Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice

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Katharine Tylko-Hill

Dear United Lincolnshire Hospitals NHS Trust,

Under the Freedom of Information Act please may I have answers to the following questions. This request is to audit implementation of the RCOG/BSGE statement about choice and pain-relief in hysteroscopy.

1. a) Have your hysteroscopists read the following statement issued by the RCOG in December 2018 - Y/N?
b) Have your hysteroscopy managers read the following statement – Y/N?
https://www.rcog.org.uk/en/guidelines-re...
The British Society for Gynaecological Endoscopy published this statement in December 2018:
"Diagnostic hysteroscopy is a commonly performed investigation; it is safe and of short duration. Most women are able to have the procedure in an outpatient setting, with or without local anaesthesia, and find it convenient and acceptable. However, it is important that women are offered, from the outset, the choice of having the procedure performed as a day case procedure under general or regional anaesthetic. Some centres are also able to offer a conscious sedation service in a safe and monitored environment. It is important that the procedure is stopped if a woman finds the outpatient experience too painful for it to be continued. This may be at the request of the patient or nursing staff in attendance, or at the discretion of the clinician performing the investigation."
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2. Please are ALL your hysteroscopy patients from the outset routinely offered the choice of having hysteroscopy as a day case procedure a) under GA – Y/N? b) under regional anaesthetic – Y/N? c) with IV sedation?

3. Do your hysteroscopy consent forms contain tick-boxes to enable a patient to choose a) GA – Y/N? b) regional anaesthesia – Y/N? c) IV sedation – Y/N?

4. Have all your outpatient hysteroscopy teams received written instruction to monitor the patient throughout the procedure, to ask if she is experiencing pain, and to stop if the patient asks or is showing signs of severe pain or distress – Y/N?

5. Do all your hysteroscopy clinics routinely record ALL patients’ VAS pain-scores a) as hysteroscope passes through the cervix – Y/N, b) at biopsy – Y/N?

6. Does your hysteroscopy department send all its patients the RCOG’s Patient Information Leaflet, published on its website - Y/N? https://www.rcog.org.uk/en/patients/pati...

7. Does your hysteroscopy department intend to start using the RCOG leaflet – Y/N? If so, in which month/year?

8. If your hysteroscopy department uses its own Patient Information Leaflet, please may I have a link to it?

9. Does the leaflet include ALL the key points listed (below) by the RCOG – Y/N?
Key points
• Outpatient hysteroscopy (OPH) is a procedure carried out in the outpatient clinic that involves examination of the inside of your uterus (womb) with a thin telescope.
• There are many reasons why you may be referred for OPH, such as to investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan or to remove a coil with missing threads.
• The actual procedure usually takes 10–15 minutes. It can take longer if you are having any additional procedures.
• You may feel pain or discomfort during OPH. It is recommended that you take pain relief 1–2 hours before the appointment.
• If it is too painful, it is important to let your healthcare professional know as the procedure can be stopped at any time.
• You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure.
• Possible risks with hysteroscopy include pain, feeling faint or sick, bleeding, infection and rarely uterine perforation (damage to the wall of the uterus). The risk of uterine perforation is lower during OPH than during hysteroscopy under general anaesthesia

Yours faithfully,

Katharine Tylko-Hill

United Lincolnshire Hospitals NHS Trust

Thank you for your email.

Your Freedom of information request has been logged and will now be processed.

If you need to contact us again in relation to this request please quote reference number 220/19 using the email address [email address].

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Katharine Tylko-Hill

Dear United Lincolnshire Hospitals NHS Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of United Lincolnshire Hospitals NHS Trust's handling of my FOI request 'Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice'.

My request was made in April.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/o...

Yours faithfully,

Katharine Tylko-Hill

United Lincolnshire Hospitals NHS Trust

Dear Katharine Tylko-Hill

Thank you for your email concerning the process of your Freedom of information request 220/19 and we sincerely apologise for not responding within the deadline. We are in the process of gathering the necessary information required in-order to satisfy your request. We are sorry for the inconvenience and we plan to respond with the information as soon as possible.

Kind Regards

Freedom of Information (ULHT)

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Katharine Tylko-Hill

Dear United Lincolnshire Hospitals NHS Trust,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of United Lincolnshire Hospitals NHS Trust's handling of my FOI request 'Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice'.

This is the second time that I'm requestion an internal review. Please would you hurry things up.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/o...

Yours faithfully,

Katharine Tylko-Hill

Katharine Tylko-Hill

Dear United Lincolnshire Hospitals NHS Trust,

Please would you chase up a response to FOIA request 220/19. I've just sent a 2nd request for an internal review of why many months have elapsed since my request re Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice.

Thank you

Yours faithfully,

Katharine Tylko-Hill

United Lincolnshire Hospitals NHS Trust

2 Attachments

 
Dear Ms Tylko-Hill
 
Please see attached the response to your Freedom of Information request.
 
Regards
 
Julie Marshall
Admin Support
United Lincolnshire Hospitals NHS Trust
Trust HQ , Lincoln County Hospital
Main Entrance, Greetwell Road
Lincoln LN2 5QY
T: 01522 573989
 
 
 

United Lincolnshire Hospitals NHS Trust

1 Attachment

Dear Ms Tylko-Hill,

 

Please see attached correspondence

 

Kind Regards

 

Freedom of Information Team