Royal College of Obstetricians and Gynaecologists
Education
Action Planned
The RCOG will be updating the article in The Obstetrician & Gynaecologist (TOG) entitled Nonmenstrual bleeding in women under 40 years of age and will work with the BGCS to review the training materials for suspected cervical cancer. (AI summary)
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Dear Sir/Madam,
Re: Julie Sandra O’Conner – deceased
Thank you for your Regulation 28 Report to Prevent Future deaths following the inquest into the death of Julie O’Connor dated 31 January 2020. I would like to begin by expressing my sincere condolences to Julie’s family.
In order to provide a full response, I have been in contact with colleagues in the British Gynaecological Cancer Society (BGCS) and the British Society for Colposcopy and Cervical Pathology (BSCCP).
The President of the BGCS has given some context to this issue and highlighted that Cancer Research UK presents data on cervical cancer incidence as being approximately 3000 new women each year; https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer- type/cervical-cancer/incidence#heading-Zero. However, she also states that junior staff in the obstetric and gynaecology specialty will see a patient with cervical cancer very uncommonly; but that post-coital bleeding is an extremely common symptom and that there is a risk that a woman presenting with cervix cancer can therefore be missed.
In order to improve awareness for junior staff, we will be updating the article in The Obstetrician & Gynaecologist (TOG) entitled Nonmenstrual bleeding in women under 40 years of age that was first published in 2004. TOG provides all health professionals working within the field of obstetrics and gynaecology with an up-to-date, peer-reviewed information resource delivered through a range of educational articles. The journal provides UK consultants with CPD-creditable questions, where TOG questions can be answered and used as part of the knowledge-based assessment, and is also relevant to all trainees and health professionals working in the field of obstetrics and gynaecology (O&G) across the world.
The President of the BSCCP has highlighted that updated colposcopy guidelines and referral indications have recently been published which can be found at the following link:
management/2-providing-a-quality-colposcopy-clinic
We all agree that having guidance on senior review of a patient with a suspected cervical abnormality is useful to have at Trust level. If this Trust had had their guidance in place, it may well have prompted the clinician to seek a more senior review which may have picked up Julie’s condition at an earlier stage. However, guidance alone may not be sufficient and we will work with the BGCS to review the training materials for suspected cervical cancer, as this is a very visual diagnosis.
The RCOG is committed to improving the standard of care delivered to women and working collaboratively with others to prevent such tragedies from occurring in the future.
Re: Julie Sandra O’Conner – deceased
Thank you for your Regulation 28 Report to Prevent Future deaths following the inquest into the death of Julie O’Connor dated 31 January 2020. I would like to begin by expressing my sincere condolences to Julie’s family.
In order to provide a full response, I have been in contact with colleagues in the British Gynaecological Cancer Society (BGCS) and the British Society for Colposcopy and Cervical Pathology (BSCCP).
The President of the BGCS has given some context to this issue and highlighted that Cancer Research UK presents data on cervical cancer incidence as being approximately 3000 new women each year; https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer- type/cervical-cancer/incidence#heading-Zero. However, she also states that junior staff in the obstetric and gynaecology specialty will see a patient with cervical cancer very uncommonly; but that post-coital bleeding is an extremely common symptom and that there is a risk that a woman presenting with cervix cancer can therefore be missed.
In order to improve awareness for junior staff, we will be updating the article in The Obstetrician & Gynaecologist (TOG) entitled Nonmenstrual bleeding in women under 40 years of age that was first published in 2004. TOG provides all health professionals working within the field of obstetrics and gynaecology with an up-to-date, peer-reviewed information resource delivered through a range of educational articles. The journal provides UK consultants with CPD-creditable questions, where TOG questions can be answered and used as part of the knowledge-based assessment, and is also relevant to all trainees and health professionals working in the field of obstetrics and gynaecology (O&G) across the world.
The President of the BSCCP has highlighted that updated colposcopy guidelines and referral indications have recently been published which can be found at the following link:
management/2-providing-a-quality-colposcopy-clinic
We all agree that having guidance on senior review of a patient with a suspected cervical abnormality is useful to have at Trust level. If this Trust had had their guidance in place, it may well have prompted the clinician to seek a more senior review which may have picked up Julie’s condition at an earlier stage. However, guidance alone may not be sufficient and we will work with the BGCS to review the training materials for suspected cervical cancer, as this is a very visual diagnosis.
The RCOG is committed to improving the standard of care delivered to women and working collaboratively with others to prevent such tragedies from occurring in the future.