Inclusion Criteria:  Staff  Endoscopy staff consenting to take part in the study Staff work in Endoscopy as their main NHS job Patients Patients consenting to be observed and complete a patient satisfaction survey Male or Female, aged 18 years or above Able (in the investigator's opinion) and wiling to comply with all study requirements  Exclusion Criteria:  Staff • Endoscopy staff not consenting to take part in the study  Patients  Patients not consenting to take part in the study  Patients unable to understand the information provided or give consent to participate  o This was determined by the researcher who in her role as surgical doctor has been trained to assess patients' capacity to give informed consent.  Aged less than 18 years