Outpatient hysteroscopy/biopsy - Pain Control and Patient Choice

The request was partially successful.

Katharine Tylko-Hill

Dear Barnsley Hospital 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?

Yours faithfully,

Katharine Tylko-Hill

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

Thank you for your information request. This is an automated response and
acknowledgement. If you have submitted a request under the Freedom of
Information Act (FOIA) or the Environmental Information Regulations (EIR),
your request will be considered and you will receive our response within
the statutory timescale of 20 working days.

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

Dear Katharine,

The Trust is aware of the deadline to respond to your Freedom of
Information request and will endeavour to get this information to you as
soon as possible.

Please accept our apologies for any inconvenience that this may cause.

Kind regards,

Information Governance Department

Ext: 2017  Direct Line: 01226 432017
Email: [1][email address]

 

Kind regards,

 

Information Governance Team

Information Governance Department

Email: [email address]

Ext: 2017  Direct Line: 01226 432017
Email: [2][email address]

References

Visible links
1. mailto:[email address]
2. mailto:[email address]

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

2 Attachments

Dear Customer,

 

I can confirm that the Trust does hold the information you have requested.

Thank you for your request for information, details of which are below:

Freedom of Information Request

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. Yes. Please find attached.

2. The consent form/s. Yes. Please find attached.

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) Not done / none planned
ii. all surveys of patients’ outpatient hysteroscopy experiences. Patient
satisfaction survey currently ongoing.

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
Not recorded in Outpatients

iv. the % of your a) diagnostic hysteroscopies, b) operative
hysteroscopies that were done in outpatients.

Diagnostic hysteroscopies can be performed in either Outpatient or
inpatient setting.
             
Diagnostic Hysteroscopy          
OPCS 46 Codes used:-          
Q181 Diagnostic endoscopic examination of uterus and biopsy of
lesion of uterus
Q188 Other specified diagnostic endoscopic examination of  
uterus
Q189 Unspecified diagnostic endoscopic examination of uterus  
             
Data extracted using the above codes used in the primary procedure code
only
    2014_15 2015_16 2016_17    
Inpatients / daycases 202 170 207    
Outpatients 446 419 411    
Percentage done in outpatients 68.83% 71.14% 66.50%    
             
Opertive Hysteroscopies - I assuming this means therapeutic hysteroscopies
OPCS 46 Codes used:-          
Q171 Endoscopic resection of lesion of uterus      
Q172 Endoscopic cauterisation of lesion of uterus      
Q173 Endoscopic cryotherapy to lesion of uterus      
Q174 Endoscopic destruction of lesion of uterus NEC    
Q175 Endoscopic metroplasty        
Q176 Endoscopic microwave ablation of endometrium    
Q177 Endoscopic balloon ablation of endometrium    
Q178 Other specified therapeutic endoscopic operations on  
uterus
Q179 Unspecified therapeutic endoscopic operations on uterus  
             
Data extracted using the above codes used in the primary procedure code
only
    2014_15 2015_16 2016_17    
Inpatients / daycases 230 170 188    

Outpatients 13 17 6

Did your Trust meet the Best Practice Target % Tariff for each of these
years? Y/N  Monitor National payment tariff system 2016_17 -Technical
guidance says 70% of diagnostic hysteroscopies is expected to be done in
outpatients.  Although this isn't a target, the British Association of Day
Surgeries (BADS) rulings included other procedures. 

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  N/A
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,Rigid,
2.9mm b) for GA patients? N/A Rigid, semi-rigid, flexible?

8. What is the minimum training and accreditation (e.g. RCOG ATSM) that
all your NEW hysteroscopists must have? Yes all accredited – ATSM /
Refresher or BSGE course

9. What % diagnostic outpatient hysteroscopy/biopsy patients had an
incomplete procedure which was repeated with epidural, GA or sedation? Not
recorded

10. Does your Trust have a psychosexual counselling service for PTSD
caused by severe procedural pain? No

This completes the Trust’s response to your request.

