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Found 262 results
  1. Content Article
    In this video, Dr Gail Busby and Dr Andrew Heck discuss the option of sedation for hysteroscopy. Hysteroscopy involves inserting a narrow telescope into the womb (uterus) to see inside. There are several options for pain relief for this procedure. Dr Heck touches on all of the options and discusses sedation in detail. Further reading on the hub: Painful hysteroscopy discussion thread Through the hysteroscope: Reflections of a gynaecologist
  2. News Article
    A Northern Ireland nurse failed to properly manage a dying patient's pain on the last night of her life, a tribunal has heard. Veteran staff nurse Bernard McGrail has been issued with a four-month suspension order over his failings in dealing with an end-of-life care resident while on a night shift at a Spa Nursing Homes Group facility in July, 2021. A Nursing and Midwifery Council fitness to practice panel said Mr McGrail's misconduct had caused "emotional distress" to the family of the woman, identified as Resident A. It added: "There was a real risk of harm to Resident A through the inadequate management of their pain on their last evening." A remorseful and apologetic Mr McGrail admitted a series of allegations including: a failure to appropriately manage Resident A’s pain; failure to investigate whether Resident A’s syringe driver was working correctly and a failure to escalate that the alarm on Resident A’s syringe driver sounded repeatedly. Mr McGrail also admitted that without clinical justification, he administered a 5mg doses of Apixiban to Resident B on three dates on October 2020. And on occasions between April 2020 and May 2022 failed to administer and/or record the administration of named medications to six other residents. Read full story (paywalled) Source: Belfast Telegraph, 12 May 2025
  3. Content Article
    Opioid-responsive cancer pain is a term used to describe cancer pain that can be effectively managed with opioid painkiller medications. This review aimed to explore a paradigm shift in the definition of opioid-responsive cancer pain. The authors argue that looking at the apparently unique properties of opioid-responsive cancer pain allows better understanding of the process by which acute (short term) pain may or may not transition into chronic (long term) pain.
  4. News Article
    People from across the UK have shared their heartbreaking experiences of living with endometriosis - as they say the NHS is “failing” them. Living with the inflammatory condition is an uphill battle, from getting a diagnosis to navigating daily life and even accessing healthcare. For Endometriosis Awareness Month, National World launched the campaign Endo the Battle to amplify the voices of those living with endometriosis across the UK and highlight the challenges patients face. This campaign surveyed members of the public to share their stories with endometriosis. They received almost 400 responses, highlighting delays in getting a diagnosis, the crippling costs of paying for private care and knowledge gaps within the healthcare sector. Read full story Source: The Scotsman, 11 April 2025
  5. News Article
    Almost 1.7 million people have had hernia mesh surgery in the NHS since 2004, figures released by the NHS have revealed. The statistics do not include people who’ve had hernia mesh in private hospitals. Nobody can say how many are now suffering complications – because patients are not tracked for their lifetime. Yet campaigners and academics globally say it can take many years for mesh to cause problems- so the scale of suffering falls into a black hole of missing data. Moreover, support groups show that patients are being implanted with hernia mesh in their thousands ever year – but nobody is being given fully informed consent of the potential risks such as pain, loss of mobility, loss of sex life and losing the ability to have children. Also autoimmune diseases and allergies caused by the plastic mesh material. The figures came to light thanks to a Written Parliamentary Question asked by MP Sharon Hodgson, chair of the All Party Parliamentary Group for First Do No Harm. In its response, The Department of Health say: “Clinicians are expected to inform patients about risks associated with recommended treatments, including reasonable alternatives, to enable informed consent and a balanced patient decision.” But campaign group Sling The Mesh says that the majority of people are told hernia mesh is ‘not the mesh in the media’, or it is a new mesh, or that this is a gold standard treatment and that mesh receives undeserved negative attention. Read full story Source: Sling the Mesh, 25 March 2025
  6. 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
  7. Community Post
    *Trigger warning. This post includes personal gynaecological experiences of a traumatic nature. What is your experience of having a hysteroscopy? We would like to hear - good or bad so that we can help campaign for safer, harm free care. You can read Patient Safety Learning's blog about improving hysteroscopy safety here. You'll need to be a hub member to comment below, it's quick and easy to do. You can sign up here.
