Managing common gynaecological conditions
Gynaecology has been identified as one of the top five specialities accounting for around two thirds of all long waits in the NHS. It is now possible to undertake a number of investigative procedures in the primary care setting.
There is an increasing number of GP practices around the country where common gynaecological conditions can be managed. By commissioning optiumum patient pathways it may be possible to cut waiting list times, shift the care closer to home and increase patient experience and satisfaction.
One GP who has done exactly this is Dr Anne Connolly, a GPwSI (General Practitioner with a Special Interest) in Bradford. Not only is she Clinical Lead for Women's and Sexual Health NHS Bradford & Airedale, she's also editor in chief of specialist magazine “Primary Care Women's Health Journal”. Dr Connolly, pictured above, and her team have pioneered the undertaking of a number of gynaecological procedures in a primary care setting which would previously have required an outpatient consultation in hospital.
NHS Bradford & Airedale began the process of moving a number of specialisms into the primary care setting some 10 years ago, including gynaecology, dermatology and neurology. This was done primarily due to pressure on waiting lists and the DoH's stated intention of moving care closer to home. These services expanded to include hysteroscopy thus increasing the capacity of diagnostics and therefore reducing patient waiting time. Dr Connolly is able to offer a medical gynaecological service which has been developed to include diagnostic hysteroscopy and extended to deliver the removal of small polyps and fibroids and endometrial ablation. She works at the Westward Park Diagnostic & Treatment Centre along with consultant Sîan Jones and Nurse Practitioner Helen Ludkin.
Helen Ludkin believes that moving a number of gynaecological procedures into the primary or intermediate setting is an exciting innovation. Nurse Practitioners from other practices regularly refer patients directly to her – there is often no need for the patient to even see a doctor, far less a consultant. Mrs Ludkin holds a Post Graduate Diploma in Gynaecology which enables her to perform a number of investigations and treatments and has trained to perform diagnostic and therapeutic hysteroscopys and endometrial ablation. Working as a team, the three women run two rooms at the same time and usually see and treat up to eighteen women in an afternoon.
From referral to treatment is usually only 2 – 3 weeks – a significant improvement on the waiting time a patient would normally experience if referred to a consultant and well within Government targets.
Clearly the health professionals undertaking these procedures in a primary or intermediate care setting need special training. ETHICON™ Women's Health & Urology has been supporting training courses for nurses in this context, and now holds courses for GPs every six months. The aim of the courses is to empower health professionals in the primary care setting with the knowledge and surgical skills to perform ambulatory gynaecology. The next course is being run in Bradford in December and will be delivered by Sîan Jones, FRCOG, Consultant Gynaecologist, Bradford Royal Infirmary. More information about these courses can be obtained by emailing Dora Wood.
Published in partnership with the Royal College of Nursing's Practice Nurse Association
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