Welcome to the latest edition of the newsletter and, as always, a particular welcome to new members.
- Opportunity: Pelvic Organ Prolapse
- Getting involved as a patient tutor
- Specialists of Tomorrow Public Insight Group
- Each Baby Counts
Foreword from Mary Twomey
Education and training is a key component of RCOG activity, developing the education and training for doctors who choose to become specialists in obstetrics and gynaecology, as well as supporting their career-long learning.
In addition to my role as co-Vice chair on the RCOG Women’s Network, I also represent the Network on the RCOG Curriculum committee. This is an exciting time for this committee, which is in the process of re-drafting the curriculum for O&G trainees. The contribution of those who use services is seen as vital in developing this new curriculum, and as a first step in this process I was delighted to co-lead a workshop in June, where contributors shared their experiences of using services to inform their views around the qualities and values, knowledge and skills that future clinicians should have. It was fantastic to meet many Women’s Voices in person. The rich discussion that characterised the day will be supplemented by future consultations, as the process continues ready for the launch of the new curriculum in 2019. For me, this reflects the College’s commitment to becoming one of the leading champions for women’s health, an ambition which can only be achieved by engaging with women as partners in care.
Both Women’s Voices and the Women’s Network have important roles to play in this respect, of course, and we also have important contributions to make in women’s health outside the RCOG. I know that Kate Brian, the College’s Women’s Voices Lead who chairs the Network, is always pleased to see so many contributors to Women’s Voices at the events of partner organisations such as the recent Eve Appeal #TalkingTaboos event during September’s gynaecological cancer awareness month. I’m sure that we all look forward to continuing to make such a positive and lively contribution.
Myself and Catherine Nestor (my co-Vice Chair) attend the RCOG Council meetings along with Kate. As you may know, the recent Council meeting considered the difficult issue of the decriminalisation of abortion. During this meeting, I spoke to many clinicians who had thought long and hard about this issue, and had engaged with the members of the College that they represent. Likewise, as Women’s Network members, we had some thoughtful debate prior to the Council discussion. All involved in this decision acknowledge the broad range of opinions on this issue but I, and the Women‘s Network, believe the Council decision to support a position to decriminalise abortion in the UK represents an important step in helping to improve access to this essential area of women’s healthcare. You can read the College’s statement on this decision.
I hope you enjoy reading this newsletter and many thanks for your continued support and involvement of the College’s work.
Mary Twomey, Co-Vice Chair of the RCOG Women’s Network
Opportunity: Pelvic Organ Prolapse
The RCOG is working in partnership with academic institutions and the NHS to involve women in a new research trial looking at helping women who have a prolapse gain the confidence, skills and knowledge to manage their condition, with the support of their healthcare professionals. The research trial will be focussing on pessary use in women who are experiencing prolapse. Pessaries are one of the treatment options for prolapse.
We are looking for a group of women to take part via phone or email to help develop some of the materials for women that form part of this research study. We want to make sure the materials are written and designed in a way that will be most helpful for women.
Who is this opportunity for?
Any women in the UK who have experienced or have an interest in pelvic organ prolapse. Ideally we’re keen for some women who have experienced using a pessary and some who haven’t.
What will you be asked to do?
You will be asked to read a series of draft information leaflets, short questionnaires and other relevant documents, then give feedback either by email or by phone. This shouldn’t take more than 2 hours.
When will this be happening?
Resources will be shared in stages with feedback on the first resources required by the end of October. We will then share other resources to gain feedback later in the year.
If you are interested in finding out more and taking part, please email Kerri O’Rourke at firstname.lastname@example.org.
Getting involved as a patient tutor
Women’s Voices member Rachael Edgerton speaks about her experience of being a Patient Tutor and the impact she hopes this will have on the next generation of doctors.
“I was recently appointed as a Patient Tutor at the John Radcliffe University Hospital, in Oxford. The role of patient tutors is to use their personal experiences to help students gain a better understanding of the realities of living with certain conditions.
On my first session as a tutor there were just two of us, instead of the usual four or five, so we were talking to groups of 10 or more fifth year medical students about menstrual dysfunction.
The students had a lecture before we went in for an informal talk about our experiences and, essentially, the effect our conditions had had on our life and relationships. The students, who will go on to specialise in many different areas, all listened carefully and asked thoughtful questions about how my experiences of heavy bleeding affected my family, work and general health.
I found it cathartic, but it is heartening that these students were so willing to listen and to ask questions beyond what they would learn from a lecture or textbook. For example, I talked about the financial implications of heavy bleeding from sanitary products to new mattresses. The male students, particularly, had never thought of the cost of it and realised how difficult it would be for women on low incomes. They didn’t know that you get around 25% fewer “industrial” sized tampons (as I used to call them), in a box compared to the regular size.
