Darlington Memorial Hospital
Switchboard Tel: 01325 38 0100
Foundation Trust Office: 01325 74 3625
Corporate Records Office: 01325 74 3700
Request for Information Reference: 02.19.33
Direct line: 01325 743700
Ms K Tylko-Hill
11 March 2019
Dear Ms Tylko-Hill Freedom of Information Act 2000 – Request for Information
Thank you for your request for information received on 18 February 2019
to the County Durham and Darlington NHS Foundation Trust (Trust). We are dealing
with your request under the provisions of the Freedom of Information Act 2000.
You requested information regarding the choice and pain-relief in hysteroscopy.
Specifically you requested information as follows: Under the Freedom of Information Act please may I have answers to the
following questions. This request is to audit implementation of the
RCOG/BSGE statement about choice and pain-relief in hysteroscopy.
a) Have your hysteroscopists read the following statement issued by the
RCOG in December 2018 – Y/N?
b) Have your hysteroscopy managers read the following statement – Y/N?
The British Society for Gynaecological Endoscopy published this statement in
"Diagnostic hysteroscopy is a commonly performed investigation; it is safe
and of short duration. Most women are able to have the procedure in an
outpatient setting, with or without local anaesthesia, and find it convenient and
acceptable. However, it is important that women are offered, from the outset,
the choice of having the procedure performed as a day case procedure under
general or regional anaesthetic. Some centres are also able to offer a
conscious sedation service in a safe and monitored environment. It is
important that the procedure is stopped if a woman finds the outpatient
experience too painful for it to be continued. This may be at the request of the
patient or nursing staff in attendance, or at the discretion of the clinician
performing the investigation."
2. Please are ALL your hysteroscopy patients from the outset routinely
offered the choice of having hysteroscopy as a day case procedure
a) under GA –
b) under regional anaesthetic –
No. c) with IV sedation? –
Please note: The Trust does not offer GA hysteroscopy at initial visit routinely.
GA would only be offered if they could not tolerate hysteroscopy under LA or
requested GA. 3. Do your hysteroscopy consent forms contain tick-boxes to enable a
patient to choose
a) GA –
No b) regional anaesthesia –
No c) IV sedation –
No - If GA - different consent form is used 4. Have all your outpatient hysteroscopy teams received written instruction
to monitor the patient throughout the procedure, to ask if she is experiencing
pain, and to stop if the patient asks or is showing signs of severe pain or
5. Do all your hysteroscopy clinics routinely record ALL patients’ VAS pain-
a) as hysteroscope passes through the cervix –
b) at biopsy –
6. Does your hysteroscopy department send all its patients the RCOG’s
Patient Information Leaflet, published on its website - Y/N?
7. Does your hysteroscopy department intend to start using the RCOG
leaflet – Y/N? If so, in which month/year?
Answer: Yes - April 2019 8. If your hysteroscopy department uses its own Patient Information Leaflet,
please may I have a link to it?
Answer: Please see attached - Menstrual disorder leaflet and Cancer 2ww leaflet 9. Does the leaflet include ALL the key points listed (below) by the RCOG –
• Outpatient hysteroscopy (OPH) is a procedure carried out in the
outpatient clinic that involves examination of the inside of your uterus (womb)
with a thin telescope.
• There are many reasons why you may be referred for OPH, such as to
investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan
or to remove a coil with missing threads.
• The actual procedure usually takes 10–15 minutes. It can take longer if
you are having any additional procedures.
• You may feel pain or discomfort during OPH. It is recommended that you
take pain relief 1–2 hours before the appointment.
• If it is too painful, it is important to let your healthcare professional know
as the procedure can be stopped at any time.
• You may choose to have the hysteroscopy under general anaesthetic.
This will be done in an operating theatre, usually as a daycase procedure.
**These are discussed with Patient at consultation.
• Possible risks with hysteroscopy include pain, feeling faint or sick,
bleeding, infection and rarely uterine perforation (damage to the wall of the
uterus). The risk of uterine perforation is lower during OPH than during
hysteroscopy under general anaesthesia. **Discussed with patient during
In line with the Information Commissioner’s directive on the disclosure of information
under the Freedom of Information Act 2000 your request will form part of our
disclosure log. Therefore, a version of our response which will protect your anonymity
will be posted on the County Durham and Darlington NHS Foundation Trust website.
If you have any queries or wish to discuss the information supplied, please do not
hesitate to contact me on the above telephone number or at the above address.
If you are unhappy with the way your request for information has been handled, you
can request a review by writing to:
The Chief Executive
County Durham & Darlington NHS Foundation Trust
Darlington Memorial Hospital
If, you remain dissatisfied with the handling of your request or complaint, you have a
right to appeal to the Information Commissioner at:
The Information Commissioner’s Office
Telephone: 0303 123 1113
There is no charge for making an appeal.
Freedom of Information Officer