General Gynaecology - Dual-scoring

Introduction

General Gynaecology Dual-Scoring

Dual-scoring

You are using a dual-scoring form for the General Gynaecology tool. You will be asked questions required to complete both the 2006 and the 2018 versions of the tool.

The score for this event will be based on the 2006 version of the tool. A second prioritisation event based on the 2018 version of the tool will also be created as a “Test” event, which you will be able to see in your history in case it is of interest. These test events will be assessed to establish an appropriate threshold before the 2018 version of the tool goes live.

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.

Special cases

Automatic Priority

An appropriate priority score reflecting the clinically appropriate timeframe for treatment will be automatically assigned for the following cases:

Prioritisation

DRAFT General Gynaecology 2018

Impact on Life - Part I
Impact on Life - Part II
Impact of gynae problem on ability to engage in and enjoy activites which are important to the individual patient.
Is there significant compromise to any important activity?
Is this because symptoms are controlled by other non-surgical management?
Is the important activity compromised or avoided?
How frequent are the symptoms?
Effectiveness of procedure in improving the impact on life
  • (<50% likelihood of optimal outcome)
  • (50-80% likelihood of optimal outcome)
  • (80-95% likelihood of optimal outcome)
  • (95% likelihood of optimal outcome)
Risk of complications / Adverse effect of the surgical procedure
  • (e.g. MI last 6 months, Cardiac Failure, Respiratory Failure, Smoking > 20/day, BMI > 40)
  • (e.g. BMI 30-40, PHx DVT/PE, IHD)
New special cases