In my second session, I was particularly struck by the sensitivity of the students. They asked me what had prompted me to go to my GP. I said it was my extreme menopausal mood swings and that I only mentioned my heavy bleeding as an afterthought, as if it wasn’t important. The students saw how emotional just talking about it can be, (yeah, I cried) and my group said how sorry they were I’d had to deal with it.
At the end of the session, the lecturer comes back in and does a round up, asking students to feed back. One student made the very pertinent comment that, if someone was bleeding like that from their leg, abdomen or bowel, it would be blues and twos to hospital, so why do we accept heavy menstrual bleeding as something we just have to put up with? Because we do, I said. Because we’re women, and that’s what we do.
I will be going again, and for as long as I can, and would thoroughly recommend anyone else taking up this kind of opportunity if it arises in their own region. I am actively seeking ways to get involved further and recently wrote to my GP to see if I would be able to speak to their students. Unfortunately, at the moment, it would be difficult to set up something formal because they only have one student at a time for five weeks and they are very busy seeing patients. However, she did say that if a student shows a particular interest in gynaecological issues and would like to speak to a patient, then she’ll be in touch. In the near future, we will have a new surgery, they will be able to accommodate more students and my GP is keen to set up a formal arrangement. I was pleased that she is willing to incorporate Patient Tutors into their training programme and that she can see the benefit.
I truly believe that if we are to change women’s health care for the future then we have to talk to and influence students. Hopefully, one day, the doctors I have spoken to will have patient in front of them, who is struggling to explain what the problem is, and somewhere in the back of their minds they will remember me, telling them about the blood running down my leg in a classroom full of teenagers. After all, isn’t that what Women‘s Voices is all about?”
A note from the RCOG: If you know about any opportunities to get involved as a patient tutor in your area, please do get in touch with us. Over the next few months we will be working with colleagues to identify similar opportunities throughout the UK so do look out for more information via the WVIP Facebook page or email email@example.com.
Specialists of Tomorrow Public Insight Group
“Often what you are sharing with a doctor can be very intimate and sometimes uncomfortable for you. You need to feel like they are on your side, like they understand how difficult it can all be. Having a doctor with the ‘human touch’ can change your whole experience. The doctors of tomorrow need to understand the impact they can have on people’s lives – and their families.”
Member of the Specialists of Tomorrow Public Insight Group
In June the RCOG ran a public insight workshop around the curriculum for O&G specialists. Training to become a specialist takes seven years after a medical degree and two foundation years. The core curriculum outlines what knowledge and skills doctors undertaking this seven year training need to develop during this time. It is currently being completely revised so this public insight project is designed to make sure the views of those who use O&G services have a voice and inform what it looks like.
25 members of the public came along to the day to share what knowledge, skills and qualities they feel are important for an O&G specialist to have.
Some of the key themes from the discussion were around doctors needing to:
- Be able to empower their patients and support them to make informed choices
- Have enhanced communications skills and show qualities such as empathy and respect
- Keep up to date with their knowledge and skills through continued learning beyond their training skills
- Have a thorough understanding of the wider determinants and characteristics that can impact on an individual’s O&G health.
There were many other important areas identified on the day which were also captured. Following the workshop a wider consultation group was also asked for their views by email. All insight is currently feeding into the development of a new curriculum. We see this as the first stage of involving O&G service users throughout this project so watch this space for further opportunities to get involved.
You may like to read a blog article about the day from Women’s Voices member Shona Beaver from Womb Cancer Support UK, who attended the workshop.
Each Baby Counts
The RCOG published its latest Each Baby Counts (EBC) report in the summer. EBC is a 5 year initiative which aims to reduce the number of term babies who die or are left severely disabled as a result of incidents occurring during term labour. When these cases tragically occur, hospitals report their local review of the case to the EBC project. These are then analysed, national patterns and themes identified, and recommendations for changes in practice made. The project started in 2014 and this summary report is the first time a full year of data (2015) has been analysed.
The investigation team has now conducted 2,500 expert assessments of the local reviews into the care of 1,136 eligible babies born in the UK in 2015 – 126 who were stillborn, 156 who died within the first seven days after birth and 854 babies who met the eligibility criteria for severe brain injury. The report concluded that three quarters of the babies - 76% - might have had a different outcome with different care.
The recommendations from the report are aimed at doctors and midwives working in maternity units across the UK and centre around:
- improving the quality of investigations including the involvement of parents if they wish to be
- fetal monitoring
- neonatal care
- human factors
Read the Each Baby Counts 2015 Summary Report
The next step for the project is to work with the maternity teams on implementation of the recommendations, as well as continuing to analyse data year on year and make further recommendations.
Women’s Voices, Nicky Lyon and Michelle Hemmington from the Campaign for Safer Births continue to offer crucial input into the project as members of the EBC Independent Advisory Group. As always, thank you to you both for your continued commitment to this work, as well as all other Women’s Voices and the wider public who continue to support the initiative.
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