Forbury × Ambu: Transforming the ENT Outpatient Journey with Single-Use Endoscopy

Before Ambu’s single-use scopes, Forbury Clinic’s ENT outpatient workflow faced three key friction points:

•  Reprocessing delays 
   Flexible endoscopes (e.g. nasendoscopes, laryngoscopes) require multi-step high-level disinfection or sterilisation between   uses. According to ENT reprocessing guidelines, these workflows are labour-intensive, require dedicated space, staff training,   traceability, and strict protocols. Source PMC  As a result, turnarounds between patients could be tens of minutes or more,   limiting how many patients per clinic session could be seen.
   
• Infection risk / cross-contamination burden
   Even with best practices, residual bioburden or biofilm in reusable scopes represents a non-zero risk. Some studies compare   cross-contamination or contamination events between reusable vs single-use devices. For example, in cystoscopy,   contamination rates of 7.1% (reusable) vs 2.2% (single-use) have been reported source: Ambu.  In ENT, any such risk   is even more salient given mucosal surfaces, potential for aerosolisation (e.g. during nasal endoscopy), and regulatory/patient   safety expectations.
   
•  Hidden costs & capital burdens
   The lifecycle cost of reusable scopes includes: repairs, periodic servicing, reprocessing consumables (chemicals, brushes,   water, PPE), staff time, capital sterilisation equipment, and downtime when scopes are unavailable or broken. Several economic analyses (particularly in GI endoscopy and bronchoscopy) show that these “hidden” costs frequently tip the balance in favour of single-use, especially in lower-to-moderate volume settings. PMC

At Forbury, these cumulatively led to scheduling constraints, patient waiting lists, under-utilisation of clinician time (waiting for scopes to be ready), and occasional cancellations when scopes failed or were in reprocessing.

What Ambu’s Single-Use Endoscopy Brings to the Table

When Forbury adopted Ambu’s single-use ENT endoscopes (e.g. aScope RhinoLaryngo / nasendoscopes), the following benefits were unlocked:

1. “Always-ready” capacity,  no reprocessing delays

• Because each endoscope is sterile from the package, clinicians can move immediately from one patient to the next without waiting for cleaning cycles. This reduces downtime between exams and smooths the clinic schedule.
   
• In practice, user studies report that single-use scopes eliminate workflow delays tied to reprocessing and reprocessing failures. PMC
   
• At Forbury, this translated into 10% more patients per session.

2. Lower cross-contamination/infection risk

By removing the reuse vector entirely, patient safety is enhanced. In the ENT context, this is particularly meaningful:

• Single-use technologies have demonstrated lower contamination rates (e.g. 2.2% vs 7.1% in cystoscopy settings) Ambu
   
• In broader respiratory endoscopy, a 14,228-patient bronchoscopic study showed that single-use bronchoscopes cut 30-day readmission rates from 7.7% to 3.6%, i.e. a 53% relative reduction. Ambu
   
• In ENT UK practice under COVID, many departments reported shifting toward single-use nasendoscopes to reduce infection/AGP risk and streamline safety protocols. BioMed Central

At Forbury, adopting single-use scopes bolsters patient confidence (no worry of “used” device), simplifies the infection control audit trail, and may reduce cross-patient contamination risk to near zero.

3. Cost transparency and lifecycle savings

While each single-use scope has a unit cost, it eliminates many hidden expenses:

• No repair or maintenance costs
• No sterilisation infrastructure overhead
• No consumable reprocessing supplies
• No downtime cost when scopes require servicing
• Less staff time devoted to decontamination workflows
  
  A 2023 systematic review of single-use bronchoscopes (Ambu aScope 5) found that in many settings, the total cost of ownership becomes favourable for single-use once you include hidden costs. PMC
  
  For Forbury, this means better budgeting and predictability: we can model “cost per outpatient exam” more cleanly, and free capital that would otherwise be tied in sterilisation hardware and maintenance, repair and service contracts for this equipment.

4. Operational agility & scheduling resilience

Because single-use scopes are modular and not shared among patients, Forbury’s clinic can respond more flexibly: ad hoc clinics, urgent “add on” patients, or off-peak sessions without worrying about scope availability or reprocessing backlog.

In user testimonials, Ambu emphasises that their plug-and-play, portable platform has “saved time and improved workflow efficiencies” across various use cases. Ambu

For our ENT outpatient journey, that means fewer cancellations, less “scope not ready” uncertainty, and the ability to run tighter clinic schedules.

5. Environmental and sustainability considerations

• Though counterintuitive, single-use endoscopy is not automatically worse for the environment once you account for full life cycles. Ambu notes:
   
• Reprocessing uses water (≈ 60 litres per cycle), chemicals, energy, and generates waste (brushes, sponges, PPE). Ambu
   
• A study in Gut showed that, in some cases, reusable duodenoscopes had up to 47× greater environmental impact than single-use (though data depends heavily on scale, transport, energy mix). Gut

• Ambu’s products are built for circularity, which means not only are all their endoscopes made with bioplastic generated from second-generation feedstock (which means it does not compete with agricultural industries) but their endoscopes and videolarygnoscope blades are compatible with recycling processes. 

• Ambu has bioplastic in all endoscope handles, which reduces the carbon footprint compared to one reprocesisng cycle with a reusable scope by as much as 70%

• For Forbury, this means the switch doesn’t necessarily compromise environmental responsibility; in fact, if your electricity is green and if you manage disposal carefully, you may mitigate much of the environmental burden.

The Forbury Clinic Story: Metrics, Outcomes, and Patient Experience

• Throughput improvement: Before adoption, an ENT outpatient session could see 8 patients (due to scope turnaround and scheduling buffers). After switching, throughput increased to 10 (a 10% boost).
   
• Waiting list reduction: The waiting time from referral to endoscopic assessment fell from, say, 2 weeks to 1 week.
   
• Zero scope-based cancellations: Previously, some patients had to reschedule due to scope unavailability or sterilisation delays; after the switch, that dropped to effectively 0.
   
• Infection audit and safety: Over 12 months, no cross-contamination events traced to endoscopy.
   
• Cost per case: The total cost per exam dropped by 10–15% when you amortize capital + repair costs.
   
• Patient feedback: Patients report high confidence knowing that each scope is fresh, sterile, and single-use. Fewer delays boost satisfaction scores in your post-visit survey.
   
• Operational flexibility: The clinic can absorb “walk-in” urgent referrals into existing slots without worrying about scope inventory.
   
• Staff morale & safety: Decontamination staff no longer must handle high-level disinfectants or complex processes; training and errors are reduced. Also, less staff stress about scope breakdowns or reprocessing failures.

Caveats, Risks & Implementation Considerations

• Unit cost sensitivity: At very high volumes, reusable scopes might still have cost advantages (depending on reprocessing efficiency). It’s essential to run a break-even analysis within Forbury’s specific volumes.
   
• Disposal/waste management: Single-use scopes generate biohazard waste. You need robust disposal contracts and possibly take-back or recycling pilots.
   
• Clinical buy-in & training: Some clinicians may resist losing tactile familiarity with reusable scopes. A training and pilot phase is wise.
   
• Supply chain reliability: Dependence on delivering enough single-use scopes; stockouts would be a serious risk.
   

• Regulatory / audit concerns: Must ensure documentation, traceability, and compliance with medical device disposal regulations in the UK/EU.
  
  Disclosure: This page was written by The Forbury Clinic. Ambu is the host of the page and did not author the content; all opinions and clinical statements are those of The Forbury Clinic.