**2. Location of services**

An endoscopy unit may be hospital-based or free standing. For hospital-based endoscopy units, the location shall be in close proximity to acute emergency services. The location within the complex shall permit free access for out-patients and for the transport of inpatients by bed, trolley or wheel chair. Where the endoscopy unit is not located within the main hospital complex, provision for enclosed transfer of patients is advisable. Where the endoscopy service is in a free standing facility, it should be located within a 15 minute ambulance journey of an acute hospital that provides an intensive care or emergency service. There should be an agreed arrangement with this hospital to admit patients in a medical emergency.

The endoscopy services that are available in the developing countries do not meet the standards stated above. Very often there is a lot of improvisation in the siting of endoscopy suites. In some countries they are located in wards without any consideration for access to out-patients and transport of in-patients. The privately owned endoscopy services are even worse because in most cases, once the equipment is procured, it is installed in any existing facility. The absence of effective certification and accreditation of centres makes matters worse.
