Outpatient hysteroscopy/biopsy - Pain Control and Patient Choice

Response to this request is long overdue. By law, under all circumstances, Ipswich Hospital NHS Trust should have responded by now (details). You can complain by requesting an internal review.

Katharine Tylko-Hill

Dear Ipswich Hospital 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

Information.Access, Ipswich Hospital NHS Trust

Please be advised that we have received your request for information.

 

Your reference number is [4215] 

 

We shall deal with your request in accordance with the Trust's Freedom of
Information Act 2000 procedures.

 

In the meantime, if you have any queries, please do not hesitate to
contact us. Please direct any responses to the address supplied or email
[1][email address]

 

Kind Regards

 

Jane Mathias

FOI Team

Email: [2][email address]

Ipswich Hospital NHS Trust

 

show quoted sections

References

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

Information.Access, Ipswich Hospital NHS Trust

Thank you for your recent enquiry regarding information held by The
Ipswich Hospital 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. 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

5. 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?

 

Your enquiry has been dealt with in accordance with the Trust’s Freedom of
Information Act 2000 Policy and Procedures. We are pleased to enclose the
information you requested:

 

1.       The patient information leaflet/s – YES

2.       The consent form/s – VERBAL CONSENT ONLY

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) We record if the
procedure was tolerated and then a pain score but this is for Myosure
treatments only. If a perforation occurs a patient would be sent to the
ward and a datix would be submitted. If a patient was admitted with an
infection post outpatient Hysteroscopy, a datix would be submitted. An
audit of OP hysteroscopy is planned in the next financial year.

ii. all surveys of patients’ outpatient hysteroscopy experiences. Are all
your patients allowed to complete the satisfaction survey at home? YES

iii. the number of your outpatients who had a) GA -0, b) spinal
anaesthesia-0, c) monitored procedural IV sedation-0, d) local anaesthetic
80%, e) no anaesthetic 20%

iv. the % of your a) diagnostic hysteroscopies – 80%, b) operative
hysteroscopies 10%[myosures] that were done in outpatients. Did your
Trust meet the Best Practice Target % Tariff for each of these years? Y/N
– No

4. Is local anaesthetic available in all your outpatient hysteroscopy
clinics? YES

ii. Is Entonox available in all your outpatient hysteroscopy clinics? yes
it is if needed can be accessed from the ward

5. Are all your hysteroscopy patients (including See & Treat/One Stop
Shop/Late Cancellations) offered

i. local anaesthetic? Yes as an outpatient

ii. GA? if patient do not wish to have a OPD Hysteroscopy we would offer
inpatient GA

iii. spinal anaesthesia? NO –  but available as an inpatient

5. safely monitored IV sedation? N/A

6. Do you use electro-surgery in any of your outpatients clinics? NO

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 – 2 MM,
2.4 MM

b) for GA patients – 3.5-4MM Rigid

8. What is the minimum training and accreditation (e.g. RCOG ATSM) that
all your NEW hysteroscopists must have? RCOG ATSM

9. What % diagnostic outpatient hysteroscopy/biopsy patients had an
incomplete procedure which was repeated with epidural, GA or sedation? –
5-10%. More in the PMB clinic due to cervical stenosis. Additional 10% are
converted for treatment

10. Does your Trust have a psychosexual counselling service for PTSD
caused by severe procedural pain? yes CNS offers this

 

If you have any queries about the enclosed information please contact us.

The Public Sector Information Regulations provide a framework for public
sector organisations to licence the re-use of their information.  Please
request a re-use licence in order to re-use the information. Without the
necessary permission, you can breach our copyright.

Brief extracts of any material may be reproduced without our permission,
under the “fair dealing” provisions of the Copyright, Designs and Patents
Act 1988 for the purposes of research for non-commercial purposes; private
study; criticism; review and news reporting. All are subject to an
acknowledgement of ourselves as the copyright owner.  For guidance notes
on a range of copyright issues, see the Office of Public Sector
Information web site.

 

If you are unhappy with the service you have received in relation to your
request you should write to us. Please also contact us if you require a
copy of our Freedom of Information Act 2000 Complaints Procedure.  Any
complaints you wish to make in relation to Environmental Information
Regulations (EIR) requests, must be sent to us within 40 working days of
receipt of this letter.

 

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

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Telephone: 08456 30 60 60 or 01625 54 57 45

Website: [1]www.ico.org.uk

 

There is no charge for making an appeal.

 

We hope that we have been able to answer your query to your satisfaction
and that you find the information provided useful. 

 

Kind Regards

 

Jane Mathias

FOI Team

Email: [2][email address]

Ipswich Hospital NHS Trust

 

show quoted sections

References

Visible links
1. http://www.ico.org.uk/
2. mailto:[email address]

Katharine Tylko-Hill

Dear Information.Access,
Please would you send me a link to your OUTPATIENT HYSTEROSCOPY leaflet missing from your recent FOIA response.

Many thanks,

Yours sincerely,

Katharine Tylko-Hill

Information.Access, Ipswich Hospital NHS Trust

1 Attachment

Dear Katharine - apologies for not sending this initially.

Many thanks,

Sarah Preston
FOI Team
Email: [email address]
Ipswich Hospital NHS Trust