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

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Katharine Tylko-Hill

Dear Wirral University Teaching Hospital NHS Foundation 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."
________________________________________

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

Accesstoinformationoffice (WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST), Wirral University Teaching Hospital NHS Foundation Trust

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Our Ref:           LMS/LG/JT/Access.61050-04-19

 

 

Dear Ms Tylko-Hill,

 

We acknowledge receipt of your request for information received in this
office on 5^th April 2019.

 

Please note, as the Freedom of Information Act requires us to produce your
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Yours sincerely

 

Jan Taylor

 

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Accesstoinformationoffice (WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST), Wirral University Teaching Hospital NHS Foundation Trust

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Our Ref:            LMS/LG/JT/Access.61050-04-19

 

 

Dear Ms Tylko-Hill,

 

We do apologise profusely for the delay in responding to your request for
information.

 

Please be advised your request is currently being processed but we are
still awaiting information from the department supplying the response on
behalf of the Trust. We have sent a reminder to them today.

 

Therefore, we would respectfully like to request more time in which to
respond.

 

Hopefully a full and final response should be with you shortly.

 

 

 

Yours sincerely

 

Jan Taylor

 

Sent by Jan Taylor (Mrs) on behalf of Lin Snow

Head of Information Governance & Records Management

Data Protection Officer and Copyright Lead

With responsibility for Data Quality, Clinical Coding & Information
Security

Information Governance Department

 

Direct dial: 0151 604 7120

Internal extension: 8477

Email [1][Wirral University Teaching Hospital NHS Foundation Trust request email]

Normal Office Hours: Monday to Friday 8.30am to 5pm

 

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Katharine Tylko-Hill

Dear Wirral University Teaching Hospital NHS Foundation Trust,

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

I am writing to request an internal review of Wirral University Teaching Hospital NHS Foundation 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. It was part of a countrywide survey into the implementation of an important RCOG statement. Over 100 other Trusts have already replied.

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

Thank you very much for your help.

Yours faithfully,

Katharine Tylko-Hill

Accesstoinformationoffice (WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST), Wirral University Teaching Hospital NHS Foundation Trust

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Our Ref:           LMS/LG/JT/Access.61050-04-19

 

 

Dear Ms Tylko-Hill,

                                                  

 

Please find attached our response to your recent request for information
in accordance with the Freedom of Information Act.

 

We also would like to offer our sincere apologies again for the delay you
have experienced in receiving this information.

 

 

Yours sincerely

 

Jan Taylor

 

Sent by Jan Taylor (Mrs) on behalf of Lin Snow

Head of Information Governance & Records Management

Data Protection Officer and Copyright Lead

With responsibility for Data Quality, Clinical Coding & Information
Security

Information Governance Department

 

Direct dial: 0151 604 7120

Internal extension: 8477

Email [1][Wirral University Teaching Hospital NHS Foundation Trust request email]

Normal Office Hours: Monday to Friday 8.30am to 5pm

 

[2]cid:[email address]

 

P Consider the Environment/Save Paper - Do you really need to print this
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disclosure under the Freedom of Information Act 2000. Unless the
information is legally exempt from disclosure, the confidentiality of this
e-mail and your reply cannot be guaranteed. Any views or opinions
presented are solely those of the author and do not necessarily represent
those of Wirral University Teaching Hospital. If you are not the intended
recipient, be advised that you have received this e-mail in error and that
any use, dissemination, forwarding, printing or copying of this email is
strictly prohibited. If you have received this e-mail in error please
notify the sender.

 

 

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