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NHS England - Transformation Directorate

Using patient education videos to improve quality of bowel preparation for colonoscopy

Bowel preparation for colonoscopy is dependent on several factors, but is a consistent problem for clinical practice. Patients with poor prep may need to have their procedure repeated and there is a higher chance of abnormalities being missed, even if the colonoscopy does go ahead. Poor preparation rates have been reported in the region of 5% to 25%, representing a significant financial burden and challenge to service provision.


Multiple sources of data suggest that improved patient education can help to significantly improve bowel preparation. However, existing methods (mostly paper information leaflets) have not achieved the desired effect given the current rates of poor preparation.


Improve the quality of bowel preparation for patients having colonoscopy by inviting them to access and watch online information videos.

Solution and impact

Online patient education videos have been developed and commissioned by NHSX as a central resource for patients and clinicians.

View online patient education videos.

Links and QR codes to videos were sent to patients, along with written instructions for bowel prep prior to procedure. Endoscopy nurses recorded whether patients had watched the videos on the day of procedure. Bowel cleanliness was graded by the endoscopist using the Boston bowel preparation (BBPS) and Aronchick scores.


Improved bowel preparation as a result of patients watching videos (rate of good/excellent prep by Boston scale increased to 85% compared to 79%; p=0.047).


  • Video library available through web browser and mobile application


  • Static library of patient information videos in the health and care sector in the UK


The online video library is free to use and approved for use by NHS Trusts to refer their patients to view as appropriate.

Key learning points

Uptake to watch videos was low (approximately 11%) but the intervention was highly effective. Strategies to improve uptake such as prominent inclusion in the written patient information, posters, pre-assessment and SMS to patients with an embedded link, were discussed but have not been initiated as yet.

Find out more

More about the Health and Care Innovations web video library

Read "World Journal of Gastroenterology, Hepatology and Endoscopy vol 3.3"

Key contact

Jonathan Landy, gastroenterology consultant, West Hertfordshire Hospitals NHS Trust