As part of our on-going evaluation, we ask that you complete a
satisfaction survey found at the link below. This helps us to identify
areas of improvement and to highlight good practice to share with other
teams. [1]https://www.surveymonkey.co.uk/r/L3HLQV3

Re-use of Public Sector Information

© Barnsley Hospital NHS Foundation Trust

You may re-use this information (not including logos) free of charge in
any format or medium, under the terms of the Open Government Licence.

 

To view this licence, visit:
[2]http://www.nationalarchives.gov.uk/doc/o...

Alternatively, you can consult the Guidance for Information Providers
section on The National Archives
website:[3]http://www.nationalarchives.gov.uk/infor...

Your rights

If you are unhappy with the way we have handled your request, you may ask
for an internal review in accordance with Section VI Complaints Procedures
of the Section 45 Code of Practice of the Freedom of Information Act 2000:
and in accordance with the Trust’s Code of Practice for Responding to
Requests for Information.

If you wish to complain you should contact:

Katie Hunter

Information Governance Manager

Tel: 01226 432017

Information Governance Department

Admin Block

Barnsley Hospital NHS Foundation Trust

Gawber Road

Barnsley

S75 2EP

[email address]

If you are not content with the outcome of the internal review, you have
the right to apply directly to the Information Commissioner for a
decision.

The Information Commissioner can be contacted at:

Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

If you have any queries about this letter, please contact me. Please
remember to quote the reference number above in any future communications.

 

Yours sincerely,

Information Governance Team

Information Governance Department

Ext: 2017 Direct Line: 01226 432017
Email: [4][Barnsley Hospital NHS Foundation Trust request email]

Kind regards,

 

Information Governance Team

Information Governance Department

Email: [email address]

Ext: 2017  Direct Line: 01226 432017
Email: [5][email address]

References

Visible links
1. https://www.surveymonkey.co.uk/r/L3HLQV3
2. http://www.nationalarchives.gov.uk/doc/o...
3. http://www.nationalarchives.gov.uk/infor...
4. mailto:[email address]
5. mailto:[email address]

Katharine Tylko-Hill

Dear [email address],

Thank you for the reply re OUTPATIENT HYSTEROSCOPY. There doesn't appear to be an answer to the question about whether electro-surgery is used in any of your outpatient hysteroscopy clinics. Please could you possibly answer this question which is part of a nationwide survey.

Yours sincerely,

Katharine Tylko-Hill

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

Thank you for your information request. This is an automated response and
acknowledgement. If you have submitted a request under the Freedom of
Information Act (FOIA) or the Environmental Information Regulations (EIR),
your request will be considered and you will receive our response within
the statutory timescale of 20 working days.

barnsley@infreemation.co.uk, Barnsley Hospital NHS Foundation Trust

2 Attachments

Dear Requester,

 

I can confirm that the Trust does hold the information you have requested.

Thank you for your request for information, details of which are below:

Freedom of Information Request

1. The patient information leaflet/s. Yes. Please find attached.

2. The consent form/s. Yes. Please find attached.

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) Not done / none planned
ii. all surveys of patients’ outpatient hysteroscopy experiences. Patient
satisfaction survey currently ongoing.

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
Not recorded in Outpatients

iv. the % of your a) diagnostic hysteroscopies, b) operative
hysteroscopies that were done in outpatients.

Diagnostic hysteroscopies can be performed in either Outpatient or
inpatient setting.
             
