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Showing results for tags 'Obstetrics and gynaecology/ Maternity'.
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Content Article
In 2015, few people had even heard of pelvic mesh implants, let alone the devastating complications they could cause. Women were told their pain was “normal,” their concerns dismissed, their injuries hidden behind a wall of medical gaslighting. But what began as a small group of women raising their voices against an invisible epidemic turned into one of the UK’s most powerful grassroots campaigns for patient safety and medical justice. As Sling The Mesh marks its 10th anniversary, it celebrates a decade of courage, compassion, and relentless campaigning that has changed lives – and policy – forever. Over the next decade, Sling The Mesh will: Demand proper aftercare and support for all mesh-injured patients. Push for accountability from manufacturers and regulators. Campaign for awareness around hernia and other less-recognised mesh complications. Advocate for safer alternatives and patient-centred decision-making. Empower the next generation of campaigners to keep raising their voices. Push for tougher regulations and oversight of medical devices. Lobby for Sunshine legislation for transparency around funding from industry to the healthcare sector which can bias prescribing and affect research integrity.- Posted
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Each year since May 2023 the Sands & Tommy’s Joint Policy Unit have published an annual report setting out the extent of pregnancy and baby deaths across the UK. This year’s report argues that progress made to date falls short of what is needed to stop babies dying every day in the UK, and that unacceptable inequalities in pregnancy and baby loss persist despite continued calls for change. It estimates that at least 2,500 fewer babies – the equivalent of around 100 primary school classrooms - would have died since 2018 if the government had achieved its ambition of halving the 2010 rates of stillbirth, neonatal and maternal deaths in England. The report draws on the latest data from MBRRACE-UK, which shows that the gap continues to grow between neonatal death rates in the most deprived areas and those in the least deprived areas of the UK. It highlights that the stillbirth rate among babies of Asian ethnicity has risen sharply, and Black babies are still twice as likely as White babies to be stillborn. It includes 10 key actions for policymakers Renew commitments to save babies’ lives. Specifically, a stillbirth rate of 2.0 stillbirths, and a neonatal mortality rate of 0.5 neonatal deaths for babies born at 24 weeks’ gestation and over (per 1,000 live births). A preterm birth rate of 6.0%. Count miscarriages in the UK. The number and rate of miscarriages are not reported across the UK or for any individual nation. All UK governments should set up routine data collection on miscarriage. Take coordinated and meaningful action to eliminate inequalities. There are a range of policy areas where specific action is needed, including: understanding whether current efforts to reduce inequalities are working, and a comprehensive review of translation and interpreting services in maternity and neonatal care. Strengthen national leadership to make progress on the safety of maternity and neonatal services. Clarify the workforce needed to deliver safe care. Future development of the workforce must move away from a binary debate focussed on whether we do or don’t have enough staff and focus on the staffing requirements needed to deliver safe care, in line with nationally-agreed standards. Put the resources needed in place to deliver safe care. More investment is needed to improve the safety and quality of services if the government is going to deliver on its commitments to reduce rates of stillbirth and neonatal death and eliminate inequalities. Make informed choice a reality. Everyone should receive personalised care, know what they are entitled to, such as their birth choices, and services need the resources and operational capacity to provide this. Address unwarranted variation in care. Too often babies are dying because of care that is not in line with nationally-agreed standards. We need clarity on how national guidance is applied and clear national standards to improve the consistency of service provision. Ensure lessons are learned when babies die. The NHS is still not properly learning lessons when babies die or listening to the experiences of bereaved families to improve care in the future. There must be more robust oversight of the implementation of actions that are identified by reviews and investigations. Prioritise pregnancy and baby loss in research. This requires a broad range of research topics, the involvement of bereaved parents and communities, and a strong connection with policy and practice. -
News Article
Government accused of misleading claim on health hubs
Patient Safety Learning posted a news article in News
Most integrated care systems lack a women’s health hub offering full services — contrary to government claims — according to research seen by HSJ. In spring last year, the government and NHS England said all systems were expected to have at least one operational women’s health hub in place by the end of December 2024. They were required to provide clinical support and consultations/triaging in eight “core” services. Health minister Karin Smyth told Parliament at the start of this year the objective had been met in 39 out of 42 integrated care systems. But research by the Menstrual Health Coalition found only 14 integrated care boards had established hubs offering all eight core services, as required. The services are: menstrual problems assessment and treatment; menopause assessment and treatment; contraceptive counselling and provision of all methods; preconception care; breast pain assessment; pessary fitting and removal; cervical screening; and screening and treatment for sexually transmitted infections and HIV. The coalition, an alliance of patient and advocate groups, collected information from all ICBs between October and December. Its co-chair Anne Connolly, a GP specialising in gynaecology, said: “Our findings challenge the narrative that women’s health hubs have been successfully implemented nationwide. “While figures suggest that hubs are in place, the reality is that many do not provide the full range of services women were promised… There is now an urgent need for transparency alongside the rollout of women’s health services, particularly as the current funding is short term and lacks the necessary commitment to future-proofing these services.” Read full story (paywalled) Source: HSJ, 30 April 2025- Posted
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Reproductive health is central to overall health and wellbeing. A multitude of conditions and experiences can impact a person's reproductive health, and needs and priorities change according to age and life-stage. The Reproductive Health Survey for England 2023 surveyed nearly 60,000 women across England in 2023. This study looks at its results, seeking to quantify the burden of poor reproductive health in England by age, ethnicity, and financial security.- Posted
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One in four women in England have serious reproductive health issue, survey finds
Mark Hughes posted a news article in News
