The majority of women are satisfied with the care they receive in outpatient clinics for heavy menstrual bleeding (HMB) finds the third annual report of the National HMB Audit, published today. However, the report identified younger women and women of non-white ethnicity as needing more information and better quality of care.
HMB is a relatively common condition and affects about a quarter of women during their reproductive years.
The National Audit is a 4-year audit, which aims to describe the care received by women with HMB referred to NHS outpatient clinics in England and Wales, and to assess their experience of care. The Audit is commissioned by the Healthcare Quality Improvement Partnership and is led by the Royal College of Obstetricians and Gynaecologists, in collaboration with the London School of Hygiene & Tropical Medicine and Ipsos MORI.
This third annual report focuses on the experiences and health outcomes of women with HMB once they have been referred to the NHS outpatient clinics. 8517 women completed a 1-year follow-up questionnaire.
Looking at the treatment in the first year after referral to secondary care, 18% of women reported no treatment, 58% received one treatment and 24% received two or more treatments. Intrauterine system treatment was most common amongst women of older age, whilst oral medication was most common amongst women of younger age.
Patient experience in secondary care was rated excellent or very good by three-quarters of the women, with the majority of patients reporting that they received the right amount of information (73%), were treated with dignity and respect (80%), and were involved in the decisions about their care (60%). However, younger patients and patients of non-white ethnicity were more likely to rate the overall care received as fair or poor.
The proportion of women who said they had not received enough information was higher amongst those of younger age (32% of those under 35 years compared to 16% of those aged over 50 years) and those of non-white ethnicity (26% amongst those of non-white ethnicity compared to 18% amongst those of white ethnicity).
Overall, 76% of women said that they had a meaningful improvement in the severity of their condition one year on and 61% of patients had a meaningful improvement in their quality of life.
Dr Tahir Mahmood, Co-Chair of the National HMB Audit, said:
“Overall, there are many positive findings in this report. The majority of women were satisfied with the care they received in secondary care. However, this was higher among older women, of white ethnicity and those who had medical or surgical intervention.
“This report does however show that younger women, women of non-white ethnicity, and women with severe symptoms have not received enough information and are less happy with the care they have received.
“We need to undertake further research to understand the specific issues in these vulnerable groups and ensure they have access to patient focused literature and relevant information.”
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The full report can be found here.
The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme comprises more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions.