Outpatient hysteroscopy/biopsy - Pain Control and Patient Choice

Katharine Tylko-Hill made this Freedom of Information request to East Lancashire Hospitals NHS Trust

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Katharine Tylko-Hill

Dear East Lancashire Hospitals NHS 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

Freedom of Information (ELHT) Mailbox, East Lancashire Hospitals NHS Trust

Dear Ms Tylko-Hill
Thank you for your FOI request detailed below. We confirm that a response will be sent to you within the regulatory timeframe of 20 working days – 23rd May 2017.

Regards
Freedom of Information Officer
East Lancashire Hospitals NHS Trust
Trust HQ
Royal Blackburn Hospital

The information contained in this email may be privileged. It is intended for the addressee only. If you are not the intended recipient, or the designated substitute, please notify the sender and delete this email immediately. The contents of this email must not be disclosed without the sender's consent. We cannot accept any responsibility for viruses, so please scan all attachments.

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Freedom of Information (ELHT) Mailbox, East Lancashire Hospitals NHS Trust

6 Attachments

Dear Ms Tylko-Hill,

 

Thank you for your request for information under the Freedom of
Information Act 2000.

 

Please find attached/below answers to your questions.  In relation to
question 9, our colleagues need further clarification on exactly what
details you require to enable them to answer.

 

 

  Query Response
1 The Patient information Updated April 2017
leaflet/s
Please see attached:

(i)          Information for Patients
attending for a Hysteroscopy Leaflet and

(ii)         (ii) Information for patients
attending Hysteroscopy Clinic for an
Endometrial Biopsy.
2 The Consent form/s Pre-printed consent for OP Hysteroscopy and
endometrial biopsy.

 

Please see attached Patients/Parental
agreement to investigation or treatment

Consent Form.

 

Clinician adds any further procedures at
time of consent if agreed following option
discussion

 
  For the last 3 financial  
years
3.1. All audits of OP No formal audits
Hysteroscopy adverse
events  

( including Infection,  
Perforation, pain equal
to or above 7/10 on VAS)
3.2 All surveys of patients 17949: Patient Satisfaction Survey –
outpatient hysteroscopy Outpatient Hysteroscopy Clinic (April 2014)
experiences. Are
patient’s allowed to Monthly Outpatient patient satisfaction
complete satisfaction survey.
surveys at home
Monthly Outpatient  Friends and family Test
feedback which has an option of reporting
from home
3.3 The number of patients Data not collected
having a) GA b) spinal
anaesthesia c)monitored
procedural sedation d)
local anaesthetic e) no
anaesthetic
Iv % of your a) diagnostics [1]cid:image001.png@01D2CA4F.976AC630 
b) operative
hysteroscopies that were  
done in the OPD.
Data not  available to  breakdown the
  diagnostic and Treatment % however the
table above indicates the % of all
  Hysteroscopy carried in ELHT  Outpatients

   

   

  No

 

 

 

 

 

 

 

 

Did your Trust meet Best
practice target % tariff
for each of these   for
each of the 3 years
4 .1 Is local anaesthetic in Yes
all your outpatient
clinics
4.2 Is local Entonox Yes
available  in all your
outpatient clinics
5.1 Are all you Hysteroscopy Yes
patient (including see &
treat/one stop/late
cancellations offered
local anaesthetic Y/N
5.2 Are all your Hysteroscopy See & Treat patients are offered option of
patient ( including see & GA. 
treat/one stop/late
cancellations offered GA  One Stop diagnostics – patients attend OPH
Y/N expecting procedure in clinic, so GA
offered only selectively to those who do
not wish to be examined or highly anxious 
5.3 Are all your Hysteroscopy As above – decision made at Anaesthetic
patient ( including see & assessment when listed as inpatient or day
treat/one stop/late case.
cancellations offered
Spinal anaesthetic Y/N
5.4 Are all you Hysteroscopy Only for in patients / Day case - decision
patient ( including see & made by anaesthetist
treat/one stop/late
cancellations offered IV
sedation  Y/N
6. Do you use electro – No
surgery in any of your
outpatient clinics? Y/N
7. What type and diameter of Outpatients
scopes do you use in a)
Outpatients  b) For GA Rigid Karl STORZ 
patients? Rigid, semi
rigid, Flexible? 2.9 Hysteroscope with a 4.1 diagnostic
sheath.

 

Theatres

Rigid Karl STORZ

 

2.8mm &  4.5 mm
8. What is the minimum Nurse: Post Graduate Certificate in
training and Diagnostic Hysteroscopy
accreditation ( e.g RCOG
ATSM) that all your NEW Doctors:
hysteroscopists must
have? -          For Diagnostic hysteroscopy -
doctors in training complete OSAT's to
assess their competence. The minimum
requirement is 3 competent ones before they
can do a procedure independently.

-          For Treatment procedures eg See
& Treat  - ideally RCOG ATSM,  but due to
simplicity of Truclear equipment, 4
competent OSATs

-          For Essure – RCOG ATSM + Theory
course + Preceptor based supervised
competency assessment/ certification 

 
9. What % diagnostic Our colleagues require further
outpatient clarification to enable them to answer this
hysteroscopy/biopsy question.
patients has an
incomplete procedure  
which was repeated with
epidural , GA, Sedation
10. Does you Trust have a No
psychosexual service for
PTSD caused by severe  
procedural pain?