More than a quarter of women in England are living with a serious reproductive health issue, according to the largest survey of its kind, and experts say “systemic, operational, structural and cultural issues” prevent women from accessing care. The survey of 60,000 women across England in 2023, funded by the Department of Health and Social Care and analysed by academics at the London School of Hygiene & Tropical Medicine, found that 28% of respondents were living with a reproductive morbidity, such as pelvic organ prolapse, uterine fibroids, endometriosis, polycystic ovary syndrome, or cervical, uterine, ovarian or breast cancer. Almost a fifth (19%) of women reported experiencing severe period pain in the last year, and 40% of respondents reported heavy menstrual bleeding. More than 30% of participants aged 16-24 reported severe period pain. Read full story Source: The Guardian, 10 April 2025 -
Content Article
Ambulance services play a pivotal role in ensuring the safety of mothers and their newborns during urgent and emergency situations. These services act as the frontline responders, providing immediate care and facilitating timely transport to appropriate healthcare facilities. World Patient Safety Day, observed annually on 17 September, serves as a global platform to raise awareness about patient safety and encourage collaborative efforts to reduce harm in healthcare settings. The theme for 2025, 'Safe care for every newborn and every child', underscores the critical importance of safeguarding our youngest and most vulnerable patients from preventable harm. In the UK, ambulance services play a pivotal role in ensuring the safety of mothers and their newborns during urgent and emergency situations. These services act as the frontline responders, providing immediate care and facilitating timely transport to appropriate healthcare facilities. Their contributions are multifaceted, encompassing emergency childbirth assistance, neonatal transfers and the management of obstetric emergencies. In addition, many women and families will use the 999/111 service throughout the childbearing continuum, often using these services as a gateway to accessing maternity care. A recent review of Maternity and Newborn Safety Investigations (MNSI) highlighted that 6 in 10 independent investigations that met the criteria for MNSI involved the ambulance service. Out-of-hospital births, though relatively rare, present unique challenges for ambulance clinicians. Intrapartum care accounts for approximately 0.05% of emergency medical services' caseload, with only about 10% of these cases resulting in deliveries managed by ambulance staff. This limited exposure can lead to a decline in obstetric clinical skills, potentially impacting patient care. To address this, continuous training and simulation exercises are essential. For instance, the London Ambulance Service has developed a bespoke communication tool to support midwives in out-of-hospital settings, ensuring effective communication during the transfer of women or babies in emergencies and delivers bespoke mandated emergency training to its frontline clinicians. Such initiatives enhance the preparedness of ambulance clinicians to manage emergency deliveries safely; however, these are not standardised across services. Challenges and areas for improvement Despite their critical role, UK ambulance services face challenges that can impact maternal and neonatal safety. Incidents of delayed response times have been reported, leading to tragic outcomes. For example, a three-day-old baby named Wyllow-Raine Swinburn passed away after an eight-minute delay in answering a 999 call and a 31-minute wait for the ambulance to arrive. Although the delays were not deemed the direct cause of death, they highlighted inefficiencies in the emergency response system. In other cases, the lack of effective training for ambulance clinicians impacted upon the management of a time critical breech delivery, with tragic consequences. Such cases underscore the need for systemic improvements, including better resource allocation, enhanced training and the implementation of robust protocols to minimise delays in emergency response. Collaboration between ambulance services and midwifery teams is essential for improving outcomes in maternal and neonatal emergencies. The development of communication tools and training programmes exemplifies efforts to standardise information exchange during emergencies, thereby reducing the potential for errors and delays. Furthermore, ambulance services are increasingly recognising the importance of specialised roles focused on maternity care. For instance, paramedics with additional training in neonatal and maternity care can provide more comprehensive support during emergencies. Susie, a paramedic with the Northwest Ambulance Service, highlighted her passion for improving maternity care within the ambulance service, emphasising the importance of continuous professional development in this area. Conclusion As we observe World Patient Safety Day 2025, it is imperative to acknowledge and support the vital role of UK ambulance services in safeguarding mothers and their newborns during and following pregnancy. Continuous training, effective communication tools and collaborative practices are essential to enhance the safety and quality of care provided. By addressing existing challenges and building on successful initiatives, we can move closer to the goal of ensuring safe care for every newborn and every child from the very start. Further reading Exploring the pre-hospital setting for the emergency care and transfer of neonates: the role of UK ambulance and neonatal transport services Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens An exploration of maternity and newborn exposure, training and education among staff working within NWAS Disparities In Access to the Northwest Ambulance Service during pregnancy, birth and postpartum period and its association with neonatal and maternal outcomes World Patient Safety Day 2025- Posted
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Content Article
In this interview, researcher Zara Ward tells us about her latest project looking at adverse experiences of intrauterine device (IUD) fittings, removals and cervical smear tests. Zara is seeking volunteers to take part in the research to help develop understanding of lived experiences. Find out what’s involved and how to take part… Can you tell us a little bit about yourself? I’m a second- year counselling psychology doctorate trainee at the University of the West England. I work within a community mental health service for those with additional needs. I have a background of working within women's services for those who have experienced sexual abuse both online and offline. I have published research relating to so-called "revenge porn" and the effects this can have on those affected. I am incredibly passionate about exploring understudied areas, especially relating to the reproductive and sexual experiences of women and marginalised groups. What is the focus of your research and what led you to this area? The research focus is the adverse experiences of intrauterine device (IUD) fittings, removals and cervical smear tests. I was led into this area from my conversations with others following an adverse experience myself and being slightly floored by the lack of research and support in this area. The experiences shared within the Patient Safety Learning hub and social media were indicative that more work needed to be done. Who can