Pioneers in patient care: consultants leading change
South West
Innovations: A dedicated abortion clinic and the introduction of an investigation clinic for post-menopausal bleeding
Mr John Edwards
Poole Hospital
Job title: Consultant obstetrician and gynaecologist
Specialty: Obstetrics and gynaecology
The disorganised process of care women encountered when having an abortion at Poole Hospital led consultant obstetrician and gynaecologist Mr John Edwards to radically re-organise the process. “I wanted to make this traumatic experience a little easier for the women involved,” says Mr Edwards.
He says: “Traditionally, termination of pregnancy has been a badly organised and under- resourced part of the gynaecological service and one which is viewed as an intrusion into proper clinical activity. It is a problem that involves both huge emotional aspects and difficulties in administration due to this ‘add-on’ nature.
“In Poole, and across the rest of the UK, GPs experienced difficulties in finding clinical appointments for these patients. Problems were also experienced in funding operating times – so patients were added on to the end of whatever operating list was available. Patients often found themselves in a disorganised process of care involving frustrated GPs, rushed clinical appointments, no advice, counselling or information and women were being discharged without appropriate support or fundamental details such as ongoing contraceptive advice.”
“The re-organisation of services at Poole streamlined the entire process,” says Mr Edwards. “We have introduced a nurse counsellor and an additional sessional payment for a consultant to undertake a dedicated termination list. A central point of contact has also been created on the Day Ward, which can provide GPs with a date for the patient’s outpatient appointment.
“Once the patient arrives in the outpatients department she is met by the nurse counsellor who is able to discuss with her any anxieties she may have and discuss issues like ongoing contraception. A proforma regarding the processes on the day ward is completed and the patient is given a survey form to complete so the patients’ feedback can be properly assessed. A date for the surgical procedure is also given at this time and the patient is given full instructions regarding the requirements for pre-treatment. After treatment the patient is seen again by the nurse counsellor who can address any further questions the patient may have.”
Mr Edwards says: “As a result the process of patient care is significantly improved. Administration arrangements for primary care are much simplified and all the patients receive counselling and information before and after the treatment that they need.”
Mr Edwards has also introduced a post-menopausal bleeding outpatient investigation clinic to treat a very common condition which always requires investigation, he says. “Patients are referred from their GP and once at the clinic receive a consultation, scan and if need be, a biopsy, all in one visit. The system means patients can have all relevant investigations during one visit, and therefore cancer can be detected earlier, and treated accordingly.”
“It is a major benefit to women that these services are provided in a dedicated women’s health clinic, outside the main hospital. It is staffed by a specialist group of individuals who are fully aware of the integration of all the aspects of care involved into one unified and very functional clinical environment,” Mr Edwards adds.