Recommendation 17

The NHS must do more to monitor and enforce protocols governing procedures such hysteroscopy, IUD fitting and cervical screening and ensure that they are underpinned by informed consent and are trauma-informed. A risk assessment that allows a patient to make an informed choice on the recommended procedure should be undertaken as standard, taking account of any previous history of undergoing related procedures. This should also include consideration of the patient’s mental and physical preparedness for a penetrative procedure, particularly in cases where the individual has not had or recently had penetrative sex. The full range of options on pain relief, including anaesthesia, should be considered and a clear commitment made that if the level of pain during the procedure is unbearable, that procedure will be halted and a separate appointment will be made. As membership bodies, the Royal College of Obstetricians and Gynaecologists and the Royal College of General Practitioners should be doing far more to ensure their members adhere to guidelines and best practice.