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FOI Request 2192 - Womb Cancer
Written by FOI Lead   

Case Number 2192
Request Date 19/10/2010

Details of the Request


  • Please may I have a copy of your Trust's 2WW Urgent Referral form for womb cancer?
  • Under the heading 'Symptoms of Gynae Cancer' is 'persistent intermenstrual bleeding' listed?
  • Is there provision for the referral of perimenopausal women?
  • Is there provision for the referral of women with polycystic ovarian syndrome?
  • Is there a tickbox saying 'this patient has agreed to OP biopsy'?
  • Is there a tickbox saying 'this patient requires general anaesthetic (GA)'?
  • Please may I have a copy of your Trust's diagnostic algorithm for womb cancer?
  • What outpatient diagnostic method/s do you use? (E.g. Pipelle without hysteroscopy.)
  • What percentage of your hysteroscopy/endometrial biopsy patients do not attempt OP diagnosis but have a general anaesthetic?
  • What is your DNA rate for outpatient hysteroscopy/endometrial biopsy?

Completion Date 16/11/2010


Details of the Response

Thank you for your request to Ashford and St. Peter’s Hospitals NHS Trust regarding Endometrial Biopsy - Removing barriers to early diagnosis of womb cancer.

The Trust’s Business Unit Service Manager Womens Health /Gynae has responded as follows:
  • Please may I have a copy of your Trust's 2WW Urgent Referral form for womb cancer?

    Referrals come from the GP in different formats. This is usually in letter format. There is, therefore, no detailed breakdown of the following questions as every patient will have a variety of different symptoms which the GP will specify according to the patient.
     
  • Under the heading 'Symptoms of Gynae Cancer' is 'persistent intermenstrual bleeding' listed?

    N/A
     
  • Is there provision for the referral of perimenopausal women?

    N/A
     
  • Is there provision for the referral of women with polycystic ovarian syndrome?

    N/A
     
  • Is there a tickbox saying 'this patient has agreed to OP biopsy'?

    N/A
     
  • Is there a tickbox saying 'this patient requires general anaesthetic (GA)'?

    N/A
     
  • Please may I have a copy of your Trust's diagnostic algorithm for womb cancer? 

    The requester was sent a copy of the Surrey and west Sussex and Hampshire cancer Network guidance for Gynaecological cancer. Please refer to the section ‘Management of endometrial cancer – a pathway of care’. This guidance is used by all hospitals within the network, including Ashford and St Peter’s NHS Trust. The website is http://www.swshcn.nhs.uk.
     
  • What outpatient diagnostic method/s do you use? (E.g. Pipelle without hysteroscopy.)

    All patients undergo a transvaginal Ultrasound, some will require a pipelle biopsy and Hysteroscopy depending on the TVS finding. An MRI will be carried out if cancer is confirmed.
     
  • What percentage of your hysteroscopy/endometrial biopsy patients do not attempt OP diagnosis but have a general anaesthetic?

    Out of 439 patients who underwent hysteroscopy last year 66 underwent inpatient hysteroscopy ie 15%. The remainder were carried out as day cases.
     
  • What percentage of your OP hysteroscopy/endometrial biopsy patients have a failed OP procedure followed by a general anaesthetic?

    We do not perform outpatient hysteroscopy at Ashford and St Peter’s.
     
  • What is your DNA rate for outpatient hysteroscopy/endometrial biopsy?

    As above.
     
  • What is/are the name/s of the outpatient clinic/s which diagnose/s womb cancer?

    A patient could be referred from any gynae pathway as they may not initially be referred under the 2 week rule. However Ashford and St Peter’s NHS Trust run several specific clinics for gynae oncology and post menopausal bleeding. We run a Gynae oncology clinic (code GYONSP) and a one stop clinic (also GYONSP) which provides the facility for scanning and biopsy if required. There is a weekly post menopausal bleeding clinic (GYMBSP) which provides a scanning slot and facility to biopsy if required. A menstrual disorder clinic (BHMDSP) where patients can also receive a one stop service is also offered.
     
  • Are pre and perimenopausal women with womb cancer symptoms referred to a Post Menopausal Bleeding clinic?

    Women are referred to the above clinics.
     
  • What diagnostic provision is made for women who would not tolerate or do not wish to have a Trans-Vaginal Ultrasound Scan?

    Women will be offered an abdominal Ultrasound or go on to have a hysteroscopy
     
  • May I have a copy of your consent form for OP endometrial biopsy?

    We do not have a consent form for pipelle biopsy.
     
  • Approximately how many women in your Trust have an OP endometrial biopsy per annum?

    173 cases from 1 October 2009 and 30 September 2010.
     
  • Does your Trust audit how many OP endometrial biopsies result in infections and/or other complications?

    Not currently
     
  • May I have a copy of any surveys, studies or audits of patient satisfaction with OP endometrial biopsy at your Trust? WE have recently carried out a patient survey for all patients who have gone through the TWR pathway.

    The requester was sent the results although it was not specific to endometrial biopsy.
     
  • Do your OP endometrial biopsy/hysteroscopy patients have access to psychosexual counselling before, during or after the procedure?

    For these patients the priority is in establishing the diagnosis of cancer and expediting its therapeutic management. If counselling is subsequently required then this can be arranged through the RSCH where cancer patients are then referred. There is no psychosexual counselling within St Peter’s. However patients can be referred direct to the Community mental Health Team or alternatively patients can self refer to RELATE. For psychological counselling the Trust can cite the Fountain Centre.
     
  • Please may I have a copy of your Trust's Patient Information Leaflet for Hysteroscopy and/or Endometrial Biopsy?

    We currently don’t have a leaflet for this procedure
     
  • Does the leaflet state that patients may choose the option of hysteroscopy with general anaesthetic?

    N/A
     
  • Does the leaflet state that patients may choose to have local anaesthetic and/or conscious sedation?

    N/A
     
  • Does the leaflet warn what percentage of patients may faint from severe pain during hysteroscopy and/or endometrial biopsy?

    N/A
     
  • Does the leaflet recommend that patients take mefenamic acid or another painkiller and/or diazepam/equivalent before the procedure?

    N/A
     
  • Is the leaflet published on your Trust's hospital website/s?

    N/A
     


Last Updated ( Wednesday, 08 June 2011 11:19 )