We report the data from two of the VESPA study strands: 1) the prospective cohort study of women attending EPAUs due to first trimester complications; and 2) the emergency hospital care audit of women admitted as an emergency with first trimester pregnancy complications. f) Intrauterine Contraceptive Device in-situ. e0260534. The female toilet(s) is/are approximately 20m (21yd 2ft) from the clinic entrance. Carole Johnston / Nicky Hewitt, Clinical Nurse Specialists for early pregnancy: 01924 541123, Gynaecology assessment unit: 01924 541135, Back to top of page Do you want to change or cancel an appointment? Copyright 2023 Imperial College Healthcare NHS Trust, Early pregnancy and acute gynaecology units, Assessment of women with bleeding and/or pain in early pregnancy, Diagnosis and subsequent management of miscarriage and ectopic pregnancy, Nausea and vomiting in pregnancy (hyperemesis), Gynaecology: scans for suspected pelvic pathology requiring emergency review, Possible ovarian cyst accidents (ovarian cyst rupture or torsion), Significant heavy menstrual bleeding with anaemia requiring hospital admission, Expectant, medical and surgical management of miscarriage, Management of ectopic pregnancy: medical, surgical and close monitoring with expectant management, Inpatient and outpatient management of nausea and vomiting in pregnancy, Surgical management of molar pregnancy and liaison with the, Incision and drainage of Bartholins cysts and abscesses under local anaesthesia or general anaesthesia. We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. Traffic light controlled pedestrian crossing points are located adjacent to each tube station. The contrast between the external door and wall is good. Clinical follow-up was not standardised but was based on local management protocols and womens medical needs. The height of the wash basin is 86cm (2ft 10in). Investigation, Location and opening times The EPU is based in the gynaecology clinic on the ground floor of Lanesborough Wing. We also accept GP referrals for emergency gynaecology problems. This accessible toilet is approximately 15m (16yd 1ft) from the clinic entrance. As a result, the group prioritised the need for future good quality research into the relative effectiveness of different EPAU configurations [10]. The room does not have background music playing. The waiting room / area does not have background music playing. The barrier controls/touchscreen can be reached from the car. Funding acquisition, There is a horizontal wall-mounted grab rail on the opposite side of the seat to the transfer space. BSL interpreters can be provided on request. There are vertical wall-mounted grab rails on both sides of the wash basin. Investigation, The height of the soap dispenser is 99cm. You can change the description, reflection or CPD Credit Hours at any time from within These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. A mobile hoist is not available on the department/service. There is a dropdown rail on the transfer side. Women may self-refer to the Royal Free EPAGU with early pregnancy problems. In addition to senior clinicians presence, we also explored the effect that weekend opening of an EPAU has on emergency admissions. Warren Street (Northern / Victoria Lines) and Euston Square (Circle / Hammersmith & City / Metropolitan Lines) are the closest tube stations to University College Hospital (UCH). The admission rate among 44 units ranged from 0% to 13.7% (median 2.8). Standard manual wheelchairs are available for people to borrow at this entrance. Women are seen in order of clinical priority, which means that you may be in the department for longer than anticipated. Copyright: 2021 Memtsa et al. Scans appointments are every weekday morning and afternoon. There are also several bus routes which stop at the Southampton General which is a short walk from the Princess Anne Hospital on Tremona Road. There is sufficient space for a wheelchair user to use the waiting area. Where applicable, participants gave informed written consent before taking part in the study. No, Is the Subject Area "Critical care and emergency medicine" applicable to this article? They will be asked to sign a declaration form and wait for you outside the department until you are called in for your scan. The car parking facilities are for Blue Badge holders only. You can do this by calling theCentral Booking Line on 01282 804512 (available 9am - 12pm, Monday - Friday). By clicking any link on this page you are giving your consent for us to set cookies. There is sufficient space next to the bed/couch for a mobile hoist to operate. 08.30am - 7.00pm Monday - Friday; 9.00am - 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day) Ultrasound services There is level access to this accessible toilet. The VESPA study recruited from the EPAU population. Your local Accident and Emergency department can still be used if you have an emergency or accident not related to your pregnancy (chest pain, difficulty breathing, collapse, etc). Monday to Friday 8.30am - 4.30pm (excluding Bank Holidays). If you are not under the care of the EPAU, please contact your GP. Tameside and Glossop Integrated Care NHS Foundation Trust Fountain Street Ashton-under-Lyne OL6 9RW. The towel dispenser is placed higher than 100cm (3ft 3in). The miscarriage association have put together acollection of storiesabout experiences of pregnancy after loss. This involves clinical review, investigations,diagnosis and treatment on the same day. A total of 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. The door(s) open(s) automatically (towards you). The lateral transfer space is 145cm (4ft 9in). You might find it helpful to talk to your GP, midwife or early pregnancy staff if you are feeling anxious. This variable was also dichotomised for some analyses to indicate whether the annual number of patient visits for a unit was above or below the median. . The dimensions of the designated Blue Badge parking bay(s) surveyed are 360cm x 420cm. The route from the car park to the entrance is accessible to a wheelchair user with assistance. There is a clear unobstructed route to the reception point. The staff in the unit are skilled in the management of early pregnancy complications, including ultrasound scanning. The results of our study indicate that the presence of senior clinicians in early pregnancy units may not lead