  8. News Article
    The UK High Street pharmacy chain Boots is asking customers to return packs of 500-milligram paracetamol tablets because a labelling error incorrectly states they are a different painkiller, aspirin. More than 110,000 packs, with the batch number 241005 and expiry date "12/2029" on the bottom, are affected. Customers can receive a full refund without a receipt. Boots and the supplier, Aspar Pharmaceuticals Limited, have begun a full investigation. The outer cardboard packaging is correctly labelled: "Paracetamol 500mg Tablets" but the inner foil blister pack of pills instead reads: "Aspirin 300mg Dispersable Tablets". The affected packs should not be used or kept, even if the error is known, as this could lead to an incorrect dose. Dr Stephanie Millican, from the Medicines and Healthcare Products Regulatory Agency (MHRA), said: "Patient safety is always our priority. "It is vitally important that you check the packaging of your Boots Paracetamol 500mg Tablets 16s - and if the batch number is 241005, you should stop using the product and return it to a Boots store for a full refund. "If you are unsure which pack you have purchased or have taken Boots Paracetamol 500mg Tablets and experienced any side effects, seek advice from a healthcare professional. "Please report any suspected adverse reactions via the MHRA's Yellow Card scheme. "If you have any questions or require further advice, please seek advice from your pharmacist or other relevant healthcare professional." Read full story Source: BBC News, 4 March 2025
  9. Content Article
    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
  10. Content Article
    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.
  11. Content Article
    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.  
  12. Content Article
    The objective of this study, published in BMJ Sexual & Reproductive Health, was to explore experiences of pain during medical abortion and provide patient-centred recommendations for improving abortion experience and pain counselling. Authors concluded: Abortion providers should use patient-centred recommendations to better prepare patients for pain during medical abortion. Setting realistic expectations can improve abortion experience and support informed method choice. Further research is needed to develop and test patient-centred counselling materials.
  13. Content Article
    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)
  14. News Article
    Women and girls are enduring years of pain because their reproductive conditions are being dismissed due to “medical misogyny”, according to a damning parliamentary report. The report, by the Women and Equalities committee, found that gynaecological conditions such as endometriosis and adenomyosis are treated with inadequate care due to a “pervasive stigma”, a lack of education by healthcare professionals and “medical misogyny”. The Commons select committee, which set out to examine the experiences of care women with reproductive conditions get in England, found that symptoms are often “normalised” and it can take years for women to get a diagnosis and treatment. The substandard gynaecological care cited by the report also includes routine IUD contraceptive fittings, cervical screenings, and hysteroscopies. The report said women were being left in pain and discomfort that “interferes with every aspect of their daily lives”, including their education, careers, relationships and fertility, while their conditions worsen. It also found there to be a “clear lack of awareness and understanding of women’s reproductive health conditions among primary healthcare practitioners” and concluded that gynaecological care is not being treated as a priority. Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions. Read full story Source: The Guardian, 11 December 2024
  15. Content Article
    Women’s reproductive health conditions, such as endometriosis, adenomyosis and heavy menstrual bleeding are highly prevalent in the UK. This report looks at the experiences of care women with reproductive conditions get in England. It states that many women find their symptoms dismissed and normalised by those they turn to for help. For some conditions, it highlights that accessing diagnosis and treatment can take years, leaving patients to endure pain that interferes with every aspect of their daily lives, while their conditions worsen. Key issues highlighted in this report include: Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions. Diagnosis is slow not only because reproductive health conditions often have non-specific symptoms, but because of a lack of expertise and resource. Women continue to undergo harrowing experiences of painful procedures such as hysteroscopy and having a contraceptive coil fitted. This includes not being informed of the potential pain, feeling they cannot stop procedures and not having access to sufficient pain relief. This is against medical best practice and guidelines. Women’s health hubs are being established across integrated care boards as part of the previous Government’s Women’s Health Strategy for England. The model has the potential to be a positive step towards providing the joined-up care and commissioning needed to support women with reproductive health conditions but it requires funding to do so effectively. Research into women’s reproductive health conditions lags behind other, similarly prevalent conditions. It is not adequately prioritised by funders or commissioners and is not incentivised enough in clinical academia. Although there are patches of progress since the Women’s Health Strategy for England published in 2022, it has been too slow. The strategy lacks