take part? I am looking for adults based within the UK who have had an adverse experience relating to an IUD fitting, removal or smear test within the last two years. What would the process involve? The process would be an interview with myself via a Teams video call and would allow time for exploration of areas important to the individual. Once an interview has been completed, I shall transcribe, anonymise and analyse the interview to bring together themes across the people I interviewed. Is it confidential? It is. All information will be anonymised at the point of myself transcribing. How can people get in touch if they are interested? Anyone interested is welcome to e-mail me on: [email protected] and I would be happy to speak with them more about the process before any expectation of participation. What is your hope for the research findings? My hope for the research is to understand the lived experiences of those having adverse experiences during IUD fittings, removals and cervical smear tests and provide recommendations relating to mental health support. Related reading on the hub My experience of an IUD insertion: frozen with shock - no one was asking if I was OK Gynaecology procedures: patient survey example One hour with a women's health expert and finally I felt seen Fitting coils: developing a safe and supportive service Medical trauma from IUD fitting: it’s not just five minutes of pain for five years of gain- Posted
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The government's response to the recommendations made in the Women and Equalities Committee: Women’s reproductive health conditions report. The government agrees with the overarching aims of the findings and recommendations for improving women’s health outcomes and experiences. The government acknowledges the impact that reproductive health conditions have on women’s lives, relationships, and participation in education and the workforce. The report acknowledges that, since the publication of the Women’s Health Strategy for England, some progress has been made, including: the appointment of the Women’s Health Ambassador work to build trust with women from marginalised groups improved research into reproductive health conditions. However, we recognise that much more needs to be done to support women with reproductive health conditions, particularly around: listening to women improving information and education improving access to healthcare services. Tackling waiting lists, including for gynaecology, is a significant part of the government’s health mission Build an NHS Fit for the Future. NHS England’s Reforming elective care for patients plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing to ensure that patients receive more timely, accessible and accurate diagnostic testing, including for women’s reproductive health conditions. It sets out how the NHS will: reform elective care services meet the 18-week referral-to-treatment standard, For gynaecology specifically, NHS England will support the delivery of innovative models, offering patients care closer to home and piloting gynaecology pathways in community diagnostic centres. The government is also working with NHS England and the Women’s Health Ambassador on how to take forward the Women’s Health Strategy for England, by aligning it to the government’s missions under the Plan for Change and forthcoming 10 Year Health Plan. The 10 Year Health Plan will set out how we tackle the inequities that lead to poor health, including those for women. As part of this, the government is committed to setting an explicit target to close the Black and Asian maternal mortality gaps.- Posted
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Haemorrhage – severe heavy bleeding – and hypertensive disorders like preeclampsia are the leading causes of maternal deaths globally, according to a new study by the World Health Organization (WHO). These conditions were responsible for around 80 000 and 50 000 fatalities respectively in 2020 – the last year for which published estimates are available – highlighting that many women still lack access to lifesaving treatments and effective care during and after pregnancy and birth. Published in the Lancet Global Health, the study is WHO’s first global update on the causes of maternal deaths since the United Nations’ Sustainable Development Goals were adopted in 2015. In addition to outlining the major direct obstetric causes, it shows that other health conditions, including both infectious and chronic diseases like HIV/AIDS, malaria, anaemias, and diabetes, underpin nearly a quarter (23%) of pregnancy and childbirth-related mortality. These conditions, which often go undetected or untreated until major complications occur, exacerbate risk and complicate pregnancies for millions of women around the world. “Understanding why pregnant women and mothers are dying is critical for tackling the world’s lingering maternal mortality crisis and ensuring women have the best possible chances of surviving childbirth,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO as well as the UN’s Special Programme on Human Reproduction (HRP). “This is also a massive equity issue globally - women everywhere need high quality, evidence-based health care before, during and after delivery, as well as efforts to prevent and treat other underlying conditions that jeopardize their health.”- Posted
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Despite recognition of the importance of patient and public involvement (PPI) in healthcare improvement, compelling examples of “what good looks like” for PPI in co-design of improvement efforts, how it might be done, and formalisation of methods and reporting are lacking. The authors of this study sought to address these gaps through a case study. The case study aimed to involve maternity service users in the co-design of clinical resources for a maternity improvement programme, using a four-stage approach: 1) establishing guiding principles for PPI in the pro gramme, 2) structuring PPI for the programme, 3) co-designing improvements with PPI, and 4) seeking feedback on PPI in the co-design process. Partnership-focused frameworks and other literature on PPI and co-design informed the guiding principles. The structure included a five-member PPI group who provided continuous input, and an additional 15-member PPI group who met twice to discuss experiences of obstetric emergency. PPI in the co-design processes shaped the development of the resources in multiple ways, such as strengthening the prominence given to listening to those in labour and their birth partners, ensuring inclusivity of visuals and language, and developing communication princi ples informing all resources. Feedback suggested that PPI members felt valued, listened to, and supported to provide unanticipated contributions. The case study demonstrated how a principled approach to PPI enabled service users to play a key role in co-design of clinical resources aimed at improving the quality and safety of maternity care in the UK. Further case studies, across different clinical areas and with varying levels of resources, are needed to validate this approach.- Posted
