1. “GATU” a Successful Working Model Martyn Underwood

2. Ambulatory Gynae  Why develop it  Patient and Trust benefits  Who does it  The facilities  What we can offer  How are the procedures done  The evidence  Other news “GATU” a Successful Working Model

3. Why develop it?  Patient safety  Patient demand  Increasing obesity rates and other comorbidities  Develop a quicker turn around for patients  Less reliance on DSU & in patient beds  Less cancellations (no GATU lists have been cancelled since we started this service) “GATU” a Successful Working Model

4. Patient benefits  Safety  Lees complications  Less HAI  Less VTE  Less time off work  No need for pre-op, GA, family member to recover  Shorter wait to treatment times  Quick return to “normal activities”  Less restrictions on return to work and driving  Shorter length of stay  All done with oral/PR analgesia +/- cervical block  Patient satisfaction  Patient can “be part” of the treatment – they can see and have explained what is going on “GATU” a Successful Working Model

5. Trust benefits  Beds  Quicker throughput  Less staff  Less clinic attendances  ? Saves money – kit is more expensive generally  Best practice tariffs “GATU” a Successful Working Model

6. Who does it?  GATU procedures  Mr Underwood = Lead Clinician  Mr Biswas  Mr Bentick  Colposcopy  Mr Underwood = Lead clinician  Dr Blackmore  Dr Panikkar  Mr Reed  Dr Sahu  Sr Goodall “GATU” a Successful Working Model

14. What can we offer  Hysteroscopy  Hysteroscopic endometrial polypectomy  Endometrial ablation  Hysteroscopic Sterilisation  IUS / IUCD retrieval / insertion  Vulval biopsy & excision  Colposcopy  Cystoscopy* “GATU” a Successful Working Model

15. How are the procedures done All in out patients – PRH All with oral / suppository analgesia +/- cervical block E&D as normal Home between 10mins and an hour “GATU” a Successful Working Model

16. NovaSure Hysteroscopic Views Pre-ablationPost ablation “GATU” a Successful Working Model

17. Essure “GATU” a Successful Working Model

18. The evidence  Patient satisfaction  Friends and family test – excellent results on recent review  Audits  Feedback  Significant reduction in patients needing a GA for these minor procedures  No lists cancelled!  DSU lists dropped  No major complications  Superior amenorrhoea rates to other techniques demonstrated for ablation  Centre of Excellence / Referral Centre “GATU” a Successful Working Model

19. Other news  Colposcopy  Busiest unit in West Mids  QA very happy  Publications  Research “GATU” a Successful Working Model

20. Other projects “GATU” a Successful Working Model

21.  Thank you for listening!  Any Questions? “GATU” a Successful Working Model SaTH O&G Consultants