This paper focuses on recent experience in setting up an endoscopy unit in a large regional hospital. The mix of endoscopy in
three smaller hospitals, draining into the large hospital endoscopy unit, has enabled the authors to comment on practical and
achievable steps towards creating best practice endoscopy in the regional setting. The challenges of using what is available from an
infrastructural equipment and personnel setting are discussed. In a fast moving field such as endoscopy, new techniques have an
important role to play, and some are indeed cost effective and have been shown to improve patient care. Some of the new techniques
and technologies are easily applicable to smaller endoscopy units and can be easily integrated into the practice of working
endoscopists. Cost effectiveness and patient care should always be the final arbiter of what is essential, as opposed to what is
nice to have. Close cooperation between referral and peripheral centers should also guide these decisions.
