It is unacceptable that some women have such poor experiences of hysteroscopies.

The National Health Service website page on hysteroscopy was updated in January 2024. This provides information on preparing for and recovering from a hysteroscopy, including pain relief options. The importance of pain relief is reiterated in guidance from both the Royal College of Obstetricians and Gynaecologists, and the College of Sexual and Reproductive Healthcare.

In Shropshire, Telford, and Wrekin all patients receive comprehensive information about the procedure before their appointment, including advice on pain management. Patients can access both local anaesthetic and general anaesthetic for the procedure.

Patients can additionally access local and general anaesthetic and there is a patient advocate always present during the procedure to provide continuous support and aid in pain management.

The Government is committed to prioritising women’s health as we build an NHS fit for the future. Through our 10-Year Health Plan and the renewal of the Women’s Health Strategy we are delivering our commitment that never again will women’s health be neglected.

The Getting It Right First Time (GIRFT) programme’s role is to provide guidance to National Health Service trusts to help improve the delivery of services and, in doing so, it follows the professional standards and recommendations of the professional bodies.

GIRFT has worked closely with the Royal College of Obstetricians and Gynaecologists and the British Society for Gynaecological Endoscopy to support hospital trusts in improving women’s choices and appropriate settings for gynaecological procedures, such as hysteroscopy and endometrial ablation, acknowledging the shift to more day case and outpatient procedures.

Since the report was published, GIRFT has responded to feedback from patients, adding an addendum to the 2021 report and amending one recommendation to reiterate the imperative that all women undergoing day case and outpatient procedures are given clear and accurate information to enable them to make informed decisions about their preferred treatment setting and pain control. Ultimately, the decision on care setting for this procedure must be made with the patient, after due consideration of all relevant information.

Decisions about what medicines to prescribe are best made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers are supported in their decisions by national guidance, for example guidance by the National Institute for Health and Care Excellence (NICE), as well as the local commissioning decisions of their respective integrated care boards (ICBs).

NICE is the independent body responsible for translating evidence into authoritative, evidence-based guidance for the health and care system on best practice, in order to drive improved outcomes for patients. NICE has made recommendations on hysteroscopy in its guideline on heavy menstrual bleeding: assessment and management, reference code NG88, but does not make recommendations on whether pain relief, such as methoxyflurane, should be administered during hysteroscopy. NICE currently has no plans to update the guideline but it will be reviewed if there is new evidence that is likely to change the recommendations.

No recent formal assessment has been made of the adequacy of the availability of hysteroscopy procedures under anaesthetic in North Shropshire and in England.

The information held by NHS England on hysteroscopy waiting times at the NHS Shropshire, Telford and Wrekin Integrated Care Board does not readily allow hysteroscopy procedures with an anaesthetist to be separately identified.

It is unacceptable that some women have such poor experiences of hysteroscopies. Women must be given the opportunity to speak to the doctor or nurse before having the procedure about what to expect, and to discuss pain relief options, including the option of local or general anaesthetic. Women can also discuss the option of alternative treatment, such as pelvic ultrasound.

For patients in North Shropshire, the gynaecological unit within the Shropshire Women and Children’s Centre at the Princess Royal Hospital in Telford provides women with access to hysteroscopy services.

It is our aim to treat all women as individuals, acknowledge they have unique expectations and unique physical, psychological, emotional, and cultural needs. The Shrewsbury and Telford NHS Trust is committed to providing a quality service for women that provides care with courtesy, kindness, and warmth for women and their families.

No recent formal assessment has been made of the adequacy of the availability of hysteroscopy procedures under anaesthetic in North Shropshire and in England.

The information held by NHS England on hysteroscopy waiting times at the NHS Shropshire, Telford and Wrekin Integrated Care Board does not readily allow hysteroscopy procedures with an anaesthetist to be separately identified.

It is unacceptable that some women have such poor experiences of hysteroscopies. Women must be given the opportunity to speak to the doctor or nurse before having the procedure about what to expect, and to discuss pain relief options, including the option of local or general anaesthetic. Women can also discuss the option of alternative treatment, such as pelvic ultrasound.