an implementation plan and resource, yet studies show that increases in funding for gynaecology services for early diagnosis and treatment provide a significant return on investment, reduces the burden on primary and secondary care settings and helps reduce sick leave and unemployment. The report makes a wide range of recommendations relating to the following areas: Public understanding of reproductive health conditions. Accessing diagnosis. Accessing treatment and support. Training and standards. Research into women’s reproductive health conditions. In relation to the Women’s Health Strategy for England, it recommends that: This should be updated to include priorities for specific, common conditions. The Government commits to reducing waiting times for an endometriosis diagnosis to less than two years by the end of this Parliament and to improved understanding, diagnosis and treatment of heavy menstrual bleeding over the same period. The Government should allocate increased, ringfenced funding to support research into the causes, diagnosis and treatment of women’s reproductive health conditions. While increased funding will in itself attract more researchers to this area, NHS England and research bodies should also consider what steps they can take to increase interest among clinical academia. The Government should publish an implementation plan for the Women’s Health Strategy for England detailing timelines, costs and resource. Related reading Failures of informed consent and the impact on women’s health: a Patient Safety Learning blog Hysteroscopy: 6 calls for action to prevent avoidable harm Medicines, research and female hormones: a dangerous knowledge gap One hour with a women's health expert and finally I felt seen The normalisation of women’s pain Sex bias in pain management decisions Misogyny is a safety issue: a blog by Saira Sundar Dangerous exclusions: The risk to patient safety of sex and gender bias Unconscious bias: gynaecological pain, the elephant in the womb! Pain bias: The health inequality rarely discussed
  16. News Article
    When Alexandra McTeare was told she might have to wait three years for knee replacement surgery, she felt desperate. “Because of how miserable your life is, how small it has become,” she says. The problems with her knee started in 2017. “It was painful and would swell up, particularly in the heat.” She would take painkillers and keep her leg elevated when she was sitting down, and did stretching exercises for her muscles. But over the next few years, “it gradually got worse, the intervals between swelling episodes reduced and the pain increased”. It reached a point where it was no longer bearable. Ten years ago, McTeare could get a GP appointment within a week. “Now, you phone up and you’re lucky if you get an appointment within a month, and nine times out of 10 it’ll be a nurse practitioner.” McTeare has nothing against nurse practitioners; she used to be a nurse herself and she was working for the NHS when they were introduced to GP practices. “But they’re not appropriate for everything,” she says. “People do need to be able to see a GP.” Her knee didn’t get better. The opposite happened. “I didn’t believe it was a torn meniscus, it was going on and on, so I decided: to hell with it, I’ll pay and see somebody privately.” In March 2023, she saw an orthopaedic consultant, got an X-ray, was told she had arthritis in her knee and needed a total knee replacement. It took no more than half an hour and cost her £400. McTeare says she is lucky she could raise the money for a private consultation. But she wants to make something clear: “I have always despised private medicine.” Read full story Source: The Guardian, 27 November 2024 Related reading on the hub: One hour with a women's health expert and finally I felt seen
  17. News Article
    An estimated 20 terminally ill people in the UK die in unrelieved pain each day, according to a study by the independent Office of Health Economics (OHE). According to its research, to be presented to MPs on Tuesday, one in four people receiving palliative care in England have “unmet pain needs”. The OHE said it used “the most conservative of estimates [suggesting] the true number is likely to be much larger”. It calculated that, even with the “highest possible standards of hospice-level palliative care”, more than 7,300 people across the UK died with unrelieved pain in the last three months of their lives in 2023. In 2019, the comparable figure was nearly 6,400 people a year – a 15% increase over four years. It also said that fewer than 5% of terminally ill people in England who needed hospice care in 2023 received it. The OHE’s findings will feed into an intensifying debate over the legalisation of assisted dying ahead of a historic vote by MPs on Friday. The OHE said that irrespective of the outcome of Friday’s vote, investment in high-quality end-of-life care should be a “crucial component of the conversation around assisted dying”. Prof Graham Cookson, the organisation’s chief executive, said: “Our research finds that even assuming the highest standards of care, there remains a group for whom no amount of pain relief will ease their suffering in the last few months of their life. Read full story Source: The Guardian, 25 November 2024
  18. News Article
