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SouthendHospital

Prittlewell Chase

Westcliff-on-Sea

Essex SS0 0RY

Tel: 01702 435555

Ms Katharine Tylko-Hill

Macmillan CancerVOICE

26 March 2014

DearMs Tylko-Hill

I am writing in respect of your recent enquiry for information held by Southend University Hospital NHS Foundation Trust under the provisions of the Freedom of Information Act 2000. We have now processed your request, please find below our response.

Under the Freedom of Information Act (2000) please would you supply the following information relating to your Trust’s practice of Outpatient Hysteroscopy/Biopsy – Pain Control and Patient Choice

1. The current patient information leaflet

Please find attachedpatient information leaflet.

2. The current consent form

Please find attachedconsent form.

3. The current surgical protocol

Individual Hysteroscopy practitioners follow their own technique of hysteroscopy.

We follow Royal College of Obstetricians and Gynaecologists (RCOG) described Vaginoscopic technique of hysteroscopy. It may be useful to look at RCOG

4. Does the leaflet advise the patient to ask her GP to prescribe gynae-specific painkillers to be taken BEFORE the procedure - Y/N?

We do not routinely advise patients to see their GP for gynae-specific pain killers.

5. What type and dose of painkillers does your Trust advise patients to take before the procedure?

Paracetamolone gram to be taken one hour before the procedure and Ibuprofen 200 mg one hour before the procedure

6. Are ALL your hysteroscopy/biopsy patients given the following choices BEFORE the procedure is attempted:

a) General Anaesthesia – Y/N? -No

b) spinal anaesthesia – Y/N? -No

c) conscious sedation – Y/N?- No

Analgesia is discussed with the patient prior to the procedure. As a default we advise the patient first about anOutpatient Hysteroscopy. If the patient declines an Outpatient hysteroscopy, then they would be offered a General Anaesthesia(G.A) Hysteroscopy. If any patient has a medical contraindication for G.A hysteroscopy then they would be offered Spinal or conscious sedation at Anaesthetists advice.

7. For each of the last 3 financial years, how many of your hysteroscopy/biopsy patients had

a) GA with overnight stay?

b) GA day-case ?

c) spinal anaesthesia?

d) conscious sedation?

e) local anaesthetic?

f) no anaesthetic?

With regard the above question in the first instance, I would like to reassure you that it is the Trust’s intention to provide information which is requested by the public under the provision of the Freedom of Information Act 2000, as long as the information exists and no exemptions apply.

We may hold the information requested in relation to responding to the above question but this information is not recorded in a way that is easily retrievable. We do not currently have a single document containing the specific data that you have requested and our current systems are unable to provide a breakdown of data in the exact manner sought. This information is held withinindividual patient case notes in paper format and in part within electronic systems. The information is not in one filing system. Accordingly, it is not held in a structured or indexed way that will allow for the information to be retrieved without a manual search. In this regard the Trust would only be able to provide you with the information you requested by examining every individual case note and by cross-referencing this with information held electronically. We have estimated that this would take more than 18 hours involving costs which would exceed the appropriate fee limit of £450 set out under Freedom of Information & Data Protection (Appropriate Limit and Fees) Regulations 2007.

The fee limit specified in regulations for NHS trusts represents the cost of one person spending 2½ working days (at a rate of £25 per hour) to determine whether the Trust holds the information requested; then locating, retrieving and extracting that information.

Having regard to section 12 of the Freedom of Information Act, in circumstances where the fee limit is likely to be exceeded, then the Trust is not obliged to respond to the request. Accordingly, we are sorry, but on this occasion we will not be processing your request further.

8. What width hysteroscopes do you use? Rigid or flexible?

We use Rigid Hysteroscope

We have1 x 2 French Olympus diagnostichystescope

4 x 3 French Olympus diagnostic hysterscope

3 x 2.9 French Karl-Storz Bettochi hysteroscope

9. For each of the last 3 financial years what % patients DNA outpatient hysteroscopy/biopsy?

We do not hold this data.

10. For each of the last 3 financial years what % OP hysteroscopy/biopsy patients had a failed procedure that had to be repeated with epidural, GA or conscious sedation?

We do not record this data

11. All audits of adverse events, e.g. infection, perforation during the last 3 financial years

There are notany audits regarding adverse events.

However, the individual practitioners keep their own data and for the financial year since April 2013 there have not been any perforations or any inpatient admissions for infection following Outpatienthysteroscopy

12. All surveys of patients’ experiences during the last 3 financial years

There have been no surveys carried out of patient experience during the last 3 financial years.

However, patient surveys are planned for the near future.

If you have any further queries or concerns then please do not hesitate to contact us.

Further information about your rights is also available from the Information Commissioner at:

The Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire. SK9 5AF

Telephone: 01625 545700

Web Address:

Yours sincerely

Nicola Frost

Freedom of Information Co-ordinator

Governance Unit

Tel: 01702 435555 Ext 6455

Email

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