to more effective care when this is measured by the proportion of women who are admitted as an emergency. Methodology, There is a level turning space (minimum 185cm x 210cm) in front of the payment machine(s). Report a problem or suggestion using this facility. The door(s) open(s) away from you (push). There is a/are Blue Badge parking bay(s) available. In preparation for the study, we carried out a prospective audit of clinical activity in eight EPAUs in London, UK, which included 3,600 women. Resources, Send email. Also required will be vehicle registration number, date of appointment and time of appointment. There is a/are door(s) into the consultation / treatment room. All women aged 16 years of age who attended the participating EPAUs presenting with first trimester pregnancy complications for the first time during the index pregnancy were included in the cohort study. We will keep you updated and we have refreshments available for your comfort. The department/service does play background music. Formal analysis, The wash basin is not placed higher than 74cm (2ft 5in). Actual senior clinician presence was defined as the percentage of hours they spent in EPAUs delivering care divided by the unit opening hours. No, Is the Subject Area "Miscarriage" applicable to this article? We are a nurse-led service, supported by sonographers and the on-call gynaecology medical team, including a lead consultant . Writing review & editing, Affiliation There is / are 4 consultation / treatment room(s) available. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical . Data curation, Do not wait to be called by the EPAU team. Formal analysis, There is a/are door(s) leading into the department/service. This showed substantial variations in the proportion of in-patient emergency admissions with 8.5% in units without, and 3.5% in those with, senior clinician presence. There is not sufficient space to write or sign documents on the counter. (2021) Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and weekend opening on emergency hospital admissions: Findings from the VESPA Study. Some women require hospital admission for rehydration. The dispensation notice is a Camden Councils parking scheme for Blue Badge holders who are attending outpatients appointments at University College London Hospitals NHS Foundation Trust (UCLH). Patients who are experiencing a loss are given contact numbers and information on how to obtain support from the Miscarriage Association. My CPD. To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). The service is then located on the right. The floors which are accessible by this lift are B-LG-G-1-2. Occasionally, for both early pregnancyand emergency gynaecology you may need to be admitted into hospital for us to perform further investigations,monitor you, or initiate treatment but we will keep you informed of this and support you through this process. We see women in the first 18 weeks of pregnancy only. Please complete the form calledEarly Pregnancy Assessment Unit (EPAU) and email to: GP to telephone to make an appointment In line with our Trusts policy a chaperone is available for all intimate examinations. The Pregnancy Sickness Support website has good advice. They can also be obtained from UCH Macmillan Cancer Centre Site Main Ground Floor Reception (08.00-20.00 Monday to Friday only). t: 020 7472 6374during opening hours (Mon-Fri 7.30am-8pm with scanning facilities from 9am-5pm), Call switchboard The unit is open Monday to Friday from 8am-6pm and Sunday 9am-5pm (closed on Saturday). There are 21 Parent and Child Bays available on this level. Department of Women and Childrens Health, Kings College London, London, United Kingdom, Roles The contrast between the internal door and wall is good. View Accessibility Symbols. This accessible toilet is located straight ahead as you enter and to the right. Your GP can be accessed for a range of non-urgent services. GPs wishing to make a referral should complete the Early Pregnancy Unit (EPAU) referral form below and send it to the correct email address. There is not a 120cm hatched zone around the Blue Badge parking bay(s). The following buses are used to access the University College Hospital (UCH): Tottenham Court Road - Northbound (Warren Street station) - no's 10, 73, 24, 29, 134. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, Affiliations There is not a bell to attract attention. For more information please contact Professor Tom Bourne, consultant gynaecologist by emailing t.bourne@ic.ac.uk at Queen Charlottes, or Dr Shahla Ahmed, consultant gynaecologist by emailing shahla.ahmed1@nhs.net at St Marys. The width of the door opening is 86cm (2ft 10in). As you face the toilet pan the transfer space is on the right. If necessary, patients can be admitted under the on-call gynaecology team 24 hours a day, seven days a week. The specific roles of these authors are articulated in the author contributions section. The height of the towel dispenser is 125cm (4ft 1in). If you require an ultrasound we aim to offer this within 72 hours of referral. gpit@camdenccg.nhs.uk to carry out the upgrade. Assistance may be required because there is/are slopes/ramps. There is a canopy or recess which provides weather protection at this entrance. The IHE does not currently receive funds for research related to the submitted work. The Early Pregnancy Unit (EPU) provides a wide range of services for women who are experiencing concerns in early pregnancy. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . North Central London GP Website. The transfer space is obstructed by a waste disposal bin. There is not a clear knee recess beneath the low section of the desk. The car park is located to the left of the main underground car parks. Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. If you are referred to the unit, an appointment will be offered for the next available clinic based on the following set criteria: Women between 6 - 13 weeks of pregnancy with a . However, there was evidence of an association between the emergency admission rate and weekend opening hours. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Scan is an appointment based service and we aim to see you at your given appointment time, but if you have been referred as an emergency without an appointment time or if you require further assessment or investigations then there may be a waiting time to be seen, which can vary. There is level access into the waiting room / area. The main door(s) open(s) towards you (pull). There are 4 consultation/treatment rooms in this department/service. There is not a flashing fire alarm beacon within the waiting room / area. The unit characteristics were confirmed again immediately prior to commencing patient recruitment. Copyright 2023 AccessAble. Return to maternity and newborn services home, View our current vacancies and read about working with us, Read about our Media service and Communications Team, you are in significant pain despite simple pain killers such as Paracetamol, experiencing moderate to severe vaginal bleeding. The upper gestational age limit was set at 13+6 weeks gestation in order to keep recruitment from all participating EPAUs consistent. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles If you are based within a GP practice please contact the GPIT Helpdesk on Opening times Weekdays: 07:30 - 15:00 Weekends and Bank Holidays: 09:00 - 13:00 Contact us Patients already under the care of the EPAU may contact the unit on 01274 364325 and Ward 20 on 01274 364414. If you experience vaginal bleeding and/or abdominal pain you can be seen for assessment up to 19+6 weeks gestation. Contact details will be put on all outpatient letters. The admission rates by patient characteristics is shown in Table 2. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. There is sufficient space to write or sign documents on the desk. The dimensions of the accessible toilet are 156cm x 241cm. The NICE guideline developing group, which includes a patient and public involvement panel, concluded that the configuration of services between different units varied considerably but, due to paucity of data, they were unable to make recommendations on the optimal structure of EPAUs that would balance clinical and service outcomes against cost-effectiveness. When you attend the Emergency Department, you will be assessed by a doctor to see whether you need to stay in hospital and receive care as an inpatient, or whether you can be discharged and referred to to the EPAU as an outpatient. Dementia friendly signage is not provided. These responses were used to categorize the units according to three factors: planned senior clinician presence (yes or no); weekend opening (yes or no); and the annual volume of patients, as reported by the corresponding clinicians (low volume <3000 appointments per year vs. high volume 3000 appointments annually). The car park surface is a shared surface. Electronic consent for treatment or a procedure at our hospitals, Nominate a nurse, midwife or clinical support worker for a DAISY Award, New QEII Hospital Community Diagnostic Centre, Patient-initiated follow-up appointments (PIFU), Personalised care follow-ups for cancer patients, To provide high quality, compassionate care. If a family member or friend has accompaniedyou, the clinician will still request that a member of staff acts as chaperone for an intimate examination. There is a waiting area close to the reception point. Prospective cohort study and emergency hospital care audit; data were collected as part of the national prospective mixed-methods VESPA study on the Variations in the organization of EPAUs in the UK and their effects on clinical, Service and PAtient-centred outcomes. The height of the towel dispenser is 106cm (3ft 6in). Continue along Grafton Way and rejoin the A400. Signs and universally accepted symbols or pictograms, indicating lifts, stairs, WCs, circulation routes and other parts of the building are not provided in the reception area. Where possible units will try to give you fluid and anti-sickness medication as a day patient to avoid you having to stay in hospital where possible. Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. The service provides specialist care for the following: Where medically appropriate, we offer a range of management options for conditions in early pregnancy and acute gynaecology. Referral: patients are mainly referred to the Unit by their GP, but also from Gynaecology wards, by Midwives and other medical routes. Yes The height of the intercom is 134cm (4ft 5in). We listen to patient feedbackto deliver patient-centred care. Data curation, There is an/are accessible toilet(s) within this venue designated for public use. 020 3688 1881 or email Find Early Pregnancy Assessment Unit in Worksop, S81. There is not a red flashing fire alarm beacon within the toilet. Therefore many women may prefer to monitor mild painless bleeding in early pregnancy (below 12 weeks and 6 days) and you may want to explore our information about bleeding and pain in pregnancy prior to contacting the unit, here. Methodology, You can visit a walk in centre for any general illness or concern for which you may have visited your GP. The toilet roll holder is not placed higher than 100cm (3ft 3in). Final diagnosis (FD) was divided into five groups: 1) Normal intrauterine pregnancy including early and live pregnancies; 2) Abnormal intrauterine pregnancy including early embryonic demise, incomplete, and complete miscarriage; 3) Ectopic pregnancy at any site; 4) Pregnancy of unknown location; and 5) Other: molar pregnancy, multiple pregnancy, and not pregnant. The hospital entrance is not clearly visible from the car park. Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. IMD scores were divided into 10 decile groups. There is not a designated drop-off point. Investigation, There is sufficient space to write or sign documents on the low section of the desk. During working hours, women needing EPAGU services who attend A&E will be sent directly to the unit. Email this page Once the sonographer is ready to scan you, we will ask you to call your partner to accompany you into the scan. This analysis was based on the 29 units (5,464 patients) that were able to provide us with reliable data regarding the attendances to Emergency Department and emergency admissions out of hours. e) three or more previous miscarriages The relationship between emergency admissions from Emergency Departments and senior clinician presence, unit volume, and weekend opening hours was investigated by fitting multivariable logistic regression models. There is a/are manual, heavy, double door(s) between the lift and the department/service.
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