Gynaecology Clinical Network

Clinical Lead: Mr. Ayman Ewies (SWBH), Project Manager: Kelly Hayward (BCPC)

The Gynaecology Clinical Network has made steady progress this year on its identified 12 priorities, which support both the elective recovery and improvement of cancer health outcomes but also focused on improving acute benign gynaecological care across the system whilst enabling the Black Country Trusts to achieve national targets and GIRFT recommendations.

Each priority was aligned to the Black Country Provider Collaborative strategic aims to improve access through recovery and restoration, improve quality through standardisation and levelling up, and to increase system resilience through transformation, consolidation, and specialisation.

Currently, of the identified priorities:

  • 83 per cent (ten of 12 priorities) were initiated during 22-23 financial year
  • Remaining 17 per cent (two priorities) are due to commence from August 23-24, subject to capacity and approval
  • 75 per cent (six of eight priorities) delivered on time or early
  • 25 per cent (two priorities) delayed due to lack of primary care approval pathways at ICB level (GP Referral Guidelines) and financial and organisational challenges within a specific Trust (one-stop PMB at DGFT). Timelines for both have been revised.

In summary, four remain ‘live’ and actively being pursued, two are at the ‘proposal’ stage (see appendix A for further details), and six priorities have been delivered, which are briefly described below:

  1. Review of waiting list validation methods – Assessed methods of waiting list validation in use across the four Trusts and determined best-practice, aligning processes where possible across the system. List validation is performed regularly and ensures an active and current understanding of demand.
  2. GP education training programme – Participated in system-wide educational programme for Primary care, organised by the BCWB GP training hub. Delivered a presentation to 50 GPs on referral pathways for nine common gynaecological conditions to support decision-making and patient management. These guidelines will be published and circulated to primary care in Q3 23-24.
  3. Menopause Clinic – Established a Black Country menopause clinic within WHT in November 2022 due to increased demand and the need to repatriate 150 menopause cases per year being referred to BSol. The clinic offers 10 new and follow up appointment slots per week to all Black Country patients. Both clinicians are trained in menopause management and are members of the British Menopause Society.
  4. Remote consultation guidelines – Developed Black Country remote consultation guidance for benign Gynaecology, ensuring a standardised approach to increasing remote consultation and to support Providers in achieving national targets. The guidelines have been implemented within each Trust and will be reviewed periodically to ensure validity.
  5. PIFU guidelines – Developed Black Country PIFU guidance to ensure a standardised approach to developing PIFU pathways, supporting Trusts to reach the national target of moving five per cent of outpatient attendances to PIFU pathways by March 2023. Each Provider has implemented the guidelines which will be reviewed periodically to ensure validity.
  6. Day case laparoscopic hysterectomy service – Following a successful pilot, WHT launched a day case laparoscopic hysterectomy service in April 2023, the first of its kind in the Black Country. They are already delivering 25 per cent of their Total Laparoscopic Hysterectomies as a day-case and will continue to increase same day delivery as per BADS recommendations. A rollout plan to expand the service to Black Country patients in other catchment areas will be developed after the service has been live for one year in April 2024. WHT will gather data, insights, and learnings over the next eight months to ensure long-term sustainability and growth of the service.

These six delivered priorities are currently undergoing a benefits review with results anticipated to be available by September 2023.

More Information

You can read more about the Gynaecology Clinical Network in the BCPC Annual Report 2022-23.