DRAFT General Gynaecology 2018

General Comments and Directions

• Scoring should be based on the considered view of the clinician taking into account the patient’s history, examination, results of investigations and the clinician’s experience in treating similar patients.
• Criteria only apply for patients where a procedure is indicated and the patient wishes it and all non-surgical therapeutic options have been explored.
• These criteria only apply to elective and arranged admissions.
• The score should be calculated during the consultation, and the patient informed whether they will be accepted for publicly funded treatment. This may occur during the first or follow-up consultation, after investigations have assisted with establishing a diagnosis (e.g. CT scans).
• If due to exceptional factors not included in the prioritisation criteria, the booking status generated does not adequately reflect the patient’s priority, the booking status may be overridden. The reason for the exception must be documented.

More than one procedure

Where two or more related but independent procedures are contemplated at the same operating session the score should relate to the most significant procedure.

Staged Procedures

A treatment procedure may be staged over several months or years. For the purpose of the priority access scoring a related series of treatments should be considered as one event. Repeat scoring is not required.

This tool does not cover:

• Treatment for infertility (see separate tool) unless the surgery is required to address physical symptoms (e.g. endometriosis which may require surgery for either indication).
• Sterilisations (refer separate tool).
• Planned terminations of pregnancy, as various requirements and processes are prescribed by the Contraception, Sterilisation and Abortion Act 1977.