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

Katharine Tylko-Hill made this Freedom of Information request to Nottingham University Hospitals NHS Trust

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Katharine Tylko-Hill

Dear Nottingham University 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."
________________________________________

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

Foulds James (ICT), Nottingham University Hospitals NHS Trust

 

REF: NUH 53861 FREEDOM OF INFORMATION ACT 2000 - INFORMATION REQUEST -
Acknowledgement

 

Thank you for your request for information. Your request was received on
13^th March 2019 and we are dealing with it under the terms of the Freedom
of Information Act 2000.

 

Nottingham University Hospitals NHS Trust (NUH) came into being on 1st
April 2006 and assumed responsibility for the services provided by both
the Queen's Medical Centre (QMC) and Nottingham City Hospital NHS Trust
(NCH).

 

In some circumstances a fee may be payable and if that is the case I will
let you know. A fees notice will be issued to you, and you will be
required to pay before I will proceed to deal with your request.

 

You will receive the information requested within 20 working days allowed
under the Act unless the Trust does not hold the information or there is a
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Further information about your rights is also available from the
Information Commissioner at:

 

Information Commissioner's Office
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Water Lane 
Wilmslow 
Cheshire 
SK9 5AF 
Telephone: 08456 30 60 60 or 01625 54 57 45
[1]www.ico.gov.uk

 

Yours sincerely,

 

James Foulds

Freedom of Information (FOI) Administrator

Information Governance Team

Heathfield House

ICT Services, Nottingham University Hospitals NHS Trust

City Hospital Tel: 0115 9691169 ext 54656

 

Please note my working hours are 08.00 -16.00 through the working week.

 

ICT Services are always happy to help, you can access our services by
calling 69000 or for non-urgent enquiries please use the Self Service form
[2]http://ictselfservice

 

Help us prevent infections at our hospitals by cleaning your hands.
Remember – hand washing is the simplest and most effective way of
preventing infections.

 

References

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2. http://ictselfservice/

Katharine Tylko-Hill

Dear Nottingham University 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 Nottingham University Hospitals 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

FOI, Nottingham University Hospitals NHS Trust

Dear Katharine

I apologise for the length of time it has taken to respond to your request for an internal review.

I have forwarded your request to the Information Governance Manager who will be in touch .

I regret that we have not been able to respond to your request for information within the 20 working days set by the Secretary of State as provisioned in the Freedom of Information Act 2000.

Kind Regards

James

James Foulds
Freedom of Information (FOI) Administrator
Information Governance Team
Digital Services, Nottingham University Hospitals NHS Trust
City Hospital
Heathfield House
Tel: 0115 9691169 ext 54656

Please note my working hours are 08.00 -16.00 through the working week.

Advance Notice of Annual Leave – None

ICT Services are always happy to help, you can access our services by calling 69000 or for non-urgent enquiries please use the Self Service form http://ictselfservice

Help us prevent infections at our hospitals by cleaning your hands. Remember – hand washing is the simplest and most effective way of preventing infections.

show quoted sections

FOI, Nottingham University Hospitals NHS Trust

Dear Ms Tylko-Hill

I apologise for the delay in returning your request for information.

We are still investigating the causes of why this hasn’t been returned to you within the 20 working day time limit set in the Freedom of Information Act 2000.

I am hopeful however that your request will be released latest by 19th July.

Thank you for your continued patience.

Regards

James

James Foulds
Freedom of Information (FOI) Administrator
Information Governance Team
Digital Services, Nottingham University Hospitals NHS Trust
City Hospital
Heathfield House
Tel: 0115 9691169 ext 54656

show quoted sections

Foulds James (Digital Services), Nottingham University Hospitals NHS Trust

REF: NUH 53861 FREEDOM OF INFORMATION ACT 2000 – Internal Review

 

 

Your response for a review of the delay in relation to your request was
forwarded to the Division responsible and reviewed by Deborah Coombs,
Records Manager, Digital Services. Please accept out apologies the delay
you have encountered which were on this occasion due to a lack of systems
in place from the Divisional FOI Lead. We have been assured that more
robust systems are now in place to prevent a repeated issue. Your FOI is
currently with the Director of Midwifery awaiting final sign off and we
hope to have it with you in the next few days.

