020-10-22T10:27:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/\"},\"wordCount\":871,\"image\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/wp-content\\\/uploads\\\/legacy\\\/2020\\\/01\\\/image-4-scaled.jpg\",\"keywords\":[\"Endoscope Decontamination\",\"Endoscopy suite\",\"Mobile\",\"Modular\"],\"articleSection\":[\"News\",\"Procedures\",\"Products and services\"],\"inLanguage\":\"pt-PT\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/\",\"url\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/\",\"name\":\"Diagnostic reform: the impact on endoscopy - Vanguard Healthcare Solutions\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/wp-content\\\/uploads\\\/legacy\\\/2020\\\/01\\\/image-4-scaled.jpg\",\"datePublished\":\"2020-10-22T10:27:21+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/#\\\/schema\\\/person\\\/426decd65e2d39321705e63d5ea4394b\"},\"description\":\"The impact of diagnostic reform in reducing patient backlog for endoscopy treatment using mobile or modular Vanguard facility\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#breadcrumb\"},\"inLanguage\":\"pt-PT\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-PT\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#primaryimage\",\"url\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/wp-content\\\/uploads\\\/legacy\\\/2020\\\/01\\\/image-4-scaled.jpg\",\"contentUrl\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/wp-content\\\/uploads\\\/legacy\\\/2020\\\/01\\\/image-4-scaled.jpg\",\"width\":2560,\"height\":1771},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/diagnostic-reform-the-impact-on-endoscopy\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Diagnostic reform: the impact on endoscopy\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/#website\",\"url\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/\",\"name\":\"Vanguard Healthcare Solutions\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-PT\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/www.vanguardhealthcare.co.uk\\\/#\\\/schema\\\/person\\\/426decd65e2d39321705e63d5ea4394b\",\"name\":\"Vanguard Healthcare Solutions\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-PT\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g\",\"caption\":\"Vanguard Healthcare Solutions\"},\"sameAs\":[\"https:\\\/\\\/www.vanguardhealthcare.co.uk\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Reforma diagn\u00f3stica: o impacto na endoscopia - Vanguard Healthcare Solutions","description":"O impacto da reforma diagn\u00f3stica na redu\u00e7\u00e3o da carteira de pacientes para tratamento endosc\u00f3pico usando a instala\u00e7\u00e3o m\u00f3vel ou modular Vanguard","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/diagnostic-reform-the-impact-on-endoscopy\/","og_locale":"pt_PT","og_type":"article","og_title":"Diagnostic reform: the impact on endoscopy - Vanguard Healthcare Solutions","og_description":"The impact of diagnostic reform in reducing patient backlog for endoscopy treatment using mobile or modular Vanguard facility","og_url":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/diagnostic-reform-the-impact-on-endoscopy\/","og_site_name":"Vanguard Healthcare Solutions","article_published_time":"2020-10-22T10:27:21+00:00","og_image":[{"width":2560,"height":1771,"url":"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg","type":"image\/jpeg"}],"author":"Vanguard Healthcare Solutions","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Vanguard Healthcare Solutions","Tempo estimado de leitura":"4 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#article","isPartOf":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/"},"author":{"name":"Vanguard Healthcare Solutions","@id":"https:\/\/www.vanguardhealthcare.co.uk\/#\/schema\/person\/426decd65e2d39321705e63d5ea4394b"},"headline":"Diagnostic reform: the impact on endoscopy","datePublished":"2020-10-22T10:27:21+00:00","mainEntityOfPage":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/"},"wordCount":871,"image":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#primaryimage"},"thumbnailUrl":"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg","keywords":["Endoscope Decontamination","Endoscopy suite","Mobile","Modular"],"articleSection":["News","Procedures","Products and services"],"inLanguage":"pt-PT"},{"@type":"WebPage","@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/","url":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/","name":"Reforma diagn\u00f3stica: o impacto na endoscopia - Vanguard Healthcare Solutions","isPartOf":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#primaryimage"},"image":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#primaryimage"},"thumbnailUrl":"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg","datePublished":"2020-10-22T10:27:21+00:00","author":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/#\/schema\/person\/426decd65e2d39321705e63d5ea4394b"},"description":"O impacto da reforma diagn\u00f3stica na redu\u00e7\u00e3o da carteira de pacientes para tratamento endosc\u00f3pico usando a instala\u00e7\u00e3o m\u00f3vel ou modular Vanguard","breadcrumb":{"@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#breadcrumb"},"inLanguage":"pt-PT","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/"]}]},{"@type":"ImageObject","inLanguage":"pt-PT","@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#primaryimage","url":"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg","contentUrl":"https:\/\/www.vanguardhealthcare.co.uk\/wp-content\/uploads\/legacy\/2020\/01\/image-4-scaled.jpg","width":2560,"height":1771},{"@type":"BreadcrumbList","@id":"https:\/\/www.vanguardhealthcare.co.uk\/diagnostic-reform-the-impact-on-endoscopy\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.vanguardhealthcare.co.uk\/"},{"@type":"ListItem","position":2,"name":"Diagnostic reform: the impact on endoscopy"}]},{"@type":"WebSite","@id":"https:\/\/www.vanguardhealthcare.co.uk\/#website","url":"https:\/\/www.vanguardhealthcare.co.uk\/","name":"Vanguard Solu\u00e7\u00f5es de Sa\u00fade","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.vanguardhealthcare.co.uk\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-PT"},{"@type":"Person","@id":"https:\/\/www.vanguardhealthcare.co.uk\/#\/schema\/person\/426decd65e2d39321705e63d5ea4394b","name":"Vanguard Solu\u00e7\u00f5es de Sa\u00fade","image":{"@type":"ImageObject","inLanguage":"pt-PT","@id":"https:\/\/secure.gravatar.com\/avatar\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/7ba7c80067fbd6952425e7e5a94fa842f37365b39fe1fd0a01287a5a0b6f7d2b?s=96&d=mm&r=g","caption":"Vanguard Healthcare Solutions"},"sameAs":["https:\/\/www.vanguardhealthcare.co.uk"]}]}},"_links":{"self":[{"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/posts\/3240","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/comments?post=3240"}],"version-history":[{"count":0,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/posts\/3240\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/media\/1347"}],"wp:attachment":[{"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/media?parent=3240"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/categories?post=3240"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.vanguardhealthcare.co.uk\/pt_pt\/wp-json\/wp\/v2\/tags?post=3240"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}