Diagnostic Hysteroscopy          
OPCS 46 Codes used:-          
Q181 Diagnostic endoscopic examination of uterus and biopsy of
lesion of uterus
Q188 Other specified diagnostic endoscopic examination of  
uterus
Q189 Unspecified diagnostic endoscopic examination of uterus  
             
Data extracted using the above codes used in the primary procedure code
only
    2014_15 2015_16 2016_17    
Inpatients / daycases 202 170 207    
Outpatients 446 419 411    
Percentage done in outpatients 68.83% 71.14% 66.50%    
             
Opertive Hysteroscopies - I assuming this means therapeutic hysteroscopies
OPCS 46 Codes used:-          
Q171 Endoscopic resection of lesion of uterus      
Q172 Endoscopic cauterisation of lesion of uterus      
Q173 Endoscopic cryotherapy to lesion of uterus      
Q174 Endoscopic destruction of lesion of uterus NEC    
Q175 Endoscopic metroplasty        
Q176 Endoscopic microwave ablation of endometrium    
Q177 Endoscopic balloon ablation of endometrium    
Q178 Other specified therapeutic endoscopic operations on  
uterus
Q179 Unspecified therapeutic endoscopic operations on uterus  
             
Data extracted using the above codes used in the primary procedure code
only
    2014_15 2015_16 2016_17    
Inpatients / daycases 230 170 188    

Outpatients 13 17 6

Did your Trust meet the Best Practice Target % Tariff for each of these
years? Y/N  Monitor National payment tariff system 2016_17 -Technical
guidance says 70% of diagnostic hysteroscopies is expected to be done in
outpatients.  Although this isn't a target, the British Association of Day
Surgeries (BADS) rulings included other procedures. 

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  N/A
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? N/A

7. What type and diameter of scopes do you use in a) outpatients,Rigid,
2.9mm b) for GA patients? N/A Rigid, semi-rigid, flexible?

8. What is the minimum training and accreditation (e.g. RCOG ATSM) that
all your NEW hysteroscopists must have? Yes all accredited – ATSM /
Refresher or BSGE course

9. What % diagnostic outpatient hysteroscopy/biopsy patients had an
incomplete procedure which was repeated with epidural, GA or sedation? Not
recorded

10. Does your Trust have a psychosexual counselling service for PTSD
caused by severe procedural pain? No
 

This completes the Trust’s response to your request.

As part of our on-going evaluation, we ask that you complete a
satisfaction survey found at the link below. This helps us to identify
areas of improvement and to highlight good practice to share with other
teams. [1]https://www.surveymonkey.co.uk/r/L3HLQV3

Re-use of Public Sector Information

© Barnsley Hospital NHS Foundation Trust

You may re-use this information (not including logos) free of charge in
any format or medium, under the terms of the Open Government Licence.

 

To view this licence, visit:
[2]http://www.nationalarchives.gov.uk/doc/o...

Alternatively, you can consult the Guidance for Information Providers
section on The National Archives
website:[3]http://www.nationalarchives.gov.uk/infor...

Your rights

If you are unhappy with the way we have handled your request, you may ask
for an internal review in accordance with Section VI Complaints Procedures
of the Section 45 Code of Practice of the Freedom of Information Act 2000:
and in accordance with the Trust’s Code of Practice for Responding to
Requests for Information.

If you wish to complain you should contact:

Katie Hunter

Information Governance Manager

Tel: 01226 432017

Information Governance Department

Admin Block

Barnsley Hospital NHS Foundation Trust

Gawber Road

Barnsley

S75 2EP

[email address]

If you are not content with the outcome of the internal review, you have
the right to apply directly to the Information Commissioner for a
decision.

The Information Commissioner can be contacted at:

Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

If you have any queries about this letter, please contact me. Please
remember to quote the reference number above in any future communications.

 

Yours sincerely,

Information Governance Team

Information Governance Department

Ext: 2017 Direct Line: 01226 432017
Email: [4][Barnsley Hospital NHS Foundation Trust request email]

Kind regards,

 

Information Governance Team

Information Governance Department

Email: [email address]

Ext: 2017  Direct Line: 01226 432017
Email: [5][email address]

References

Visible links
1. https://www.surveymonkey.co.uk/r/L3HLQV3
2. http://www.nationalarchives.gov.uk/doc/o...
3. http://www.nationalarchives.gov.uk/infor...
4. mailto:[email address]
5. mailto:[email address]

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