The Unplanned Pregnancy Service at Hope Hospital, Salford has undergone extensive redesign over the last two years from the existing clinically led surgical service, to a new patient-focused, medical and surgical service with additional nurse-led clinics and scanning facilities.
In 2004 there was no specialist nurse, service demand exceeded capacity and patient choice and individualised care was not readily available.
In 2005 nurse-led clinics were introduced offering specialist individualised care and support and patient choice for both medical and surgical termination of pregnancy. Comprehensive patient pathways were provided with individualised holistic care, including contraception and sexual health care.
The new nurse-led clinic has increased patient throughput by 25% and waiting times have significantly been reduced compared to the previous service. All patients are now seen within one to two weeks of referral, according to the R.C.O.G guidelines (September 2004)
The service has solved capacity and waiting list problems, increased throughput of patients and provides a one-stop clinic with a multidisciplinary team incorporating a full sexual health care package, condom distribution and follow-up nurse support if required.
All patients are seen within two weeks of referral, both within and outside the Salford District. A GP proforma has been developed and GPs refer directly into the service, which is soon to extend to the national choose and book system. The new service now meets all targets and expected waiting times.
Patient and carers see all team members in the Unplanned Pregnancy Service. Updated and comprehensive patient information is available and discussed. The choice of procedure is fully discussed and a counselling service is available.
The service is now working in partnership with a local crematorium and funeral directors and has successfully implemented sensitive disposal of fetal remains post procedure for medical termination of pregnancy. The service is now currently looking at introducing sensitive disposal for surgical termination of pregnancy.
Other partnerships include an active patient and public involvement and involvement with the Greater Manchester termination pregnancy action group, which is a workstream from the wider sexual health network group of Greater Manchester. Here we have shared our patient care pathways, patient information leaflets and GP proformas.
We are also currently working with the Greater Manchester chlamydia screening programme, which The Department of Health began to roll out in 2002. The programme in Greater Manchester is co-ordinated by the RU clear team, with local areas providing screening and treatment to an agreed Greater Manchester model.
Future plans are looking towards self-referral and a centralised booking service.