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

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Katharine Tylko-Hill

Dear Bradford Teaching Hospitals 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

FOI, Bradford Teaching Hospitals NHS Foundation Trust

Dear Katherine,
Thank you for your recent Freedom of Information request. Under the terms of the Freedom of Information Act we will endeavour to respond to this request promptly within 20 working days and are now investigating the nature of the request, the quantity of information requested and whether we hold the information requested.
There are a number of exemptions which the Act permits with respect to disclosure of information. The information will be assessed for these exemptions prior to disclosure and we will advise you if we are unable to provide the information requested.
If there is a cost involved in collecting the information then we will suspend the period for response until such time as we receive your payment. We will advise you of any such costs.
Please send any further correspondence to [email address] .
Kind regards,

Michal Mangham
Freedom Of Information Officer
Working Week: Mon 8-3 Tues/Wed 8-2
Communications | Duckworth Lane Cottage, BRI
Bradford Teaching Hospitals NHS Foundation Trust
T: 01274 36 4774
http://www.bradfordhospitals.nhs.uk

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FOI, Bradford Teaching Hospitals NHS Foundation Trust

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Dear Katherine,

Please find attached our response to your Freedom of Information request.

Kind regards,

[1]hellomynameis
Michāl Mangham
Freedom of Information Officer
Working Week: Mon 8-3 Tues/Wed 8-2
Communications | Duckworth Lane Cottage, Bradford Royal Infirmary
Bradford Teaching Hospitals NHS Foundation Trust
T: 01274 36 4774
[2]http://www.bradfordhospitals.nhs.uk

 

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