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Patient Safety Learning stands with others around the world to celebrate International Women’s Day (8 March). The campaign theme for 2025 is ‘Accelerate Action’ and is a worldwide call to acknowledge strategies, resources and activity that positively impact women's advancement. In this blog, we explore four key areas of patient safety relating to women’s health, where we believe action needs to be accelerated: Pain management. Waiting times for elective gynaecology care. Redress for harmed patients. Disparities in maternal outcomes. Pain management Evidence shows that women are in pain more often and more severely than men.[1,2] They are also more likely to have their pain dismissed or underestimated[3], with racial biases leaving Black women particularly vulnerable.[4] These inequities can prolong women’s suffering of both acute and chronic pain, and can lead to delays in diagnoses and treatment. Women’s pain is dismissed in areas of healthcare relevant to both men and women, for example cardiology,[5] as well as in areas specific to the female body, for example gynaecology or maternity.[6] At Patient Safety Learning, we have heard too many accounts of patients attending gynaecology procedures where they have experienced unexpected high levels of pain that has not been managed or responded to appropriately.[7,8,9,10] In many cases, these experiences have led to an erosion of trust in the healthcare system and an increased anxiety in attending future appointments that may play a critical role in their outcomes. There is no nationally adopted, standardised patient feedback collection around pain experiences in gynaecology procedures. If patient-reported outcome measures were routinely collected, this data could be used by healthcare organisations to help identify the scale of harm and amplify the voices of the women affected so that pain is better managed and no one is at risk of trauma. These feedback mechanisms need to be co-designed with those who have lived experience to ensure the data being captured is meaningful, is designed to identify inequalities and used to improve care for all women. Most importantly, whatever the setting, it is critical that women’s experiences of pain whether chronic or acute, are listened to, believed and appropriately responded to. Patients should be empowered with the information, compassion and respect needed to place them at the heart of the decision making around their pain management. Waiting times for elective gynaecology care A 2022 report from the Royal College of Obstetricians and Gynaecologists showed the number of women waiting over a year for elective gynaecology care in England had increased from 66 before the pandemic to nearly 25,000.[11] Their follow up report in 2024 showed that waiting lists had worsened in all parts of the UK, with those living in areas of deprivation most likely to wait longest.[12] With debilitating conditions like endometriosis, already notorious for taking many years to diagnose,[13,14] evidence of continued setbacks in this area, rather than progress, is devastating. Women seeking help and treatment for life-limiting symptoms are being left without the support they need and fearful that their health will worsen. This often has a negative repercussion on other areas of life, including relationships, work and mental health.[15] The Women’s Health Strategy published in 2022 sets out plans for the roll-out of women’s health hubs to provide a ‘one-stop shop’, where services are centred on women’s needs, better coordination of care and reducing the elective backlog.[16] The Strategy notes the wide and varied range of stakeholders that will need to be involved in this effort and states that the Government” will develop a delivery plan for the commitments set out in this strategy”. However, there is currently no timetable for this, or indication of what resources may be allocated to support this work. Despite some early evidence of their success in reducing waiting times,[17] there are concerns that central support for the women’s health hubs has recently been removed,[18,19] and that women’s health has been deprioritised in the NHS health plans.[20] Women’s health needs to urgently be prioritised and invested in to address the worsening wait times for gynaecological care. Healthcare professionals must be given access to the resources needed to be able to provide high quality, safe care to all women so that inequalities do not continue to widen. Without this, patients will continue to suffer avoidable pain and are at risk of further harm relating to their physical and mental health outcomes. Redress for harmed patients Last year the Patient Safety Commissioner for England published The Hughes Report, which sets out options for redress for those who have been harmed by valproate and pelvic mesh.[21] Patient Safety Learning believes, like many individual patients and patient groups, that there must be redress options for patients harmed by the interventions covered by The Independent Medicines and Medical Devices Safety (IMMDS) Review.[22] There is considerable evidence that for many patients the clinical negligence route is simply not viable. In the absence of any system of redress, this leaves them with no assistance to help meet the cost of any additional care and support they may need. We also believe that redress should extend to those affected by hormone pregnancy tests, who fell outside of the scope of The Hughes Report’s recommendations. Excluding patients and family members affected by hormone pregnancy tests from redress is not acceptable or in keeping with the spirit of the IMMDS Review’s recommendations. We believe the Government must respond to this report promptly and take steps to deliver redress for all those affected by pelvic mesh, sodium valproate and hormone pregnancy tests as a matter of urgency. Disparities in maternal outcomes The ‘Saving Lives, Improving Mothers' Care annual reports include: data on women who died during or up to one year after pregnancy in the UK lessons learned from the UK and Ireland confidential enquiries into maternal deaths and morbidity.[23] The most recent report[24] highlights a continuation of inequalities with maternal mortality rates three times as high for women from Black ethnic backgrounds and twice as high for women from Asian ethnic backgrounds when compared to White women. The data also showed that women living in the most deprived areas of the UK and Ireland were twice as likely to die compared to those living in the least deprived areas. The report also highlighted barriers to accessing maternity care for women who had recently arrived in the UK. Many didn’t get the support they needed to understand how to register with a GP to start receiving maternity care and would present for the first time in an emergency setting. Language and literacy barriers were also evident, with patient needs being poorly assessed, recorded and met. The availability of interpreters and accessible written information was inconsistent. It is clear that a continued focus is needed to ensure disparities in maternity are better understood and addressed. All women have the right to access safe maternity care, free from racism, bias and a postcode lottery. Access to information in an accessible format that enables women to give consent to interventions and make decisions about their health and the health of their babies is also vital.