Future research is needed to assess whether increased participation of senior clinicians and actual time commitment in provision of early pregnancy care, a change in their training could have more significant impact on the rate of emergency admissions and other indicators of the quality of clinical care in early pregnancy. As part of this assessment, they may ask for investigations that may be performed on the same day or within urgent time frames and a management plan will be made for you. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm. Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. Dementia friendly signage is not provided. In some cases additional treatment is needed such as: An early pregnancy loss can be a deeply distressing experience both physically and emotionally and we want to ensure that you are able to access the support you need during this difficult time. There is a/are clinical waste disposal units. (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. View Article PubMed/NCBI . There is a changing place located on level C of the Centre Block at the Southampton General Hospital. 08.30am - 7.00pm Monday - Friday; 9.00am - 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day) Ultrasound services A number of organisations give dedicated support and advice to people affected by pregnancy loss: CRADLE is anational registered pregnancy loss charity working in partnership with Lewisham and Greenwich NHS Trust. Detailed information, also Early pregnancy - Bradford Teaching Hospitals NHS Foundation Trust Senior clinicians were present only in 19 of the 44 EPAUs. If required emergency surgery can be performed, or women may be monitored and appropriate follow up arrangements made. The Blue Badge bay(s) is/are clearly marked. The dedicated staff are sensitive and committed to supporting the emotional needs of women and couples requiring this service. When we compared actual with planned senior clinicians presence, we found that in only 3/19 units (16%) did senior clinicians spend more than 15% of their time actively delivering clinical care, and in 13/19 units (68%) their actual documented presence was less than 5%. The Miscarriage Association, Wakefield, United Kingdom, Roles There are 4 consultation/treatment rooms in this department/service. We also run support groups for women and their partners who have experienced ectopic pregnancy or miscarriage. https://doi.org/10.1371/journal.pone.0260534.t001. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical need is identified. View Accessibility Symbols. King's College Hospital Early Pregnancy Assessment Unit (EPAU) Address: Suite 8, Third Floor Golden Jubilee Wing Denmark Hill London SE5 9RS Telephone: 0203 299 3168 Usual Opening Times Location Map Get Directions This is a walk in service so you need no appointment, simply attend the unit. There is not a Patient Advice and Liaison Service (PALS) at the hospital. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0260534, https://www.rcog.org.uk/globalassets/documents/guidelines/wprgynstandards2008.pdf, https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_022.pdf, https://www.aomrc.org.uk/wpcontent/uploads/2016/05/Seven_Day_Consultant_Present_Care_1212.pdf, https://www.england.nhs.uk/wp-content/uploads/2013/12/evidence-base.pdf, https://www.isdscotland.org/Health-Topics/Quality-Measurement-Framework/Emergency-Admissions/, https://www.kingsfund.org.uk/sites/default/files/Avoiding-Hospital-Admissions-Sarah-Purdy-December2010_0.pdf, https://www.rcog.org.uk/globalassets/documents/careers-and-training/atsms/atsm_acutegynae_curriculum.pdf. 023 8077 7222. People can self-refer to the unit by contacting 01924 541135 or through their GP, midwife, hospital doctor, Emergency Department staff if they have: Once you have been referred you will be contacted by a member of staff who will initially offer a triage assessment over the phone. However, there was evidence of an association between the emergency admission rate and weekend opening hours. There is not a play area or toys/books for a child to play with. Euston Square station has lift access from the platform to the street. Pinderfields Hospital Study participants will not be individually informed of the study results; however, dissemination to the public will be through media outreach (e.g., press release) upon publication of this study. Search for local Pregnancy near you on Yell. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. If you do not wish to have them in the room during your appointment, please let the nurse or doctor know and students can be asked to step outside. The room does not have background music playing. The floors which are accessible by stairs are B-LG-G-1-2. There is not a play area or toys/books for a child to play with. There is step free access to Early Pregnancy Unit and Gynae Assessment Unit. The senior clinicians were actually spending less time in the EPAUs than expected. There is / are 1 Ultrasound Room(s) available. Opening Times (Early Pregnancy Unit and Gynae Assessment Unit) Department / Service (Early Pregnancy Unit and Gynae Assessment Unit) Reception Consultation / Treatment Room (3) Imaging Room Day Room / Lounge Area (Quiet Room) Accessible Toilet (s) Related Access Guides Getting To The Hospital (Princess Anne Hospital) Collapse all By Road View Competing interests: I have read the journals policy and the authors of this manuscript have the following competing interests: MM, VG, GA, ZA, NK, JH, GB, RBA, JS, DJ has nothing to disclose. The name / number of the room surveyed was; 3. Early Pregnancy and Gynaecology Emergency Unit (EPU), Follow us on social media for all the latest news and announcements, Lister Hospital, Coreys Mill Lane, Stevenage, SG1 4AB. Project administration, Validation, The height of the toilet seat above floor level is 48cm (1ft 7in). Writing review & editing, Affiliations GP EPAU referral form [docx] 99KB (click to download). Opening Times. The lift does have a visual floor indicator. Formal analysis, GAU is a 24 hour service and can offer advice and . There is / are 10 consultation / treatment room(s) available. Treatments available for ectopic pregnancies includelaparoscopic surgery, medical treatment with methotrexate, or expectant management. The Early Pregnancy Assessment Unit is part of the Gynaecology Assessment Unit, which offers help and support for those experiencing problems in early pregnancy up to 16 weeks. Funding acquisition, We do not accept self-referral to the Early Pregnancy Unit for vomiting in pregnancy unless you are currently under our care or have been diagnosed with hyperemesis in a previous pregnancy. Our research lead, Professor Tom Bourne, is a founding member of the International Ovarian Tumor Analysis (IOTA) group and sits in the steering committee of several large international trials. It is likely that they will be unable to offer reassurance scans if you have experienced previous early pregnancy problems unless you have symptoms in this pregnancy but individual units availability may vary. Assistance may be required because there is/are slopes/ramps. 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. There is sufficient space for a wheelchair user to use the waiting area. If you feel your symptoms require urgent assessment outside of these hours the wider medical team are here to support you 24 hours a day 7 days a week. The height of the wash basin is 86cm (2ft 10in). The aim was to capture hospital emergency activity with regards to early pregnancy care in EDs. A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. Writing original draft, This is because women with an early pregnancy complication may not necessarily need to attend in-person or may be more suited for an assessment in different clinical or maternity service. The height of the bell/buzzer is 134cm (4ft 5in). This maynot always possible depending on service demand and the type of investigation, monitoring or treatment you may need. If your GP is closed you can access the out of hours GP services. Software, Investigation, Report a problem or suggestion using this facility. There is / are 4 consultation / treatment room(s) available. By clicking any link on this page you are giving your consent for us to set cookies. As you face the toilet the wall-mounted grab rail(s) is/are on both sides. A moderate level of clustering within units (Intraclass Correlation Coefficient, ICC = 0.04) was assumed. 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. There is a/are door(s) leading into the department/service. The Early Pregnancy Unit is classified as an Emergency Service and you may be invited to attend the unit for an appointment. They are not issued to carers, relatives, visitors or friends who are Blue Badge holders bringing a non-Blue Badge holder patient to an appointment. The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks. For further advice about emergency gynaecology at Barnet Hospital, call the hospital. The toilet roll holder can be reached from seated on the toilet. The lighting levels are moderate to good. BSL interpreters can be provided on request. The contrast between the wash basin wall-mounted grab rail(s) and wall is good. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles All rights reserved. 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). Child Emotional Wellbeing & Mental Health, Learning Disabilities & Neurodevelopmental Disorders (NDD), Gastroenterology, Colorectal, Renal & Urology, Care Home Training & Development (Islington), Data quality/standard referral form programme, 020 7472 6374(RFH) and 020 8216 5233 (Barnet), 020 7472 6374 (rfh: specialist nurse advice during opening hours) or020 7794 0500 ext 38205 or 31468, Early Pregnancy Assessment & Gynaecology Unit: RFL, assessment and management of women with pain and bleeding in early pregnancy (up to 15 weeks and sixdays), assessment of women at high risk of an ectopic pregnancy, assessment and management of women with acute gynaecological problems. Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom, Roles Disposal facilities are available in the cubicle. Methodology, Actual senior clinician presence was defined as the percentage of hours they spent in EPAUs delivering care divided by the unit opening hours. Copyright 2023 AccessAble. If you are having a problem in early pregnancy, your first contact should be with your GP, or the out-of-hours service when your GP surgery is closed. Wherever possible, all data relating to hospital admissions provided by the IS departments were crosschecked by a member of the research team against ward admission books/databases in an attempt to check their accuracy. here. The dimensions of the accessible toilet are 210cm x 220cm (6ft 11in x 7ft 3in). The maternity unit is situated on the second floor of the hospital (level2). The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. Methodology, If you wish to book your pregnancy care with the Trust, please instead fill out our maternity self-referral form. BSL interpreters can be provided on request. Software, This room is not accessed via a changing room. The height of the towel dispenser is 125cm (4ft 1in). Validation, Royal Free London (RFL)offers a seven-dayper week specialist service for women who need emergency care for early pregnancy and gynaecological problems at Royal Freeand Barnet Hospitals. The distance between the floor and the highest table is 43cm (1ft 5in). These are further broken down by diagnosis in Tables 3 and 4. https://doi.org/10.1371/journal.pone.0260534.g001, https://doi.org/10.1371/journal.pone.0260534.t002, https://doi.org/10.1371/journal.pone.0260534.t003, https://doi.org/10.1371/journal.pone.0260534.t004. Methodology, The height of the reception desk is high (110cm+). There is a waiting area close to the reception point. Validation, This accessible toilet is approximately 16m (17yd 1ft) from the Early Pregnancy Unit and Gynae Assessment Unit entrance. We provide a dedicated service to women under 16 weeks gestation. Data curation, 33 days (IQR 2447) was the median time for units to complete recruitment. The door(s) open(s) automatically (towards you). The wash basin is placed higher than 74cm (2ft 5in). There is level access to the consultation / treatment room. The car parking facilities are for Blue Badge holders only. We may be able to offer an immediate appointment for those walking in, but if not, women will be asked to attend A&E or return at a later date or time. Also required will be vehicle registration number, date of appointment and time of appointment. This accessible toilet is located along the department corridor. There is room for a wheelchair user to manoeuvre. Clinic 3 - Early Pregnancy Unit is/are located on the lower ground floor. Where applicable, participants gave informed written consent before taking part in the study. The entrance area/door is clearly signed. Data curation, Supervision, In addition, we recorded the amount of time senior clinicians (consultant gynaecologists) spent working in EPAUs which is of critical importance when assessing the impact of their presence on various clinical outcomes. The Blue Badge bay(s) is/are signposted but have no markings. There is not a 120cm hatched zone around the Blue Badge parking bay(s). The reception area/desk is clearly visible from the entrance. To obtain mobility aids please contact the main reception. View photos. 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. this will normally be done within 2 days and you will need to be nil by mouth for 6 hours. The EPAGU at Queen Charlottes is well-known globally for its research output. EPAU opening times EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. Initially, we investigated the association between senior clinician presence, unit volume, and weekend opening hours on emergency admissions from EPAU. This section describes the Ultrasound Room(s), located to the left along the department corridor. King's College Hospital Early Pregnancy Assessment Unit (EPAU) The contrast between the external door and wall is good. We ask that they call the unit so that we can book them a timed appointment. The soap dispenser cannot be reached from seated on the toilet. Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. There are volunteers available for help and assistance at the hospital. Data curation, Data curation, There is not a/are not Blue Badge parking bay(s) available. Send email. MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. Women may self-refer to the Royal Free EPAGU with early pregnancy problems. 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. on the right to withdraw consent, can be found in the website's privacy policy. This avoids the need for patients/carers to park illegally on the day while they come in to get their dispensation notice. Turn left as you pass through the doors and continue ahead. A total of 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. Once the sonographer is ready to scan you, we will ask you to call your partner to accompany you into the scan. My CPD. 