    Waiting lists for gynaecology appointments across the UK have more than doubled since February 2020, BBC research reveals. Records show around three-quarters of a million (755,046) women's health appointments are waiting to happen - up from 360,400 just before the pandemic. This would suggest around 630,000 people - at the very least - are on the list to be seen for problems that range from fibroids and endometriosis to incontinence and menopause care. Health ministers across the UK say they are working on plans to improve the situation, but health leaders say that women are being let down. "Women are being let down" and change is "urgently needed," says Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG). The college's new report, external looks at the impact on people waiting for care. "Gynaecology is the only elective speciality that solely treats women and has one of the worst waiting lists across the UK. "This reflects the persistent lack of priority given to women and women’s health, " Dr Thakar says. "Women are suffering. We know it is affecting their mental health. They are not able to go to work, they are not able to socialise." Read full story Source: BBC News, 18 November 2024 Further reading on the hub: One hour with a women's health expert and finally I felt seen The normalisation of women’s pain Sex bias in pain management decisions Misogyny is a safety issue: a blog by Saira Sundar
  19. Content Article
    Building on the findings documented in the the Royal College of Obstetricians and Gynaecologists (RCOG)’s previous report, Left for too long, the College commissioned new primary research to deepen our understanding of the size and impact of gynaecology waiting times on women and professionals across the system in the UK today. This report demonstrates that waiting lists for gynaecology in the UK have increased by a third since the previous report in 2022. Three quarters of a million women across the UK are now waiting for gynaecology treatment, and the data available nationally only captures a snapshot of the problem. The UK Government must deliver help now to improve care for women waiting: Continue to promote or expand schemes so that women can access free products to manage symptoms such as heavy menstrual bleeding and incontinence. Urgently prioritise improving communication with women waiting for gynaecology care and treatment, including giving women clarity on how long they should expect to wait. This work must include national, system and local leads from across the UK to ensure this is addressed at every level of operational delivery. Expand the accessible information and advice that is available at a national level which can be accessed on relevant NHS websites in England, Wales, Scotland and Northern Ireland. This should be co-produced with service users. Direct relevant system and local leads to urgently produce easy-to-read accessible bespoke summaries of what local networks and resources are available to women waiting on gynaecology lists so they can access additional support in their local communities, close to home. To support professionals, the report recommends that governments across the UK: Provide health services with the resources they need so they can protect gynaecology services against operational pressures, ensuring greater theatre and diagnostic capacity for gynaecology. Build, enable, and incentivise protected training time in gynaecology as part of any elective recovery plan, to future-proof care provision. Develop accessible professional guidance about supporting women on waiting lists, ensuring it is easily accessible nationally. Consider targeted funding at a national level to expedite the longest waits, to ensure equity. Work with leads at all levels of the system to develop or consolidate strategic support networks and partnerships, particularly those between primary and secondary care, to improve delivery of care. Thank all professionals at every part of the pathway working in women’s health, acknowledging the specific challenges in the wider system that are unique to women’s health. The UK Government must also act now to deliver for the future to ensure high-quality gynaecology care for every woman in the UK: Commit to expanding Women’s Health Hubs in an equitable and sustainable way so that they can be established, to ensure all women, wherever they live, can access care and support to manage their health across their whole life course. Set out how it plans to deliver, with sustainable funding attached, the future demand and supply requirements outlined in the Long Term Workforce Plan. This should include plans to recruit professionals and deliver retention measures to encourage professionals to stay in the NHS. Increase the levels of funding allocated to health across UK, including increased funding in devolved nations. Implement measures to improve education and awareness of gynaecology in wider society and create better access to education and training for professionals in gynaecology care. Consider how to build on existing digital initiatives, commit to expanding data collection in gynaecology and commit to ringfenced funding to enable research, patient participation, innovation and pilots to improve understanding and experiences of gynaecology. Further reading on the hub: One hour with a women's health expert and finally I felt seen The normalisation of women’s pain Sex bias in pain management decisions Misogyny is a safety issue: a blog by Saira Sundar
  20. News Article