[25] Translation capabilities within the health service must be prioritised and properly resourced across the board for these inequalities to be addressed. Summary There are many barriers to women receiving safe and equitable care. This blog has touched on just a few of the areas where action needs to be accelerated. We must recognise there are complex inter-relationships that compound these issues – intersectionality is an essential consideration. It is important to look at all variables in order to effectively identify the barriers and solutions to safer and more equitable care. In the coming months, we hope to see the importance of patient safety in women’s health emphasised and supported through the development of the NHS 10 Year Health Plan. The Royal College of Obstetricians and Gynaecologists has also recently launched a project to identify the most pressing unanswered questions in the health of women and people from the perspective of members of the public themselves.[26] We look forward to hearing more about their findings. We continue to await the Government’s response to the Hughes Report and to support the IMMDS Review’s recommendations for redress for those who have been harmed by valproate, pelvic mesh and hormone pregnancy tests. Helen Hughes, Chief Executive Officer of Patient Safety Learning says: “All patients have the right to access safe care, free from avoidable pain and harm. Women’s health has for centuries been side-lined and action must be accelerated now to address the inequities and barriers that continue to exist. This has to start with a focus on listening to and believing women when they share their experiences. Where harm has occurred, it is vital that we learn from the mistakes made and that this harm is appropriately responded to”. References Nurofen. Gender Pain Gap Index Report Year 3. Oct 2024. Editorial. Gendered pain: a call for recognition and health equity. eClinicalMedicine Mar 2024 Vol 69. C de C Williams, A. Analysis: Women’s pain is routinely underestimated, and gender stereotypes are to blame. The Conversation. Apr 2021. Hoffman KM, Trawalter S, Axt JR et al. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016 Apr 19;113. Nabel EG. Coronary heart disease in women--an ounce of prevention. N Engl J Med. 2000 Aug 24;343. J. H. Bamber, R. Goldacre, D. N. Lucas et al. A national cohort study to investigate the association between ethnicity and the provision of care in obstetric anaesthesia in England between 2011 and 2021. Anaesthesia, 78(7), 820-829. Patient Safety Learning - the hub. Painful hysteroscopy. Community forum - accessed 03/03/25. Patient Safety Learning - the hub. Pain during IUD fitting. Community forum- accessed 03/03/25. Cohen, L. The pain of my IUD fitting was horrific…and I’m not alone. Patient Safety Learning - the hub. Jun 2021. Anonymous. My experience of an IUD insertion: frozen with shock - no one was asking if I was OK. Patient Safety Learning - the hub. Jan 2025. Royal College of Obstetricians and Gynaecologists. Left for too long. 2022. Royal College of Obstetricians and Gynaecologists. Waiting for a way forward. 2024. Endometriosis UK. “Dismissed, ignored and belittled”. The long road to endometriosis diagnosis in the UK. Mar 2024. All Party Parliamentary Group (APPG) on Endometriosis. APPG on Endometriosis Inquiry Report 2020. Endometriosis in the UK: time for change. 2020. Royal College of Obstetricians and Gynaecologists. New RCOG report reveals devastating impact of UK gynaecology care crisis on women and NHS staff. Nov 2024. NHS England. Women's Health Strategy for England. Aug 2022. Crouch, H. Women's Health Hub aims to reduce wait lists for gynaecology. Barts Health NHS Trust. Nov 2024. Royal College of Obstetricians and Gynaecologists. RCOG responds to reports that central support for women’s health hubs will end. Jan 2025. Donnelly, L. Wes Streeting dumps women's health target from NHS plan. The Telegraph online. Jan 2025. NHS England. NHS England 2025/26 priorities and operational planning guidance. Jan 2025. Patient Safety Commissioner. The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh. Feb 2024. Cumberlege, J. First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review. July 2020. The National Perinatal Epidemiology Unit, MBRRACE-UK. Saving Lives, Improving Mothers' Care annual reports. The National Perinatal Epidemiology Unit, MBRRACE-UK. Saving Lives, Improving Mothers' Care 2024 - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2020-22. Oct 2024. NHS England. Accessible Information Standard (updated Aug 2017). Royal College of Obstetricians and Gynaecologists. Women's Health Research Priorities (WHRP). Jan 2025. Related hub reading Top picks: Women's health inequity Dangerous exclusions: The risk to patient safety of sex and gender bias Failures of informed consent and the impact on women’s health: a Patient Safety Learning blog Gender bias: A threat to women’s health Top picks: Six resources about improving access to cervical screening The normalisation of women’s pain Top Picks: Women campaigning for patient safety TIGER UK: A new network for people passionate about improving gynaecology experiences First Do No Harm APPG public meeting on redress: Speech from Kath Sansom Fitting coils: developing a safe and supportive service- Posted
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News Article
US gynaecologist charged with sexual abuse and performing unnecessary procedures
Patient Safety Learning posted a news article in News
A gynecologist who is accused of sexually abusing four women in Memphis, Tennessee, and reused unsanitary medical devices in unnecessary procedures was arrested on Friday. Sanjeev Kumar, 44, was charged with sexual abuse, medical fraud and illicitly reusing unsanitary medical devices after he enticed four women to travel across state lines to his clinic, where he subjected them to sexual abuse under the guise of medical procedures. Kumar’s arrest adds to a spate of cases in the US involving medical physicians being at least accused of violating patients in their most vulnerable moments. Between 2019 and 2024, Kumar allegedly performed unnecessary gynecologic procedures using medical devices that were kept in unsanitary conditions and improperly reused, with some designated for single use or requiring sterilization. According to the indictment authorities obtained against him, the 44-year-old Kumar did not inform patients about this practice before inserting the devices during procedures. Kumar, who worked at the Poplar Avenue Clinic, then billed the federal Medicare and Medicaid insurance programs for hysteroscopy biopsy services as if the treatments were medically necessary – and as if he had used new or properly sterilised equipment. Read full story Source: The Guardian, 2 March 2025- Posted
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Reproductive health in developing countries in ‘chaos’ after Trump aid freeze
Patient Safety Learning posted a news article in News