For patients in North Shropshire, the gynaecological unit within the Shropshire Women and Children’s Centre at the Princess Royal Hospital in Telford provides women with access to hysteroscopy services.

It is our aim to treat all women as individuals, acknowledge they have unique expectations and unique physical, psychological, emotional, and cultural needs. The Shrewsbury and Telford NHS Trust is committed to providing a quality service for women that provides care with courtesy, kindness, and warmth for women and their families.

It is unacceptable that some women have such poor experiences of hysteroscopies. It is important that healthcare professionals provide women with information ahead of the procedure, so that they can make an informed decision. Women must be given the opportunity to speak to the doctor or nurse before having the procedure about what to expect, and to discuss pain relief options, including the option of local or general anaesthetic. Women can also discuss the option of alternative treatment, such as pelvic ultrasound.

Letters and information sent to patients are determined at a local level by individual National Health Service trusts. A range of additional information is available for patients on hysteroscopy procedures, including on the NHS.UK website, and the Royal College of Obstetricians and Gynaecologists has created a patient information resource on hysteroscopy. This is available at the following link:

https://www.rcog.org.uk/outpatient-hysteroscopy

Details of ministerial meetings are published quarterly on the GOV.UK website.

The Department does not hold information on the number of women who were not sent a letter in advance of an outpatient hysteroscopy appointment specifically.

Letters and information sent to patients are determined at a local level by individual National Health Service trusts. A range of additional information is available for patients on hysteroscopy procedures, including on the NHS.UK website, and the Royal College of Obstetricians and Gynaecologists has created a patient information resource on hysteroscopy. This is available at the following link:

https://www.rcog.org.uk/outpatient-hysteroscopy

The Government recognises that some procedures, such as hysteroscopy, can result in pain, and the level of pain experienced will vary between individual women. It is important that healthcare professionals provide women with information prior to their procedure so that women can make an informed decisions about the procedure and pain relief options, including the option of local or general anaesthetic.

Clinical guidelines support healthcare professionals to provide evidence-based care. The Royal College of Obstetricians and Gynaecologists (RCOG) published an updated guideline on outpatient hysteroscopy in September 2024. The updated guideline has reference to minimising pain and discomfort during hysteroscopy procedures. While RCOG guidelines are not mandatory, they are designed to support high-quality care, and the Department and NHS England encourages local implementation tailored to patient needs. This is available at the following link:

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/outpatient-hysteroscopy-green-top-guideline-no-59/

Letters and information sent to patients are determined at a local level by individual National Health Service trusts. A range of additional information is available for patients on hysteroscopy procedures, including on the NHS website, and the Royal College of Obstetricians and Gynaecologists has created a patient information resource on hysteroscopy. This is available at the following link:

https://www.rcog.org.uk/outpatient-hysteroscopy

As with all procedures, healthcare professionals are expected to fully explain the procedure in advance, including expected symptoms, side effects, and risks. These conversations should be undertaken using a shared decision-making approach that ensures individuals are supported to make decisions that are right for them. This provides a collaborative process through which a clinician supports a patient to reach a decision about their treatment, bringing together the clinician’s expertise, such as treatment options, evidence, risks and benefits, with the patient’s preferences, personal circumstances and values. NHS England has published guidelines on the use of shared decision making.

The Government recognises that some procedures, such as hysteroscopy, can result in pain, and the level of pain experienced will vary between individual women. It is important that healthcare professionals provide women with information prior to their procedure so that women can make an informed decisions about the procedure and pain relief options, including the option of local or general anaesthetic.