    When Jonelle Roback went into hospital for a monthly drug treatment infusion, she was shocked to find a piece of paper on her waiting room chair informing her that her medication was suddenly being switched. Roback, 54, who was diagnosed with multiple sclerosis (MS) in 2009, had been on the intravenous drug Tysabri for 13 years, which had enabled her to “live a normal life”. But in May, as part of an NHS England drive to save money, Roback and other MS patients had their Tysabri medication changed to a “biosimilar” drug — a medicine that has been shown not to have any clinically meaningful differences from the originator drug — called Tyruko, which is cheaper. This marked the start of a horrible ordeal, with Roback experiencing debilitating symptoms including headaches, nausea, fatigue and severe bloating. She has since been in contact with dozens of other MS patients who have also experienced difficulties after having their medication switched, and they have expressed “urgent concerns” to the NHS about the failure to properly consult patients about their treatment. A group of more than 30 patients, including Roback, have written to the NHS chief executive, Amanda Pritchard, and the health secretary, Wes Streeting, to raise concerns about the “forced treatment switch”. The letter says that some patients had their drug changed without their knowledge, adding: “The lack of communication and transparency has led to serious side-effects, stress, loss of earnings, and other detrimental impacts on our lives. We have discovered that we are effectively being used as ‘guinea pigs’ for this new treatment.” Roback said it is vital that patients are given an active voice in medication decisions, adding: “It is outrageous that there was no discussion or consultation about changing the medication, just a piece of paper left on a chair. There was nothing we could do about it." Read full story (paywalled) Source: The Times, 25 October 2024
  21. News Article
    Women suffering complications from vaginal mesh implants, including after removal, are calling on the Government to overhaul the compensation process. Sharon Marchant, 61, from Bedfordshire, is one of thousands of women living with life-changing complications from a vaginal mesh implant. Vaginal mesh, which is made from the same material used to make drinks bottles, is an implant used to treat pelvic organ prolapse and stress urinary incontinence. For years it was viewed as the gold standard treatment for incontinence and prolapse in many women, but was later found to cause debilitating side effects including infection, pelvic and leg pain, difficulty urinating, pain during sex, and incontinence. Earlier this week it was revealed that propylene, the material used commonly used in vaginal mesh implants starts to degrade within 60 days of being implanted in the pelvis. Ms Marchant told i of the severe physical and mental pain she suffered due to her vaginal mesh implant. In 2014, she was recommended for a mesh implant after being diagnosed with stress-caused urinary incontinence. At the time, Ms Marchant did not know much about the vaginal mesh. “I hadn’t heard anything about it – good, bad or indifferent. “Having been a nurse in my younger years, I just thought, well, if they’re doing this, they must know what they’re doing,” she said. Within weeks she noticed something was wrong. “I could feel something that was uncomfortable. And so I had to do a self examination, and then I very quickly realised with the use of a mirror, there was a very large lump of blue mesh exposed.” She opted for a complete removal of the mesh and is relieved it is now gone. But as a result her stress incontinence worsened, requiring her to take new medication and does not feel comfortable enough to start a new relationship. “It’s just taken away a huge portion of my life,” she said. Some women are so desperate for the procedure they are travelling to the US and paying up to £30,000 for the procedure, i was told. Read full story Source: iNews, 26 October 2024
  22. Content Article
    Lee Hall sits down with Kath Sansom, who campaigns for people suffering complications from mesh implanted during surgery. Kath talks about the difficulties they face with often unremovable mesh in their bodies, the legal action taken against manufacturers, and how this scandal affects trust in our medical system.
  23. Content Article
    Chloe Bremner describes the pain she experiences from endometriosis as akin to having someone stuck inside you desperately trying to claw their way out. The 24-year-old has contended with pain from the chronic inflammatory condition since she was 14 but it was minimised, downplayed and misdiagnosed for nine years - with doctors mistaking her endometriosis for irritable bowel system and a tummy bug. Ms Bremner, who lives in Scotland, says she would routinely wake up in the middle of the night in excruciating pain. “There were countless nights and days spent in this state,” she tells The Independent. “And then throughout the years, that progressively got worse, and then it started to impact my nerves - down my legs and my hips.” “It's excruciating, and to the point where I was on morphine every day, and it didn't do anything,” Ms Bremner says. “I was still in absolute agony.” She explains that for years, nobody ever explained to her what endometriosis was, not even when she was diagnosed. “Endometriosis is a constant battle for validation and relief in a healthcare system that often fails its patients,” she says.
  24. Content Article
    From endometriosis to heart attacks, this Guardian article look into the causes and symptoms, and explore gender disparities in quality of care
  25. Content Article
    The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government. A review was launched after a BBC investigation found 9 in 10 NHS dental practices across the UK were not accepting new adult patients. Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found. The government says it invests more than £3bn a year in dentistry. But a damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly. The House of Commons Committee report with recommendations to government can be viewed at the link below. The Government has two months to respond.
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