Outpatient hysteroscopy/biopsy - Pain Control and Patient Choice

Roedd y cais yn rhannol lwyddiannus.

Katharine Tylko-Hill

Dear Salisbury NHS Foundation Trust,

Under the FOIA (2000) please would you supply the following information relating to your Trust’s (and its outsourced services’) practice of OUTPATIENT HYSTEROSCOPY/BIOPSY – PAIN CONTROL AND PATIENT CHOICE

1. The patient information leaflet/s
2. The consent form/s
3. For each of the last 3 financial years:
i. all audits of OP hysteroscopy adverse events, (including infection, perforation, pain equal to or above 7/10 on VAS)
ii. all surveys of patients’ outpatient hysteroscopy experiences. Are all your patients allowed to complete the satisfaction survey at home? Y/N
iii. the number of your patients who had a) GA, b) spinal anaesthesia, c) monitored procedural IV sedation, d) local anaesthetic, e) no anaesthetic
iv. the % of your a) diagnostic hysteroscopies, b) operative hysteroscopies that were done in outpatients. Did your Trust meet the Best Practice Target % Tariff for each of these years? Y/N
4. i. Is local anaesthetic available in all your outpatient hysteroscopy clinics? Y/N
ii. Is Entonox available in all your outpatient hysteroscopy clinics? Y/N
5. Are all your hysteroscopy patients (including See & Treat/One Stop Shop/Late Cancellations) offered i. local anaesthetic? Y/N
ii. GA? Y/N
iii. spinal anaesthesia? Y/N
iv. safely monitored IV sedation? Y/N
6. Do you use electro-surgery in any of your outpatients clinics? Y/N If so, do you always use the lowest power setting? Y/N
7. What type and diameter of scopes do you use in a) outpatients, b) for GA patients? Rigid, semi-rigid, flexible?
8. What is the minimum training and accreditation (e.g. RCOG ATSM) that all your NEW hysteroscopists must have?
9. What % diagnostic outpatient hysteroscopy/biopsy patients had an incomplete procedure which was repeated with epidural, GA or sedation?
10. Does your Trust have a psychosexual counselling service for PTSD caused by severe procedural pain?

With thanks,
Yours faithfully,
Katharine Tylko-Hill

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Thank you for the request for information you have sent in under the
[1]Freedom of Information Act 2000.

We will endeavour to answer your request within the next 20 working
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Should your request fall under any of the exemptions of the [2]Freedom
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References

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2. http://www.foi.nhs.uk/home.html
3. http://www.salisbury.nhs.uk/

Steve McCarthy, Salisbury NHS Foundation Trust

Dear Katherine,

As you will know, from the automated email acknowledgement, that we have received your FOI request and this has been provided with the reference FOI_3675.

The Trust's Information Services and Clinical Coding Departments have been looking at gathering the information for questions 4, 5 and 12 (see below).

Question No. 4 The number of your patients who had a) GA, b) spinal anaesthesia, c) monitored procedural IV sedation, d) local anaesthetic, e) no anaesthetic

Question No. 5 The % of your a) diagnostic hysteroscopies, b) operative hysteroscopies that were done in outpatients. Did your Trust meet the Best Practice Target % Tariff for each of these years? Y/N

Question No 12. What % diagnostic outpatient hysteroscopy/biopsy patients had an incomplete procedure which was repeated with epidural, GA or sedation?

They are currently unable to provide the information in the level of detail requested because it would seem for instance that the internationally recognised ICD-10 Clinical Codes are the same for both diagnostic and operative hysteroscopies i.e. code starting from Q18.

We would be grateful for your further advice as to how you wish us to proceed with the request, possibly by revising the questions or providing further clarification. In the meantime we have 'stopped the clock' on this request.

Yours sincerely

Information Governance Team

If you have any questions regarding this response, please contact us at
[Salisbury NHS Foundation Trust request email]
Visit the Freedom of Information website at
http://www.ico.gov.uk/what_we_cover/free...

dangos adrannau a ddyfynnir

Freedom Of Information, Salisbury NHS Foundation Trust

 

Salisbury NHS Foundation Trust
Salisbury District Hospital
Department of Information Technology
Salisbury
Wiltshire
SP2 8BJ

[1]www.salisbury.nhs.uk

22^nd May 2017

Reference No: FOI_3675
Dear Ms Katherine Tylko-Hill
Regarding your request for information that we received on the 7^th April 2017. We hope this
information is satisfactory and meets your intended request requirements. Should this
information not answer your questions, please contact us using the email address at the bottom
of this email, or you can write to us using the address above.
 
