Main findings
A new OPH patient satisfaction survey (OPH-PSS) was developed in
collaboration with the BSGE, with multi-disciplinary input and patient
and public involvement (PPI). Women provided feedback and insight
regarding their OPH journey leading to the development of a new
standardised assessment tool suitable for benchmarking OPH services
nationally. In two months, 5151 completed responses were received from
77 Units across the UK. This large return reflects the high prevalence
of the procedure in contemporary gynaecological practice and infers the
acceptability and utility of the developed survey tool. The majority of
procedures were recorded as diagnostic. The survey was designed to
assess all aspects of the patients OPH journey, including pre, peri and
post-procedural experiences. The global rating of overall care was
extremely high, with a mean score rating of 9.7 out of 10. Over 90% of
women considered the OPH service they experienced as at least good, with
over 80% considering the service excellent. Consistent with these
findings, 90% agreed that they would choose the outpatient setting if
the same situation arose again, with nearly 7 out of 10 women strongly
agreeing. These findings suggest that for the vast majority of women,
OPH is a safe, tolerable experience. This conclusion is further
strengthened by the finding that overall, the mean pain score for OPH
was less than the worst level of pain or discomfort experienced during a
menstrual period.
The mean pain score for diagnostic hysteroscopy with or without
endometrial biopsy was 5.2 / 10, and this intensity of pain was less
than the worst pain experienced by women during their menstrual periods.
It should be noted the most common operative procedure of polypectomy
was not associated with greater pain than diagnostic procedures.
Procedure specific data for other OPH procedures such as myomectomy and
endometrial ablation were too limited to draw any conclusions. Whilst
most women experienced pain, over half considered this to be slight.
However, 15% of women reported feeling pain nearly all the time. Whilst
women’s experience of OPH was variable, most did not experience
substantial levels of pain, distress, anxiety, or embarrassment and felt
in control. Vaso-vagal reactions from stimulation of the cervix are one
of the most common side-effects of OPH 11, but 70% of
respondents did not report feeling faint, and most women that did report
this symptom felt the intensity as slight.
Before their consultation, the majority of women reported receiving
written information in a clear and understandable format that included
material about taking analgesia. These findings show that current
patient information leaflets are fit for purpose. Standardised patient
information leaflets (PILs) are available via the RCOG12 and newer alternative video-information resources
are becoming available.13 It is important that such
resources are updated regularly to reflect current guidance, which may
change as more evidence becomes available.
Overall, almost all women felt that aspects of their consultation were
dealt with appropriately. Communication seemed of a high standard, with
most women reporting feeling at ease, with their concerns being
addressed and staff treating them with respect and dignity. The vast
majority of women had the opportunity to discuss pain relief and were
given adequate post-procedural advice.