Clinical guidelines support healthcare professionals to provide evidence-based care. The Royal College of Obstetricians and Gynaecologists (RCOG) published an updated guideline on outpatient hysteroscopy in September 2024. The updated guideline has reference to minimising pain and discomfort during hysteroscopy procedures. While RCOG guidelines are not mandatory, they are designed to support high-quality care, and the Department and NHS England encourages local implementation tailored to patient needs. This is available at the following link:

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/outpatient-hysteroscopy-green-top-guideline-no-59/

Letters and information sent to patients are determined at a local level by individual National Health Service trusts. A range of additional information is available for patients on hysteroscopy procedures, including on the NHS website, and the Royal College of Obstetricians and Gynaecologists has created a patient information resource on hysteroscopy. This is available at the following link:

https://www.rcog.org.uk/outpatient-hysteroscopy

As with all procedures, healthcare professionals are expected to fully explain the procedure in advance, including expected symptoms, side effects, and risks. These conversations should be undertaken using a shared decision-making approach that ensures individuals are supported to make decisions that are right for them. This provides a collaborative process through which a clinician supports a patient to reach a decision about their treatment, bringing together the clinician’s expertise, such as treatment options, evidence, risks and benefits, with the patient’s preferences, personal circumstances and values. NHS England has published guidelines on the use of shared decision making.

The Government recognises that some procedures, such as hysteroscopy, can result in pain, and the level of pain experienced will vary between individual women. It is important that healthcare professionals provide women with information prior to their procedure so that women can make an informed decisions about the procedure and pain relief options, including the option of local or general anaesthetic.

Clinical guidelines support healthcare professionals to provide evidence-based care. The Royal College of Obstetricians and Gynaecologists (RCOG) published an updated guideline on outpatient hysteroscopy in September 2024. The updated guideline has reference to minimising pain and discomfort during hysteroscopy procedures. While RCOG guidelines are not mandatory, they are designed to support high-quality care, and the Department and NHS England encourages local implementation tailored to patient needs. This is available at the following link:

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/outpatient-hysteroscopy-green-top-guideline-no-59/

Letters and information sent to patients are determined at a local level by individual National Health Service trusts. A range of additional information is available for patients on hysteroscopy procedures, including on the NHS website, and the Royal College of Obstetricians and Gynaecologists has created a patient information resource on hysteroscopy. This is available at the following link:

https://www.rcog.org.uk/outpatient-hysteroscopy

As with all procedures, healthcare professionals are expected to fully explain the procedure in advance, including expected symptoms, side effects, and risks. These conversations should be undertaken using a shared decision-making approach that ensures individuals are supported to make decisions that are right for them. This provides a collaborative process through which a clinician supports a patient to reach a decision about their treatment, bringing together the clinician’s expertise, such as treatment options, evidence, risks and benefits, with the patient’s preferences, personal circumstances and values. NHS England has published guidelines on the use of shared decision making.

The data requested is not held.

My hon. Friend raises an important question. We are committed to improving women’s experience of gynaecological procedures, including hysteroscopies. Women should be provided with information prior to their procedure so that they can make an informed decision about the procedure and pain relief options, including local or general anaesthetic. He will probably make further representations, which we will certainly look at.

Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?

The Government recognises that some procedures, such as a hysteroscopy, can result in pain, and the level of pain experienced will vary between individual women. It is important that healthcare professionals provide women with information prior to their procedure so that women can make an informed decisions about the procedure and pain relief options, including the option of local or general anaesthetic.

Clinical guidelines support healthcare professionals to provide evidence-based care. The Royal College of Obstetricians and Gynaecologists published an updated guideline on outpatient hysteroscopy in September 2024. The updated guideline has particular reference to minimising pain and discomfort during hysteroscopy procedures. While the Royal College of Obstetricians and Gynaecologists’ guidelines are not mandatory, they are designed to support high-quality care, and the Department and the National Health Service encourage local implementation tailored to patient needs. This guidance is available at the following link:

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/outpatient-hysteroscopy-green-top-guideline-no-59/

The NHS website also provides information for patients. The page on hysteroscopy provides information on preparing for and recovering from a hysteroscopy, including pain relief options.

The National Institute for Health and Care Excellence (NICE) is responsible for making decisions independently on whether its guidelines should be updated in light of new evidence or emerging issues not in the scope of the original guideline.

The NICE has published a number of guidelines that relate to the diagnosis of cancer or hysteroscopies, and is currently updating its guideline on the assessment of treatment of fertility problems. The NICE currently expects to publish final updated guidance in May 2025.