1. The patient information leaflet/s Yes, –
In Patient Hysteroscopy
Outpatient Flexible Hysteroscopy
2. The consent form/s Yes, –
Surgical Safety Checklist Flexible Hysteroscopies
3. For each of the last 3 financial years:
i. all audits of OP hysteroscopy adverse events, (including infection, perforation, pain equal to or above 7/10 on VAS) No serious adverse events last 3 years of which we are aware.
ii.all surveys of patients’ outpatient hysteroscopy experiences. Are all your patients allowed to complete the satisfaction survey at home? Y/N No surveys done in last three years.
iii.the number of your patients who had a) GA, b) spinal anaesthesia, c) monitored procedural IV sedation, d) local anaesthetic, e) no anaesthetic iv. the % of your a) diagnostic hysteroscopies, b) operative hysteroscopies that were done in outpatients. Only LA used in outpatients and then only when required.
Did your Trust meet the Best Practice Target % Tariff for each of these years? Not overall. Presume referring to 80% target as recommended by NICE for OP hysteroscopy.
4. i. Is local anaesthetic available in all your outpatient hysteroscopy clinics? Yes
ii. Is Entonox available in all your outpatient hysteroscopy clinics? No
5. Are all your hysteroscopy patients (including See & Treat/One Stop Shop/Late Cancellations) offered? Not sure what a late cancellation is.
i. local anaesthetic? Yes but only used when required, can be more painful than the procedure.
ii. GA? No, inappropriate in outpatients setting.
iii. spinal anaesthesia? No, inappropriate in outpatients setting.
iv. safely monitored IV sedation? No, inappropriate in outpatients setting.
6. Do you use electro-surgery in any of your outpatients clinics? Yes. If so, do you always use the lowest power setting? Always use the most appropriate power setting and waveform for what is required.
7. What type and diameter of scopes do you use in a) outpatients, b) for GA patients? Rigid, semi-rigid, flexible, Outpatients only flexi 2.9-3.1mm. Rigid not used.
8. What is the minimum training and accreditation (e.g. RCOG ATSM) that all your NEW hysteroscopists must have? All practitioners have appropriate training and assessment. Courses on hysteroscopy for all levels held every year in the MATTU, usually 3 in total. Nurse hysteroscopists have their own recognised training, qualification and updates.
9. What % diagnostic outpatient hysteroscopy/biopsy patients had an incomplete procedure which was repeated with epidural, GA or sedation? Depends on the operator: 0-5%
10. Does your Trust have a psychosexual counselling service for PTSD caused by severe procedural pain? Yes.