 

If you are unhappy with the response you have received you should write
to:

 

Information Governance Manager

Nottingham University Hospitals NHS Trust

ICT Services, Heathfield House

City Campus

Hucknall Road

Nottingham

NG5 1PB

 

If are unhappy with the overall service you have received and wish to make
a complaint, you should write to:

 

Complaints Lead

Nottingham University Hospitals NHS Trust,

Queen’s Medical Centre Campus,

Derby Road,

Nottingham, NG7 2UH.

 

If, after exhausting our internal process, you are still unhappy with the
information received, you may write to:

 

The Information Commissioner’s Office,

Wycliffe House,

Water Lane,

Cheshire, SK9 5AF.

Telephone: 08456 30 60 60 or 01625 54 57 45
[1]www.ico.gov.uk

 

Yours sincerely

 

 

 

James Foulds

Freedom of Information (FOI) Administrator

Information Governance Team

Digital Services, Nottingham University Hospitals NHS Trust

City Hospital

Heathfield House

Tel: 0115 9691169 ext 54656

 

 

References

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1. http://www.ico.gov.uk/

Foulds James (Digital Services), Nottingham University Hospitals NHS Trust

1 Attachment

Dear Ms Tylko-Hill

 

I apologise for the extraordinary length of time it has taken to respond
to your request for information.

 

I hope that this has not caused you any inconvenience.

 

REF: NUH 53861 FREEDOM OF INFORMATION ACT 2000 - INFORMATION REQUEST –
FINAL DISCLOSURE

 

I am writing in response to your correspondence dated 13^th March 2019
requesting information under the Freedom of Information Act 2000.

 

Nottingham University Hospitals NHS Trust (NUH) came into being on 1st
April 2006 and assumed responsibility for the services provided by both
the Queen's Medical Centre (QMC) and Nottingham City Hospital NHS Trust
(NCH). 

 

Your request for information has now been considered and I am pleased to
be able to answer your questions as follows:

 

o Please refer to the attached document

 

You are advised that this information is provided in accordance with the
Freedom of Information Act 2000 and is for your personal use.  Any re-use
of this information will be subject to copyright and the Re-Use of Public
Sector Information Regulations (18^th July 2015).  In the event of any
re-use, the information must be reproduced accurately and not used in a
misleading manner.

 

If you have any queries or concerns then please contact me. Please
remember to quote the reference number above in any future communications.

 

If you are unhappy with the response you have received and wish to make an
appeal, you should write to:

 

Information Governance Manager

Nottingham University Hospitals NHS Trust

ICT Services, Heathfield House

City Campus

Hucknall Road

Nottingham

NG5 1PB

 

If are unhappy with the overall service you have received and wish to make
a complaint, you should write to:

 

Complaints Lead

Nottingham University Hospitals NHS Trust,

Queen’s Medical Centre Campus,

Derby Road,

Nottingham, NG7 2UH.

 

If, after exhausting our internal process, you are still unhappy with the
information received, you may write to:

 

The Information Commissioner’s Office,

Wycliffe House,

Water Lane,

Cheshire, SK9 5AF.

Telephone: 08456 30 60 60 or 01625 54 57 45
[1]www.ico.gov.uk

 

Yours sincerely

 

 

James Foulds

Freedom of Information (FOI) Administrator

Information Governance Team

ICT Services, Nottingham University Hospitals NHS Trust

City Hospital

Heathfield House

Tel: 0115 9691169 ext 54656

 

Please note my working hours are 08.00 -16.00 through the working week.

 

ICT Services are always happy to help, you can access our services by
calling 69000 or for non-urgent enquiries please use the Self Service form
[2]http://ictselfservice

 

Help us prevent infections at our hospitals by cleaning your hands.
Remember – hand washing is the simplest and most effective way of
preventing infections.

 

 

Please note my working hours are 08.00 -16.00 through the working week.

 

ICT Services are always happy to help, you can access our services by
calling 69000 or for non-urgent enquiries please use the Self Service form
[3]http://ictselfservice

 

Help us prevent infections at our hospitals by cleaning your hands.
Remember – hand washing is the simplest and most effective way of
preventing infections.

 

 

Sent on behalf of:

Rory King
Information Governance Manager

ICT Services

Nottingham University Hospitals NHS Trust

City Hospital

Nottingham

NG5 1PB

 

Tel: 0115 9691169 Ext. 57169

Email: [4][email address]

 

References

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1. http://www.ico.gov.uk/
2. http://ictselfservice/
3. http://ictselfservice/
4. mailto:[email address]