Question No. 1
Under the FOIA (2000) please would you supply the following information relating to your
Trust's (and its outsourced services') practice of OUTPATIENT HYSTEROSCOPY/BIOPSY - PAIN
CONTROL AND PATIENT CHOICE

The patient information leaflet/s
The consent form/s
 
Answer No. 1
Patient information leaflet -
[2]http://icid/clinicalmanagement/obstetric...

The Trust uses a standard consent form for this procdure not a specific consent form for
hysteroscopy.
 
 
Question No. 2
For each of the last 3 financial years:
all audits of OP hysteroscopy adverse events, (including infection, perforation, pain equal to
or above 7/10 on VAS)
 
Answer No. 2
No adverse events in 14/15 or 15/16.

One adverse event in 16/17 in March 17 - audit not yet undertaken.
 
 
Question No. 3
All surveys of patients' outpatient hysteroscopy experiences. Are all your patients allowed to
complete the satisfaction survey at home? Y/N
 
Answer No. 3
Patients are asked to complete the Friends and Family test (whether they would recommend the
service to their friends and family if they needed similar care and treatment). Patients have
the choice to complete the test by postcard (given when the patient leaves the clinic), on
line via the internet or by Salisbury District Hospital App.
 
 
Question No. 4
The number of your patients who had a) GA, b) spinal anaesthesia, c) monitored procedural IV
sedation, d) local anaesthetic, e) no anaesthetic
 
Answer No. 4
a) b) & c) A GA, spinal anaesthetic, monitored procedurAL IV sedation are not administered in
the outpatient setting.

d) & e) This information is not available unless a case notes audit is undertaken and this
would take more than 18 hours.
 
 
Question No. 5
The % of your a) diagnostic hysteroscopies, b) operative hysteroscopies that were done in
outpatients. Did your Trust meet the Best Practice Target % Tariff for each of these years?
Y/N
 
Answer No. 5
a) & b) We cannot identify the number of operative hysteroscopies carried out in an outpatient
setting. The percentage of diagnostic hysteroscopies carried out in an outpatient setting was
51% in 2015-16 and 30% in 2016-17.

Best Practice Tariff - This information is not available.
 
 
Question No. 6
Is local anaesthetic available in all your outpatient hysteroscopy clinics? Y/N
 
Answer No. 6
Yes.
 
 
Question No. 7
Is Entonox available in all your outpatient hysteroscopy clinics? Y/N
 
Answer No. 7
No.
 
 
Question No. 8
Are all your hysteroscopy patients (including See & Treat/One Stop Shop/Late Cancellations)
offered i. local anaesthetic? Y/N ii. GA? Y/N iii. spinal anaesthesia? Y/N iv. safely
monitored IV sedation? Y/N
 
Answer No. 8
i) Local anaesthetic - yes.

ii) GA - yes, but a patient would need to be booked to attend the Day Surgery Unit for a GA on
another day.

iii) Spinal anaesthetic - this would depend on the patient's co morbidities and anaesthetic
review. If deemed appropriate - yes.

iv) Safely monitored IV sedation - no.
 
 
Question No. 9
Do you use electro-surgery in any of your outpatients clinics? Y/N If so, do you always use
the lowest power setting? Y/N
 
Answer No. 9
i) No.

ii) Not applicable.
 
 
Question No. 10
What type and diameter of scopes do you use in a) outpatients, b) for GA patients? Rigid,
semi-rigid, flexible?
 
Answer No. 10
a) outpatients - flexible hysterscope size 5

b) for GA patients - rigid scopes size 5
 
 
Question No. 11
What is the minimum training and accreditation (e.g. RCOG ATSM) that all your NEW
hysteroscopists must have?
 
Answer No. 11
ATSM in benign gynaecological surgery - Hysteroscopy or Benign abdominal surgery: open and
laparoscopic.
 
 
Question No. 12
What % diagnostic outpatient hysteroscopy/biopsy patients had an incomplete procedure which
was repeated with epidural, GA or sedation?
 
Answer No. 12
This information is not available.
 
 
Question No. 13
Does your Trust have a psychosexual counselling service for PTSD caused by severe procedural
pain?
 
Answer No. 13
No.
 
 
Yours sincerely

Information Governance Team
If you have any questions regarding this response, please contact us at
[3][Salisbury NHS Foundation Trust request email]
Visit the Freedom of Information website at
[4]http://www.ico.gov.uk/what_we_cover/free...

 

References

Visible links
1. http://www.salisbury.nhs.uk/
2. http://icid/clinicalmanagement/obstetric...
3. mailto:[Salisbury NHS Foundation Trust request email]
4. http://www.ico.gov.uk/what_we_cover/free...

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