Outpatient hysteroscopy/biopsy informed consent and RCOG patient leaflet

Katharine Tylko-Hill

Dear Northern Health and Social Care Trust (Northern Ireland),

Outpatient Hysteroscopy/Biopsy – RCOG Patient Information Leaflet
1. Please has your Lead hysteroscopist read the Montgomery v. NHS Lanarkshire ruling on informed consent? [Y/N]
https://www.supremecourt.uk/cases/docs/u...
“The doctor is under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in proposed treatment, and of reasonable alternatives. A risk is “material” if a reasonable person in the patient’s position would be likely to attach significance to it, or if the doctor is or should reasonably be aware that their patient would be likely to attach significance to it.”

2. Please has your lead Hysteroscopy read the RCOG guidance on consent https://www.rcog.org.uk/globalassets/doc...
“Women should not be given important information or asked to make decisions at the same time as undergoing gynaecological examinations.7
In the modern NHS, efficiencies such as placing patients directly onto waiting lists and admitting patients to hospital on the day of operation require careful attention to the organisation of consent. These initiatives have the potential to shorten or even eliminate the ‘cooling-off’ period during which a woman is able to reflect on her condition and the proposed treatment options. If written consent in the presence of the operating practitioner is to be obtained immediately before the operation, it is vital to ensure that she has been offered the opportunity to further discuss any intervention in a clinic visit or a visit to a preoperative assessment unit. If not, and women are being presented with information anew for the first time or are doubtful, deferral must be retained as an option in the best interests of patient care even if it means that their procedure is postponed. Such women should also be sent detailed information packs with a copy of the appropriate consent form.” [Y/N]

3. Please has your Lead Hysteroscopist read the RCOG Outpatient Hysteroscopy patient information leaflet https://www.rcog.org.uk/en/patients/pati... which warns of the material risk of severe pain; identifies cohorts of patients at high risk of severe pain; and advises women that they may choose to have a general anaesthetic? [Y/N]
“Are there alternatives to having outpatient hysteroscopy? There may be other things to consider when deciding whether OPH is the right choice for you, such as:• if you faint during your periods because of pain• if you have experienced severe pain during a previous vaginal examination• if you have experienced difficult or painful cervical smears• if you have had any previous traumatic experience that might make the procedure difficult for you• if you do not wish to have this examination when awake. You may choose to have your hysteroscopy with either a general or spinal anaesthetic. This will be done in an operating theatre, usually as a daycase procedure. You can discuss this option with your healthcare professional. The risks and complications are lower when hysteroscopy is done as an outpatient procedure rather than under anaesthesia.”

4. Does your Trust intend to start using the RCOG Outpatient Hysteroscopy patient information leaflet, and if so, when? [Y/N]

5. If the answer to 3. is NO, please why is this? Is it because
a) This is a See & Treat clinic and the patient may not need a hysteroscopy [Y/N]
b) You don’t want to mention severe pain and make patients anxious? [Y/N]
c) You don’t want patients to choose GA because it will affect your hysteroscopy Best Practice Tariff? [Y/N]
d) You don’t want to put patients through the higher risk of perforation under GA due to use of wider hysteroscopes? [Y/N]
e) You don’t want to give patients the choice of GA because there is a long waiting-list which will delay cancer diagnosis [Y/N]
f) You don’t have the budget to print out a new, longer leaflet? [Y/N]
Any other reasons ... please specify.

Thank you for your help in improving the early diagnosis of womb cancer.

Yours faithfully,

Katharine Tylko

Governance, Info, Northern Health and Social Care Trust (Northern Ireland)

Health & Social Care has experienced unprecedented pressures due to COVID-19. The Trust understands the significance of your request and we will endeavour to meet the legislative deadlines in all situations; however, delays may occur. We therefore would appreciate your forbearance during these exceptional circumstances. Should you wish to speak to a member of staff, please contact 028 2766 1293.

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Jardine, Irene, Northern Health and Social Care Trust (Northern Ireland)

Dear Katharine, I acknowledge receipt of your request below.

 

Your request is being processed under the Freedom of Information Act 2000;
however, as you will appreciate, Health & Social Care are experiencing
pressures due to COVID 19 and you may experience a delay.

 

Your patience and understanding during this period is very much
appreciated. 

 

Kind regards.

 

Irene Jardine

INFORMATION GOVERNANCE OFFICER

(T)028276 61415/X363415

 

 

 

 

 

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Jardine, Irene, Northern Health and Social Care Trust (Northern Ireland)

3 Attachments

Dear Katharine, please find attached.

 

Kind regards.

 

Irene Jardine

INFORMATION GOVERNANCE OFFICER

Tel:  276 61415 x 363415

[1]cid:image002.png@01D685FD.0EAA9A10

 

 

 

From: Jardine, Irene
Sent: 26 February 2021 08:42
To: '[FOI #731284 email]'
Subject: FW: Freedom of Information request - Outpatient
hysteroscopy/biopsy informed consent and RCOG patient leaflet - Our
Reference KT250221

 

Dear Katharine, I acknowledge receipt of your request below.

 

Your request is being processed under the Freedom of Information Act 2000;
however, as you will appreciate, Health & Social Care are experiencing
pressures due to COVID 19 and you may experience a delay.

 

Your patience and understanding during this period is very much
appreciated.

 

Kind regards.

 

Irene Jardine

INFORMATION GOVERNANCE OFFICER

(T)028276 61415/X363415

 

 

 

 

 

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