Outpatient Hysteroscopy/Biopsy - Pain control and Patient Choice

The request was partially successful.

Katharine Tylko-Hill

Dear Colchester Hospital University NHS Foundation Trust,

Under the Freedom of Information Act (2000) please would you supply
the following information relating to your Trust’s practice of

OUTPATIENT HYSTEROSCOPY/BIOPSY – PAIN CONTROL AND PATIENT CHOICE

1. The current patient information leaflet

2. The current consent form

3. The current surgical protocol

4. Does the leaflet advise the patient to ask her GP to prescribe
gynae-specific painkillers to be taken BEFORE the procedure - Y/N?

5. What type and dose of painkillers does your Trust advise
patients to take before the procedure?

6. Are ALL your hysteroscopy/biopsy patients given the following
choices BEFORE the procedure is attempted:
a) General Anaesthesia – Y/N?
b) spinal anaesthesia – Y/N?
c) conscious sedation – Y/N?

7. For each of the last 3 financial years, how many of your
hysteroscopy/biopsy patients had
a) GA with overnight stay?
b) GA day-case ?
c) spinal anaesthesia?
d) conscious sedation?
e) local anaesthetic?
f) no anaesthetic?

8. What width hysteroscopes do you use? Rigid or flexible?

9. For each of the last 3 financial years what % patients DNA
outpatient hysteroscopy/biopsy?

10. For each of the last 3 financial years what % OP
hysteroscopy/biopsy patients had a failed procedure that had to be
repeated with epidural, GA or conscious sedation?

11. All audits of adverse events, e.g. infection, perforation
during the last 3 financial years

12. All surveys of patients’ experiences during the last 3
financial years

Yours faithfully,

Katharine Tylko-Hill
Macmillan CancerVOICE

FOI REQUESTS (RDE) Colchester Hospital University NHS Foundation Tr,

Dear Ms Tylko-Hill,

Thank you for your request, which is being handled under the Freedom of Information (FOI) Act. Your enquiry has been logged and will be forwarded to the appropriate department for action. Please note that the Act allows the Trust 20 working days to provide a response, although we will endeavour to do so before then.

Kind Regards,

The FOI Team at Colchester Hospital University NHS Foundation Trust

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FOI REQUESTS (RDE) Colchester Hospital University NHS Foundation Tr,

1 Attachment

 

Dear Ms Tylko-Hill,

 

Thank you for your request under the Freedom of Information Act (FOI).

You requested:

 

Under the Freedom of Information Act (2000) please would you supply the
following information relating to your Trust’s practice of

 

OUTPATIENT HYSTEROSCOPY/BIOPSY – PAIN CONTROL AND PATIENT CHOICE

 

1. The current patient information leaflet - ATTACHED

 

2. The current consent form - ATTACHED

 

3. The current surgical protocol – NO WRITTEN TRUST PROTOCOL, RCOG AND TOG
GUIDELINES ARE FOLLOWED

 

4. Does the leaflet advise the patient to ask her GP to prescribe
gynae-specific painkillers to be taken BEFORE the procedure - Y/N? - NO

 

5. What type and dose of painkillers does your Trust advise patients to
take before the procedure? – PARACETAMOL OR IBUPROFEN – NO DOSE WRITTEN IN
LEAFLET

 

6. Are ALL your hysteroscopy/biopsy patients given the following choices
BEFORE the procedure is attempted:

a) General Anaesthesia – Y/N? – OPTIONS ARE DISCUSSED AND PATIENT
AGREEMENT IS OBTAINED

b) spinal anaesthesia – Y/N? – OPTIONS ARE DISCUSSED AND PATIENT AGREEMENT
IS OBTAINED

c) conscious sedation – Y/N? – NOT APPROPRIATE

 

7. For each of the last 3 financial years, how many of your
hysteroscopy/biopsy patients had – SEE BELOW

a) GA with overnight stay?

b) GA day-case ?

c) spinal anaesthesia?

d) conscious sedation?

e) local anaesthetic?

f) no anaesthetic?

