Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice
Dear Mid Essex Hospital Services 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."
________________________________________
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
Dear Requester
Thank you for your email and request for information under the Freedom of
Information Act.
Your request has been acknowledged. Normal Freedom of Information
timescales apply from receipt of your request (20 working days) into this
MEHT FOI mailbox.
We look forward to dealing with your request. Please
contact [1][Mid Essex Hospital Services NHS Trust request email] with any queries.
With kind regards
Rebecca Pascoe Youell
Public Information Manager
Information in this message may contain confidential and privileged
information. If you are not the intended recipient please accept our
apologies; please do not disclose, copy or distribute information in this
e-mail or take any action in reliance on its contents: to do so is
strictly prohibited and may be unlawful. Please inform us that this
message has gone astray before deleting it. Content of emails received by
this Trust will be subject to disclosure under the Freedom of Information
Act 2000. Unless the information is legally exempt from disclosure,
confidentiality of this e-mail and your reply cannot be guaranteed. Thank
you for your co-operation.
References
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1. mailto:[Mid Essex Hospital Services NHS Trust request email]
Dear Mid Essex Hospital Services NHS Trust,
Please pass this on to the person who conducts Freedom of Information reviews.
I am writing to request an internal review of Mid Essex Hospital Services NHS Trust's handling of my FOI request 'Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice'.
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
Dear Requester
Thank you for your email and request for information under the Freedom of
Information Act.
Your request has been acknowledged. Normal Freedom of Information
timescales apply from receipt of your request (20 working days) into this
MEHT FOI mailbox.
We look forward to dealing with your request. Please
contact [1][Mid Essex Hospital Services NHS Trust request email] with any queries.
With kind regards
Rebecca Pascoe Youell
Public Information Manager
Information in this message may contain confidential and privileged
information. If you are not the intended recipient please accept our
apologies; please do not disclose, copy or distribute information in this
e-mail or take any action in reliance on its contents: to do so is
strictly prohibited and may be unlawful. Please inform us that this
message has gone astray before deleting it. Content of emails received by
this Trust will be subject to disclosure under the Freedom of Information
Act 2000. Unless the information is legally exempt from disclosure,
confidentiality of this e-mail and your reply cannot be guaranteed. Thank
you for your co-operation.
References
Visible links
1. mailto:[Mid Essex Hospital Services NHS Trust request email]
Dear Ms Tylko-Hill
Thank you for your email.
I have chased this request previously for you and have asked today that an immediate response is put together by the relevant team.
As you have asked for an internal review I will ensure that your response is sent back to you by the Trust Secretary, James Day, with a reason for the delay.
If you have any queries in the meantime please do not hesitate to contact me.
Kind regards
Rebecca
Rebecca Pascoe-Youell
Public Information Manager
Corporate Department
Freedom of Information Requests to be emailed to: [email address]
South Wing - Level 3, Room 42, B346
01245 51(4536) [email address]
Normal working days – Tuesday, Wednesday and Thursday
Dear Mid Essex Hospital Services NHS Trust,
Please pass this on to the person who conducts Freedom of Information reviews.
I am writing to request an internal review of Mid Essex Hospital Services NHS Trust's handling of my FOI request 'Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice'.
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 for your help.
Yours faithfully,
Katharine Tylko-Hill
Dear Ms Tylko-Hill
I am sorry you have had to contact us again concerning this.
I have asked the team involved to deal with this immediately.
For your convenience please note your reference number above.
Kind regards
Rebecca Pascoe | Public Information Manager | Corporate
Mid and South Essex University Hospitals Group
South Wing – Level 3 – Room R42 – B346
Broomfield Hospital, Chelmsford, Essex CM1 7ET
Tel: 01245 524900 ext 4536
[email address]
Dear Ms Tylko-Hill
Thank you for your request for this to be reviewed internally.
Your request has been referred to me as Trust Secretary for review.
I am pleased to provide information beneath which has been received by the
FOI team in response to further requests to the relevant department.
Unfortunately we are unable to confirm the response to question 1 due to
circumstances out of our control but we will do this when the opportunity
presents and will revert with our response.
Please also find attached relevant leaflets.
1. a) Have your hysteroscopists read the following statement issued by the
RCOG in December 2018 - Y/N? Cannot currently answer due to current
unplanned circumstances
b) Have your hysteroscopy managers read the following statement – Y/N? Yes
[1]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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