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. This may be a stressful time for both couples and their families and the unit aims to support you through the early stages of your pregnancy. Formal analysis, We carefully assessed the burden and timings of the study participation and questionnaires on patients. In addition, patients/carers should be encouraged, where they know the date and time of their next appointment, to get their dispensation notice prior to leaving the hospital. There is a vertical wall-mounted grab rail on the transfer side. When you attend an event booked through the North Central London GP Website, North Central London GP Website. This technique was adopted to ensure that units of all configurations were equally represented in the final sample. Both telephone and email applications will be coordinated by the UCH main reception team. 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). 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 . There is not a bell to attract attention. Validation, Yes There is dedicated team of trained sonographers and consultants who provide the ultrasound services. Assistance may be required because there is/are uneven surfaces. 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. People can self-refer to the unit by contacting 01924 541135 or through their GP, midwife, hospital doctor, Emergency Department staff if they have: Please do not contact the Early Pregnancy Unit to arrange an appointment with the midwife. Investigation, There was little evidence of an association with planned senior clinician time (p = 0.280) or unit volume (p = 0.647). Early Pregnancy Assessment Unit - Betsi Cadwaladr University Health Board The door does not have a horizontal grab rail. There are sofas and also a mixture of single seats with and without armrests. There is not an assistance dog toilet or toileting area on the hospital site. The percentage of emergency admissions from the Emergency Department ranged from 7% to 58% with the majority of the units having an emergency admission rate of between 10% and 30%. By clicking any link on this page you are giving your consent for us to set cookies. The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). 2018 37:1533-1538. pmid:29119588 . The unit characteristics were confirmed again immediately prior to commencing patient recruitment. As you face the toilet pan the transfer space is on the right. Contact details for early pregnancy services for your Trust can be found on the homepage. Princess Anne Hospital, Coxford Road, Southampton, Hampshire, SO16 5YA. This website is for healthcare professionals only. There is a low section of the desk (76cm or below) available. The Early Pregnancy Unit is a consultant-led service and is delivered by a team of specialist nurse sonographers who provide consultation, assessment, scans and treatment plans for women with complications of pregnancy from 5 to 20 weeks. There is sufficient space next to the bed/couch for a mobile hoist to operate. The contrast between the wall-mounted grab rail(s) and wall is fair. A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. Writing review & editing, Roles The gynaecology emergency room (GER) at St Marys Hospital provides an acute seven-day service. The reception area/desk is approximately 6m (6yd 1ft) from the clinic entrance. The staff in the unit are skilled in the management of early pregnancy complications, including ultrasound scanning. The width of the door opening is 87cm (2ft 10in). gpit@camdenccg.nhs.uk to carry out the upgrade. The lighting level in the lift is medium. Early Pregnancy Unit and Gynae Assessment Unit is located on Level D of Princess Anne Hospital. Writing review & editing, Roles Software, Email this page Please note: Dispensations are only issued to outpatients with Blue Badges who are attending hospital appointments. View Accessibility Symbols. We collected data about the total number of Emergency Department attendances and emergency in-patient admissions of women who presented with first trimester pregnancy complications. We would like to express our gratitude to the 44 participating Early Pregnancy Assessment Units and their supporting research staff: Bishop Auckland Hospital, Bishop Auckland, Gloucestershire Royal Hospital, Gloucester, Luton and Dunstable University Hospital, Luton, Queen Elizabeth The Queen Mother Hospital, Margate, The James Cook University Hospital, Middlesborough, Association of Early Pregnancy Units (AEPU), Pat Doyle (Chairperson), Professor in Epidemiology, London School of Hygiene and Tropical Medicine, Cecilia Bottomley, Lead clinician for Early Pregnancy, Chelsea and Westminster Hospital, Elizabeth Bradley, General Practitioner, Hampstead Group Practice, Hannah-Rose Douglas, Research lead for Analytical Services, NHS England, Marjory Maclean, Consultant Obstetrician and Gynaecologist, NHS Ayrshire and Arran, Brad Manktelow, Associate Statistics Professor, University of Leicester, Alex Peace-Gadsby, Chair, The