 

 

If you are not satisfied with the response you have received in relation
to your request and wish to request a review or make a complaint, you
should write to the Associate Director of Corporate Governance at the
Trust Headquarters, Level 2, Royal Blackburn Hospital, Haslingden Road,
Blackburn, BB2 3HH.  Tel: 01254 735998. Email: [2][East Lancashire Hospitals NHS Trust request email]

 

If you are not content with the outcome of our review, you may apply to
the Information Commissioner for a decision.  The Information Commissioner
can be contacted at:-

 

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

 

Regards

 

Hansa Cannon

Corporate Governance Compliance Officer

Company Secretariat

 

East Lancashire Hospitals NHS Trust | Trust Headquarters | Level 2
 | Opposite Ward B2 and Ward B4 | Royal Blackburn Teaching Hospital
| Haslingden Road | Blackburn | Lancashire | BB2 3HH

 

Tel (DDI):  01254 732110

Int Ext:      82110

Email:       [3][East Lancashire Hospitals NHS Trust request email]

 

Website: [4]www.elht.nhs.uk

Twitter: [5]www.twitter.com/EastLancsHosp

Facebook: [6]www.facebook.com/EastLancashireHospitals

    

                          

[7]cid:image001.png@01D18388.95C60AB0

The information contained in this email may be privileged.  It is intended
for the addressee only.  If you are not the intended recipient, or the
designated substitute, please notify the sender and delete this email
immediately.  The contents of this email must not be disclosed without the
sender's consent.  We cannot accept any responsibility for viruses, so
please scan all attachments.

 

 

 

show quoted sections

Katharine Tylko-Hill

Dear Freedom of Information (ELHT) Mailbox,

Thank you very much for your reply re OUTPATIENT HYSTEROSCOPY. Please would you send me a copy of the Outpatient Hysteroscopy Audit which you mentioned in your reply to Question 3.

My enquiry is part of a nationwide survey to identify best practice in the pain-control of outpatient hysteroscopy.

Yours sincerely,

Katharine Tylko-Hill

Freedom of Information (ELHT) Mailbox, East Lancashire Hospitals NHS Trust

1 Attachment

Dear Ms Tylko-Hill,

 

Thank you for your request for information under the Freedom of
Information Act 2000.

 

We are unable to send you a copy of the Outpatient Hysteroscopy Audit as
stated in our response sent to you on 11 May 2017 informing you that there
were no formal audits.

 

If you are not satisfied with the response you have received in relation
to your request and wish to request a review or make a complaint, you
should write to the Associate Director of Corporate Governance at the
Trust Headquarters, Level 2, Royal Blackburn Hospital, Haslingden Road,
Blackburn, BB2 3HH.  Tel: 01254 735998. Email: [1][East Lancashire Hospitals NHS Trust request email]

 

If you are not content with the outcome of our review, you may apply to
the Information Commissioner for a decision.  The Information Commissioner
can be contacted at:-

 

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

 

Regards

 

Hansa Cannon

Corporate Governance Compliance Officer

Company Secretariat

 

East Lancashire Hospitals NHS Trust | Trust Headquarters | Level 2
 | Opposite Ward B2 and Ward B4 | Royal Blackburn Teaching Hospital
| Haslingden Road | Blackburn | Lancashire | BB2 3HH

 

Tel (DDI):  01254 732110

Int Ext:      82110

Email:       [2][East Lancashire Hospitals NHS Trust request email]

 

Website: [3]www.elht.nhs.uk

Twitter: [4]www.twitter.com/EastLancsHosp

Facebook: [5]www.facebook.com/EastLancashireHospitals

    

                          

[6]cid:image001.png@01D18388.95C60AB0

The information contained in this email may be privileged.  It is intended
for the addressee only.  If you are not the intended recipient, or the
designated substitute, please notify the sender and delete this email
immediately.  The contents of this email must not be disclosed without the
sender's consent.  We cannot accept any responsibility for viruses, so
please scan all attachments.

 

Katharine Tylko-Hill

Dear Freedom of Information (ELHT) Mailbox,

Thanks very much for your reply re OUTPATIENT HYSTEROSCOPY. I do apologise for the confusion. Please may I have a copy of the Patient Satisfaction Survey (April 2014) which you mention in 3.2.
Many thanks.
Yours sincerely,

Katharine Tylko-Hill

Freedom of Information (ELHT) Mailbox, East Lancashire Hospitals NHS Trust

1 Attachment

  • Attachment

    FOI Request Tylco Hill K Answer to Q3 Patient Satisfaction Survey Outpatient Hysteroscopy 3.ppt

    211K Download View as HTML

Dear Ms Tylko-Hill,

Thank you for your request for information under the Freedom of Information Act 2000.

As requested, please find attached a copy of the Patient Satisfaction Survey (April 2014) mentioned in our answer in relation to Question 3.2.

If you are not satisfied with the response you have received in relation to your request and wish to request a review or make a complaint, you should write to the Associate Director of Corporate Governance at the Trust Headquarters, Level 2, Royal Blackburn Hospital, Haslingden Road, Blackburn, BB2 3HH. Tel: 01254 735998. Email: [East Lancashire Hospitals NHS Trust request email]

If you are not content with the outcome of our review, you may apply to the Information Commissioner for a decision. The Information Commissioner can be contacted at:-

Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Regards