Donald Trump’s 90-day freeze on foreign aid has caused “absolute chaos” on the ground in developing countries, with vital reproductive health services being forced to halt treatment, charities have warned. Immediately after his inauguration in January, US President Donald Trump announced an immediate 90-day freeze on all USAID including family planning, which, amounts annually to over $600 million, according to the Guttmacher Institute, a leading reproductive health policy organisation. That will mean an estimated 11.7 million women and girls losing access to contraception, resulting in 4.2 million unintended pregnancies and, 8,340 maternal deaths, as well as a surge in unsafe abortions, according to Marie Stopes International, a non-governmental organisation providing contraception and safe abortion services in 37 countries around the world. Speaking during a panel event at the London premiere of The A-Word, The Independent’s documentary about reproductive rights in America, Sarah Shaw, MSI associate director of advocacy, said in some developing countries USAID funding accounts for almost 70% of the health budget. For every week without USAID, nearly one million women and girls worldwide are denied contraceptive care, according to analysis from the Guttmacher Institute. Shaw describes how right now, $150 million worth of sexual and reproductive health essential medicines are sitting in warehouses in countries with extremely high needs. “There is literally no way of getting that stock from the warehouse into the clinics because the distribution systems have all ground to a halt because the US government didn’t just fund services, it funded the health infrastructure,” she added. Read full story Source: The Independent. 28 February 2025- Posted
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In this opinion piece for the BMJ, Stephanie O’Donohue explains how a collaborative dialogue between clinician and patient can make a huge difference to patient experiences of gynaecology procedures. With a focus on pain, Stephanie draws on her own experiences, both positive and negative, to illustrate the value of shared-decision making.- Posted
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Gynaecology procedures: patient survey example
Patient_Safety_Learning posted an article in Women's health
The attached patient survey has been shared by Jonathan Lord, a Consultant Gynaecologist at Royal Cornwall Hospitals NHS Trust. It is given to all patients who attend their ambulatory clinic for a gynaecology procedure. Their procedures include: Hysteroscopy MVAs (uterine evacuation for abortion and miscarriage) Ablations IUD/coil removals and fittings Z-plasty (vulval revision) Bartholin’s cyst/abscess procedures. The feedback is used to review and improve the service provided.- Posted
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Content Article
PROMPT (Practical Obstetric Multi-Professional Training) is an evidence-based training package for local maternity staff, previously associated with improvements in maternal and neonatal outcomes, reduction in litigation related to preventable harm and improved safety culture. PROMPT has previously been disseminated internationally using a train-the-trainer model. However, this has been associated with variations in uptake, fidelity and impact. In Wales, the project was supported by Welsh Government, and a structured scaling plan was developed, encompassing ongoing implementation support from a multi-professional team. This study describes the approach and process measures for national scaling of PROMPT across 12 obstetric-led maternity units in Wales. -
News Article
Beware ill-fitting menstrual cups, warn doctors
Patient Safety Learning posted a news article in News
Doctors are advising women to take care using menstrual cups, after one user developed temporary kidney problems because the cup was misaligned. The patient, in her 30s, had been experiencing intermittent pelvic pain and blood in her urine for months, but had not linked the symptoms to the menstrual cup, which is used to catch monthly blood flow. Although exceedingly rare, a poorly positioned cup inside the vaginal passage can press on other nearby structures, such as ureters - tubes carrying urine to the bladder, according to Danish doctors quoted in the British Medical Journal, external. Selecting the appropriate size cup is important, as well as inserting it properly, doctors have stressed. The patient made a complete recovery, but doctors have warned: "Correct positioning, along with choosing the correct cup shape and size, is important to prevent negative effects on the upper urinary tract. "Menstrual cups can be bought and used without clinical advice from a health professional, which emphasises the importance of detailed and clear patient information material." Read full story Source: BBC News, 11 February 2025- Posted
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RCOG: Women's Health Research Priorities survey
Patient Safety Learning posted an article in Women's health
The Royal College of Obstetricians and Gynaecologists (RCOG) is undertaking an important project to identify the most critical unanswered research questions for women’s health. To inform this, they want to hear from women, people and stakeholders based in the UK. The results of this project will be used by the RCOG to shape future UK women’s health research. The project aims to identify the most pressing unanswered questions in the health of women and people from the perspective of members of the public themselves. The topics that may be covered within this work are broad ranging and could include: Gynaecological conditions Fertility and early pregnancy Obstetrics and maternity care Abortion Sexual and reproductive health Health during older age.- Posted
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Nine in 10 women don’t know signs of heavy periods, research says
Patient Safety Learning posted a news article in News
As few as one in ten women can pinpoint signs of heavy menstrual bleeding, as one of the UK’s top women’s health doctors says women and girls were “suffering in silence” from period problems, despite the availability of potential treatments. Research by the charity Wellbeing of Women found that one in two women (51%) said their period negatively impacts their life, and the same proportion avoid exercise when on their period while nearly three in five (57%) experienced problems at work because of their period. A Censuswide survey of 3000 people, commissioned by the charity, found that half of women also said their period symptoms had been dismissed, and just under a quarter said they felt their symptoms had been dismissed by a healthcare professional. On Tuesday, the charity launched a new period symptom checker to help women and girls understand more about their menstrual cycle, which could help women talk to their GP about receiving better treatment. The checker, which takes just four minutes to complete, asks various questions about health and reproductive symptoms, and at the end of the checker drafts a letter for women to give to their GP which can help open discussions about symptoms. Wellbeing of Women said many women are "putting up with" disabling levels of pain and heavy bleeding, waiting for an average of two years before seeking help. Professor Dame Lesley Regan, who was appointed as the first-ever Women's Health Ambassador for England under the Conservative government and is the chairwoman of Wellbeing of Women, said: "It is shocking that women are still suffering severe period pain and heavy bleeding in silence. "A variety of medical treatments could be offered to girls and women with these distressing conditions. "We hope that our new Period Symptom Checker will encourage women to speak up and seek help for their period problems. "It aims to promote better engagement with GPs and other community healthcare professionals by creating a letter that outlines how their symptoms are affecting their everyday lives." Read full story Source: The Independent, 11 February 2025- Posted
