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.