 

 

  2010/11 2011/12 2012/13
GA with overnight stay 72 72 61
GA day-case/0 day LOS 460 414 368
spinal anaesthesia/epidural 9 6 7
conscious sedation 1 0 1
local anaesthetic 2 1 1
no anaesthetic 0 0 0
Not Specified 3 1 0

 

·         Financial Year Based on Discharge Date

·         Patients has one of the following OPCS codes recorded against
the spell:

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
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

 

 

8. What width hysteroscopes do you use? Rigid or flexible? – RIGID 1.9mm &
3mm

 

9. For each of the last 3 financial years what % patients DNA outpatient
hysteroscopy/biopsy? – SEE BELOW

 

 

DNA Rate for Hysteroscopy Clinics (Clinic Codes: ALYHY, KHLHY, KADHY, and
KADH2)
Count of Patient ID Financial Year    
Attended 2010/11 2011/12 2012/13
Attendance 197 261 314
DNA 11 8 10
Grand Total 208 269 324
  2010/11 2011/12 2012/13
% DNA 5.29% 2.97% 3.09%

 

 

 

10. For each of the last 3 financial years what % OP hysteroscopy/biopsy
patients had a failed procedure that had to be repeated with epidural, GA
or conscious sedation? – SEE BELOW

 

Added to Waiting List following OP Attendance at Hysteroscopy Clinic
(Clinic Codes: ALYHY, KHLHY, KADHY, and HADH2)
Count of Patient ID Financial Year    
Outcome Text 2010/11 2011/12 2012/13
Add to day case waiting
list 33 50 58
Add to inpatient waiting
list 8 16 23
Grand Total 41 66 81
% Failed OP Procedure 19.71% 24.54% 25.00%

Failed procedures have been identified by an outcome of Add to Waiting
List following the Hysteroscopy clinic OP attendance.

 

11. All audits of adverse events, e.g. infection, perforation during the
last 3 financial years –

 

I am sorry to inform you that the Trust is applying a refusal notice under
Section 12 to this request as it has been estimated that the cost of
complying with the request exceeds the ‘appropriate limit’ as this
information is not held centrally and would require us to go through
individual patient records.

The appropriate limit

Section 12 of the FOIA provides an exemption from a public authority’s
obligation to comply with a request for information where the cost of
compliance is estimated to exceed the appropriate limit. The appropriate
limit is the key concept concerning fees.

The Fees Regulations state that this cost limit is £600 for central
government, legislative bodies and the armed forces (ie Part 1 of Schedule
1 of the FOIA) and £450 for all other public authorities.

 

 

12. All surveys of patients’ experiences during the last 3 financial years
–  

 

I am sorry to inform you that the Trust is applying a refusal notice under
Section 12 to this request as it has been estimated that the cost of
complying with the request exceeds the ‘appropriate limit’ as this
information is not held centrally and would require us to go through
individual patient records.

The appropriate limit

Section 12 of the FOIA provides an exemption from a public authority’s
obligation to comply with a request for information where the cost of
compliance is estimated to exceed the appropriate limit. The appropriate
limit is the key concept concerning fees.

The Fees Regulations state that this cost limit is £600 for central
government, legislative bodies and the armed forces (ie Part 1 of Schedule
1 of the FOIA) and £450 for all other public authorities.

 

 

Hopefully this answers your request.

If you are dissatisfied with the way Colchester Hospital University NHS
Foundation Trust has handled your request for information, you can request
a review by writing to :

The Senior Information Risk Owner
Colchester Hospital University NHS Foundation Trust
Trust Headquarters
Colchester General Hospital
Turner Road
Colchester, Essex, CO4 5JL

If you remain dissatisfied with the handling of your request or complaint,
you have a right of 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.gov.uk

There is no charge for making an appeal.

This information is protected by Intellectual Property Rights and
Colchester Hospital University NHS Foundation Trust does not give you
permission to make any commercial use of any part of this message. Any
copies you make must be attributed to us and you must seek permission from
the Trust if you wish to reproduce or publish this information in any
format.

If you have any ideas on how to improve our FOI service or changes that
you'd like to see, then please submit a Feedback Form at
[2]www.colchesterhospital.nhs.uk/foi_feedback.shtml. These can be
completely anonymous and will help us to provide a better service in the
future.

Kind Regards

The FOI Team at Colchester Hospital University NHS Foundation Trust

 

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