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In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. Peter and Helen speak to Martyn Pitman, who worked as a consultant obstetrician and gynaecologist in the NHS for more than 20 years. Martyn describes how grievances were raised against him by colleagues after he shared concerns about the safety of maternity services at the trust he worked for. He believes these complaints were raised as a response to him speaking up about his patient safety concerns and they eventually resulted in Martyn losing his job and career. Martyn describes the impact of his experience over the last few years on his mental health and highlights the unrelenting support he received from individuals he had looked after throughout his career as an consultant. He talks about how the current legal and regulatory framework is ineffective in protecting whistleblowers from retaliatory action. He also shares why we need more effective ways to hold NHS leaders and managers to account and describes the role that regulation might play in this. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series- Posted
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In this short blog, Stephanie O'Donohue tells us about a brand new network called TIGER UK. Based on the belief that progress lies in collaboration, TIGER UK is open to anyone who is passionate about sharing insights and working together to improve gynaecology experiences. Find out how a personal experience motivated her to start the group, and how you can join. The motivation behind TIGER UK I'm Stephanie O'Donohue, the founder of TIGER UK. Fifteen years ago, I had an awful experience of a gynaecological procedure. I wasn’t forewarned of the possibility of high levels of pain, my distress wasn’t responded to well and there was no pain relief offered to me other than the advice to take paracetamol. Sadly, I have learnt that my experience is far from rare. I have since been advocating for improvements to be made in gynaecology care, amplifying the patient voice and sharing insights from key healthcare professionals who understand the need for change. My vision? That positive gynaecology experiences become standard and that no one leaves a gynaecology appointment having suffered avoidable trauma. A collective force for good I have found that different perspectives and knowledge surrounding gynaecology care improvements seem to largely exist in isolation – the clinical knowledge, lived experience and research findings. TIGER UK is based on the belief that collaboration is key if we are to make progress in this area. Together we will create a safe space for different experiences and knowledge to be shared, listened to, captured and learned from. We will empower each other to understand the actions we might take – big or small – to contribute to meaningful change. When we have enough members, we will be sending out details of our first webinar and our patient experience survey. We'll also be asking healthcare staff to share their insights through a survey. So why not join or follow us to see how we can influence gynaecology care to be as compassionate, timely, pain-free and dignified as possible. Join TIGER UK on: LinkedIn Facebook Please note, TIGER UK members should be UK-based. Related reading Pain and the role of patient information in gynaecology- Posted
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Women in Britain are paying up to £11,154 for a hysterectomy in a private hospital, amid huge delays for NHS gynaecological care, research reveals. The cost of undergoing the procedure privately has soared by 19% from £7,385 in 2021 to £8,795 last year, at a time when NHS waiting lists have risen sharply. The disclosure has prompted claims independent sector healthcare providers are taking advantage of long waits for health service treatment by increasing their prices. The number of women waiting for care in an NHS hospital for conditions such as fibroids and endometriosis more than doubled from 360,400 when Covid struck in 2020 to 749,329, the Royal College of Obstetricians and Gynaecologists has shown. In November 584,607 women in England were on an NHS gynaecological waiting list, with 20,809 of them being on the list for more than a year, which led to a growing number of women going private to beat delays. Dr Ranee Thakar, the RCOG’s president, said untreated conditions “have a devastating impact on almost every aspect of [women’s] lives, including their physical and mental health, and their ability to work and socialise. “Long NHS waiting times are certainly a factor in why some women choose to have their surgery privately,” she added. Read full story Source: The Guardian, 24 January 2025- Posted
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The following account has been shared with Patient Safety Learning anonymously. We’d like to thank the patient for sharing their experience to help raise awareness of the patient safety issues surrounding IUD procedures. *Trigger warning: Some people may find the following account distressing to read. Please note that experiences of pain and the care given during gynaecological procedures vary greatly. I came across Patient Safety Learning's forum page about IUD experiences after having my first Mirena coil fitting. I felt unable to comprehend the sense of violation and trauma I had just experienced. A suspected cancer referral I was referred by my GP on the 'suspected cancer pathway' for some post menopausal bleeding. On a positive note, I cannot fault the system and the speed with which I was seen, but my treatment during the appointment was so awful I am actually shaking again as I write this. Although this was an urgent referral, I was not particularly anxious as I felt the erratic bleeding I was experiencing was likely due to my hormone replacement therapy (HRT) regime. I was expecting a consultation and a scan, possibly a hysteroscopy; with a change in my HRT regime being the likely outcome. Off to a bad start The appointment started off on the wrong foot with the consultant asking if I thought there was actually any benefit in taking HRT, likening it to long term antidepressant usage. I explained that, as a runner, I was largely taking it for the well researched bone health benefits but I found his question rather belittling with its implied suggestion of menopause being all in the mind. He went on to advise that a Mirena coil would be a better option for me for HRT which I agreed I would consider. He did not explain the procedure or the possible complications or risks. I will add here that I was sterilised at the age of 30 after my second child. Contraception wasn't something I'd had to consider for the past 23 years so it wasn't really something I'd chatted about with friends. I had heard rumours of bad experiences but took it with a pinch of salt - there are after all rumours of bad experiences in all walks of life. I could not have been more wrong. The procedure - I was frozen with shock I stripped to the waist, legs in stirrups and the consultant explained he would first perform a transvaginal ultrasound to check the thickness of the endometrium - this was reassuringly normal. Then without any warning, he told me he was just going to inject some anaesthetic into my cervix and fit a coil. I had no time to prepare myself at all for this - I didn't really feel I had consented but he and both nurses in the room were acting as though this was all very normal. The injections weren't pleasant in themselves, particularly as I wasn't expecting them. There was no pause at all before I felt awful searing pain and pulling sensations, nothing was being explained prior to it being performed. Something was said about my cervix needing to be dilated