The RCOG undertook a review against national standards of the current work profile and gynaecology laparoscopy service across two sites.
Our assessors found that the Trust had a high workload, with a larger proportion of gynaecology to obstetric practice, compared to many other similar sized units. The staff interviewed were passionate and impressive in their commitment to the service. However, there was a lack of team cohesion among the consultant body during the interviews. Adherence to department clinical policies appeared slightly ‘ad hoc’ and the current membership and structure of the Gynaecology Forum did not seem to have the authority or seniority of membership to deliver. The assessors found that clinicians and managers were lacking in a shared, unified strategic agenda and there was no reassurance that these problems were understood.
Our assessors made recommendations including:
- Immediate development of an emergency gynaecology assessment unit
- Immediate job plan analysis and the provision of dedicated on-call surgical services at consultant level
- Appointment of a suitable clinical director and other medical managers
- Prioritise safety and quality issues – ensuring that they are at the top of the directorate agenda
- Review of the clinical governance structure for gynaecology and the appointment of an officer accountable for safety, with access to the directorate and Trust management