Ectopic Pregnacy Trust. There is/are 10 designated Blue Badge parking bay(s) within the hospital car park. The Early Pregnancy Unit (EPU) is a walk-in unit open and free of charge to any woman who is . This involves clinical review, investigations,diagnosis and treatment on the same day. If our guide needs updating - just let us know using this form. Women with nausea and vomiting in pregnancy should contact their GP for an assessment of their symptoms to exclude other causes for nausea and vomiting in pregnancy such as urinary tract infections. Get contact details, videos, photos, opening times and map directions. Writing original draft, Some women may also be advised to monitor their symptoms at home. The width of the accessible toilet door is 87cm (2ft 10in). Data curation, The total number of opening hours per weekend was used to illustrate weekend opening. Language interpreters can be provided on request. 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. PLOS ONE promises fair, rigorous peer review, Funding acquisition, Data curation, Twenty-three units were open during weekends. Validation, IMD scores were divided into 10 decile groups. PLoS ONE 16(11): be as descriptive as possible and include any specific error messages you may see. Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. Conceptualization, The Patient Advice and Liaison Service (PALS) is located on Level C of the Centre Block at the Southampton General Hospital. Bearing in mind that women attending the ED are eight times more likely to be admitted than those seen in the EPAU, keeping EPAUs open over the weekend reduces the overall number of emergency admissions to hospital. Referrals are accepted direct to the unit from GPs, Midwives and the Emergency Department. Disposal facilities are available in the toilet. If the outcome of your consultation is that you require an ultrasound then our ultrasound scanning appointment times are from 9:30am 4.00pm on weekdays. There is a/are door(s) into the consultation / treatment room. Monday to Sunday 08:00 to 13:00. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. Both provide consultant-led care for women who experience problems in early pregnancy. Data Availability: All relevant data are within the papers Supporting information files. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Scans appointments are every weekday morning and afternoon. The lateral transfer space is 170cm (5ft 7in). You will be given a copy of your ultrasound report. Modelling and Analytical Systems Solutions (MASS) Ltd, Edinburgh, United Kingdom, Roles Please send a referral letter with all patients. There is sufficient space for a wheelchair user to manoeuvre within the imaging room. 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). Referrals are either from GP or the emergency department. If an appointment is necessary you will be offered a time to attend the unit for an ultrasound scan or to be assessed by the doctor. The drop off bays have a maximum 20 minute waiting restriction. From the west of the city Southampton General Hospital can be accessed via several routes from the M271. The miscarriage association have put together acollection of storiesabout experiences of pregnancy after loss. Dementia friendly signage is not provided. Opening Hours for patient assessment and care planning. There is a canopy or recess which provides weather protection at this entrance. The contrast between the wall-mounted grab rail(s) and wall is good. You can at any time read our cookie policy. Early pregnancy assessment unit - East Lancashire Hospitals NHS Trust Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. Equally, weekend opening of an EPAU, even for a limited number of hours, is associated with lower probability of emergency hospital admissions. We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. Contact us. An implantation bleed, when the pregnancy is settling into the womb lining, can be common at around 4-6 weeks. We would advise you attend your local emergency department unitif bleeding worsens whereby you are having to change your sanitary pad more frequently and feel unwell, or ifyou are experiencing severe abdominal pain which is not improving with simple pain relief egparacetamol. The wash basin can be reached from seated on the toilet. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm. The contrast between the dropdown rail(s) and wall is good. EPAGU Level 2, Wellhouse Lane, Barnet, EN5 3DJ, 020 7472 6374, 020 7794 0500 ext 38205 or 31468, EPAGU 5th Floor, Pond Street, London, NW3 2QG, 020 7472 6374 (RFH) 020 8216 5233 (Barnet), Emergency clinic for women with pain or/and bleeding in early pregnancy or pregnant women with high risk of ectopic pregnancy, For recurrent miscarriages and early pregnancy concerns, For women with problems during early pregnancy. Project administration, We are closed in Bank holidays. Early Pregnancy Unit - Cardiff and Vale University Health Board

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