and it seemed to take forever. I didn't shout out, I didn't ask him to stop, i just let the tears come. I felt absolutely frozen with shock throughout the whole procedure - no one was asking if I was OK so I assumed I was being a bit of a baby. He announced the coil was in place and I was sat up. Lack of compassion Within seconds I was flooded with heat, I wanted to be sick and everything started to go black. The nurse laid me back down and I remember coming round with a fan on my face and my feet elevated on a stool. The nurse seemed very chilled about the whole thing and just said - oh you're a fainter! I am 53 and have only ever fainted once in my life and that was over 20 years ago. The consultant did not even look at me, let alone speak. I actually felt embarrassed and just wanted to get out as fast as possible. I was slowly sat up and the nurse went and got my daughter from the waiting room. My daughter was told that I felt a little bit wobbly and suggested we go get a coffee from the hospital coffee shop, no one checked my pulse or blood pressure and they seemed keen to get on so we dutifully left. I felt horrific. I couldn't make it to the coffee shop at first. I had to sit down with my head between my legs twice in the hospital corridor as I felt so faint, sick and hot. I've no idea how I dragged myself to the cafe as I continued to feel so awful. After 30 minutes of this my daughter went to get help. She was advised to get a wheelchair and take me back to the clinic which she did. We were laughingly told by the receptionist that I wasn't the first and wouldn't be the last and that we were welcome to sit in a quiet room until I felt better. She brought me a cup of tea but no nurse checked on me at all. It took almost an hour after the fitting before I could stand for long enough to get out to the car. We just sort of slunk out and that was it. Later when I felt better, I checked my sports watch data. My heart rate had averaged 46 for over 30 minutes with the lowest reading being 38 beats per minute. Left in disbelief but inspired to advocate for change How is this happening in 2024? The thought of ever having another pelvic exam, smear test or anything else makes me feel sick and shaky. Where do people go for support with this? It's not ok. I work in Primary Care and often refer women on the same pathway I have just been through. I will absolutely be raising my concerns with the care provider involved. I also have since spoken to a number of women of perimenopausal age and have been horrified to hear so many upsetting experiences from others. It does seem that there is an embedded culture within gynaecological care within which women are neither heard nor permitted agency over their own bodies. Two weeks on and I am feeling far less traumatised, but incredibly inspired to help bring an end to this poor treatment of women. It can be easier to speak up in advocacy than solely for oneself. Share your experience Have you had a gynaecological procedure recently? Would like to share your experience - positive or negative? What makes the difference when it comes to feeling safe or unsafe when accessing these services? You can comment below (sign up first for free), or contact our editorial team at [email protected]. You can also add your experience of a hysteroscopy or IUD procedure to our community forum. Pain during IUD fitting Painful hysteroscopy Related reading Pain experiences during intrauterine device procedures: a thematic analysis of tweets (11 June 2024) Failures of informed consent and the impact on women’s health: a Patient Safety Learning blog Gynecology has a pain problem Our discomfort is routine. What if it didn’t have to be? (1 June 2022) Fitting coils: developing a safe and supportive service The ripples of trauma caused by severe pain during IUD procedures (BMJ Opinion, July 2021) -
News Article
Questions have been raised about one of the UK’s most well-known fertility doctors after two people whose parents attended his clinic reportedly made the shock discovery that their biological father is a lab scientist who worked in the same hospital as the physician. Patrick Steptoe, who died in 1988, was an obstetrician and gynaecologist who helped develop in vitro fertilisation (IVF) and ran a fertility clinic in Oldham Hospital, Greater Manchester. The parents of Roz Snyder, 52, and David Gertler, 51, attended the clinic around the 1970s after struggling to conceive children. Ms Snyder and Mr Gertler were shocked after DNA tests revealed they are half-siblings, the Telegraph reported. The pair were recently alerted by the genealogy website Ancestry that their late fathers are not their biological ones, but that they shared a biological father in Roy Hollihead, who ran a pathology laboratory one floor above Dr Steptoe’s clinic. The 84-year-old told Ms Snyder that Dr Steptoe “used sperm from lab staff, medical students and doctors… but no records of any were kept” and told the Telegraph that he was not sure the hospital was aware of the apparent scheme. Northern Care Alliance, the NHS trust that now runs Oldham Hospital, said it had no records of Dr Steptoe’s clinic, according to the Telegraph. Read full story Source: The Independent, 23 December 2024 -
News Article
One in four babies in England delivered by caesarean section, NHS data shows
Patient Safety Learning posted a news article in News
One in four babies born in NHS hospitals in England last year were delivered by caesarean section, official figures show. The gradual increase in the number of caesarean births over the past decade is due to a growing number of complex pregnancies and births, caused by factors including rising obesity rates and women waiting until they are older to have children. The proportion of spontaneous deliveries that do not involve drugs or other medical interventions has steadily declined in the last 10 years. “Over the past decade, there has been a gradual national increase in the number of caesareans,” said Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists (RCOG). “A major factor of this is the growing number of complex births. We are seeing national rising rates of obesity and people choosing to have children at a later stage in their life, both of which can increase the chance of complications.” Most women seek a C-section for medical reasons, but also have the right to opt for one based on personal preference according to guidelines published by the National Institute for Health and Care Excellence. These state that if a mother does not want a vaginal birth after discussing the benefits and risks, the medic should “offer a planned caesarean birth for women requesting a caesarean birth”. In 2022, hospitals in England were told to abandon targets aimed at limiting the number caesarean sections carried out to below 20%, over fears for the safety of mothers and babies. At the time, the chief midwife described the targets as potentially unsafe. This followed the Royal College of Midwives formally abandoned its normal birth campaign in 2017, after years of promoting vaginal births as preferable. Dr Thakar said: “The RCOG does not promote one form of birth over another. Women should be supported to make an informed decision about how they want to give birth, including a discussion on the risks and benefits of both vaginal and caesarean births. The safety and care of the woman and baby during pregnancy, labour and birth should always be the main focus.” Read full story Source: The Guardian, 16 December 2024