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Payment machines are located inside the hospital building. The association between the three factors: senior clinician presence, unit volume, and weekend opening hours, and the proportion of emergency admissions was investigated by using regression models, where hierarchical models were used for analysing patient-level data, and standard models were used for analysing unit-level data. Accessible toilet facilities are available. Early Pregnancy Unit and Gynae Assessment Unit is approximately 14m from the Level D entrance. As long as the future appointment can be verified then there is no time limit on how far in advance a specific dated dispensation notice can be issued. There is a/are door(s) leading into the department/service. Download the app Get a . EPAUs are currently operating in most acute hospital units in the UK aiming to provide women with comprehensive early pregnancy care, which includes clinical and ultrasound assessment, laboratory investigations, further management, as well as counselling and support, all in an out-patient setting. As it is not necessary for UCH staff to see the Blue Badge at the time of issuing a dispensation notice, a notice can be issued in advance and posted or emailed to patients. You are accessing this website using a legacy browser. Sergio A. Silverio (Kings College London) is supported by the National Institute for Health Research Applied Research Collaboration South London [NIHR ARC South London] at Kings College Hospital NHS Foundation Trust. Writing review & editing, Affiliation The Early Pregnancy Assessment Unit (EPAU) in Ward C1 at the University Hospital of Wales is an integrated single unit, which takes referrals from all overCardiffand the Vale of Glamorgan. The car park is located on Level C of the hospital building. You can change the description, reflection or CPD Credit Hours at any time from within Monday to Sunday 08:00 to 13:00. No, Is the Subject Area "Critical care and emergency medicine" applicable to this article? Supervision, The accessible toilet was out of use at the time of the survey. Data curation, The height of the reception desk is high (110cm+). Funding acquisition, The entrance door(s) does/do contrast visually with its immediate surroundings. Access to the waiting area is unobstructed. These associations did not markedly change after further confounder adjustment. There is a space for a wheelchair user to manoeuvre. The Miscarriage Association, Wakefield, United Kingdom, Roles The reception area/desk is clearly visible from the entrance. Early pregnancy services. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. If you would prefer to contact the Early Pregnancy Unit for information and support, you can contact the Specialist Nursing Team for a consultation between 8:30 am and 5:30 pm, Monday to Friday. If you want to park near, or in UCLH disabled parking bays, you will need to apply for a parking dispensation to use with your Blue Badge. The telephone number for the Patient Advice and Liaison Service (PALS) is 023 8120 6325. The contrast between the wall-mounted grab rail(s) and wall is fair. The width of the door is 88cm (2ft 11in). d) previous tubal surgery There is a clear unobstructed route to the reception point. Our findings are in contrast with the results of previous studies in other clinical settings, which showed that involvement of more experienced clinicians in delivering emergency care results in a significant reduction in emergency hospital admissions and the length of stay in hospital [12, 18]. The contrast between the dropdown rail(s) and wall is good. There is some flooring in corridors which is shiny and could cause issues with glare or look slippery to some people. There is an/are accessible toilet(s) within this venue designated for public use. The relationship between emergency admissions from the Emergency Department and senior clinicians presence in EPAU is shown in Fig 4. https://doi.org/10.1371/journal.pone.0260534.g004. Citation: Memtsa M, Goodhart V, Ambler G, Brocklehurst P, Keeney E, Silverio SA, et al. The majority of units (37/44) had a unit volume of less than 4000 visits per year, and 22 units had a yearly visit volume lower than 2500 visits per year. new North Central London GP Website do not work as expected. The drop-off point is located to the right of the Level D entrance. The soap dispenser can be reached from seated on the toilet. gpit@camdenccg.nhs.uk to carry out the upgrade. Resources, Water bowls for assistance dogs are available on request. The IHE does not currently receive funds for research related to the submitted work. Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. (include Trust leaflet get the updated version), medical management which involves taking medication, surgical management with either a general or local anaesthetic. Monday to Friday 8.30am - 4.30pm (excluding Bank Holidays). It is likely that they will be unable to offer reassurance scans if you have experienced previous early pregnancy problems unless you have symptoms in this pregnancy but individual units availability may vary. be as descriptive as possible and include any specific error messages you may see. The unit is open Monday to Friday from 7.30am-8pm with scanning facilities from 9am-5pm, and Saturday 9am-5pm (closed on Sunday). The height of the bell/buzzer is 134cm (4ft 5in). There are volunteers available for help and assistance at the hospital. If an appointment is necessary you will be offered a time to attend the unit for an ultrasound scan or to be assessed by the doctor. Telephone: 0161 922 6000 The route from the car park to the hospital entrance is not clearly signposted. The NICE guideline developing group, which includes a patient and public involvement panel, concluded that the configuration of services between different units varied considerably but, due to paucity of data, they were unable to make recommendations on the optimal structure of EPAUs that would balance clinical and service outcomes against cost-effectiveness. The contrast between the wall-mounted grab rails to the left of the toilet and wall is poor. The Early Pregnancy Unit runs in parallel with the Gynaecology Assessment Unit (GAU) and provides services for women with complications of pregnancy such as pain or bleeding up to 16+6 weeks gestation. Copyright 2023 AccessAble. The intercom is in a suitable position to allow wheelchair users to gain access. On the UCH site, security staff, at the security desk in the UCH Atrium and at the Elizabeth Garrett Anderson Hospital EGAH reception are able to issue dispensation notices out of hours. Early Pregnancy and Gynaecology Emergency Unit (EPU), Follow us on social media for all the latest news and announcements, Lister Hospital, Coreys Mill Lane, Stevenage, SG1 4AB. Carole Johnston/ NickyHewitt, Clinical Nurse Specialists for early pregnancy. Send email. The sonography team will advise if you need to empty your bladder prior to the scan. Senior clinicians were present only in 19 of the 44 EPAUs. There is not a red flashing fire alarm beacon within the imaging room. You can find more information about these on the patient information page. Continue along Grafton Way and rejoin the A400. It has been created to raise awareness and help others to see that what they are going through is completely normal. Do you want to change or cancel an appointment? Gynaecology Outpatient Department,Ground floor, Green Zone, Lewisham High Road, SE13, Gynaecology Outpatients Department, Stadium Road, Greenwich, London SE18 4QH. Tameside and Glossop Integrated Care NHS Foundation Trust Fountain Street Ashton-under-Lyne OL6 9RW. As a result, the group prioritised the need for future good quality research into the relative effectiveness of different EPAU configurations [10]. This link takes you to the University College Hospital (UCH) page with information on travelling to the hospital. A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. A total of 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. Please complete the form calledEarly Pregnancy Assessment Unit (EPAU) and email to: GP to telephone to make an appointment The Early Pregnancy Unit (EPU) provides a wide range of services for women who are experiencing concerns in early pregnancy. Assessment is by appointment only following a consultation with a healthcare professional or telephone consultation with EPAU. The wash basin and tap(s) can be reached from seated on the toilet. Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. That is, a one-hour increase in weekend opening hours was associated with a 3.0% (95% CI: 0.3% to 5.8%) increase in the odds of an emergency admission from EPAU. Writing review & editing, Roles Wakefield A number of organisations give dedicated support and advice to people affected by pregnancy loss: CRADLE is anational registered pregnancy loss charity working in partnership with Lewisham and Greenwich NHS Trust. Writing review & editing, Affiliation Opening Hours for patient assessment and care planning. This department/service has; a main reception, accessible toilet facilities for everyone, ambulant toilet facilities for everyone, consultation rooms, standard toilet facilities and a waiting room/area. The dimensions of the accessible toilet are 210cm x 220cm (6ft 11in x 7ft 3in). Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. The car parking facilities are for Blue Badge holders only. For more information about what these symbols mean, view our Accessibility Symbols Guide. EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. If your condition may affect your pregnancy, you will be referred to the appropriate department. This information is for the entrance located on Grafton Way. View Accessibility Symbols. BSL interpreters can be provided on request. Once the sonographer is ready to scan you, we will ask you to call your partner to accompany you into the scan. PLoS ONE 16(11): Writing review & editing, Affiliation No, Is the Subject Area "Obstetrics and gynecology" applicable to this article? Treatments available for ectopic pregnancies includelaparoscopic surgery, medical treatment with methotrexate, or expectant management. this will normally be done within 2 days and you will need to be nil by mouth for 6 hours. The Early Pregnancy Assessment Unit is part of the Gynaecology Assessment Unit, which offers help and support for those experiencing problems in early pregnancy up to 16 weeks. No car parking (other than for Blue Badge holders) is available at University College Hospital (UCH). Clinic 3 - Early Pregnancy Unit is/are located on the lower ground floor. There is not a flashing fire alarm beacon within the waiting room / area. A member of staff is available to assist with opening the door if required. The National Institute for Health and Care Excellence (NICE) guideline on Ectopic Pregnancy and Miscarriage (CG 154) [10] included a review of evidence comparing EPAUs with other models of providing early pregnancy care for women presenting with first trimester pregnancy complications. View Accessibility Symbols. Women may also be referred to the units if they are pregnant and have a previous history of miscarriage or ectopic pregnancy, or if there is a suspected gynaecological problem that requires urgent clinical assessment. The female toilet(s) is/are approximately 20m (21yd 2ft) from the clinic entrance. We value all people andstrive to beopen, honest and accountable for the care provided. Getting To The Hospital Senior clinician (consultant gynaecologist) involvement in the delivery of acute clinical care has been of interest recently [11], as there is emerging evidence of their positive impact on Emergency Departments (EDs) and Acute Medical Units, contributing to reduced mortality, fewer emergency hospital admissions and accelerated discharge from hospital [1214]. Areas in Camden, south of the Euston Road, are not covered by the national Blue Badge disabled parking scheme. Methodology, For more information please contact Professor Tom Bourne, consultant gynaecologist by emailing t.bourne@ic.ac.uk at Queen Charlottes, or Dr Shahla Ahmed, consultant gynaecologist by emailing shahla.ahmed1@nhs.net at St Marys. The admission rates by patient characteristics is shown in Table 2. To obtain mobility aids please contact a member of staff. The email address for the Patient Advice and Liaison Service (PALS) is. VESPA included the services provided by MASS in the submittal for funding to NIHR. The wash basin can be reached from seated on the toilet. The other possibility is that senior clinicians, who are fully trained in general obstetrics and gynaecology, lack the additional clinical and ultrasound skills necessary for the effective running of an EPAU. Parking spaces for Blue Badge holders do not need to be booked in advance. Yes There is not sufficient space to write or sign documents on the counter. Opening Times. The door(s) open(s) away from you (push). Please call the ward to find out more. Copyright 2023 AccessAble. The Blue Badge bay(s) is/are clearly marked. EPAU opening times EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. We do not accept self-referral to the Early Pregnancy Unit for vomiting in pregnancy unless you are currently under our care or have been diagnosed with hyperemesis in a previous pregnancy. J Ultrasound Med. The Blue Badge bay(s) is/are signposted but have no markings. You must telephone the unit before attending we do not run a walk-in clinic or service. The height of the wash basin is 86cm (2ft 10in). There is step free access into the imaging room. In some miscarriages the uterus (womb) empties itself completely. We carefully assessed the burden and timings of the study participation and questionnaires on patients. After yourscan, you will be reviewed by one of the specialist nurses who will then discuss with you the likely cause of your symptoms, whether you need to have any more investigations, and your treatment options. Data Availability: All relevant data are within the papers Supporting information files. 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Pregnancy Sickness Support website, here. Patients can call 0203 447 3013 to request a dispensation notice in advance. Data curation, The unit has strong international links, in particular with KU Leuven in Belgium. You should contact your midwife if you require advice on non-urgent symptoms or conditions in pregnancy. t: 020 7472 6374during opening hours (Mon-Fri 7.30am-8pm with scanning facilities from 9am-5pm), Call switchboard Pinderfields Hospital Funding acquisition, There is a/are Blue Badge parking bay(s) available. Despite the fact that an advanced training module in acute gynaecology and early pregnancy has been running for a number of years from The Royal College of Obstetricians and Gynaecologists, to our knowledge, a rigorous assessment of its quality and effectiveness has not been undertaken [21]. The route from the car park to the entrance is accessible to a wheelchair user with assistance. When we compared actual with planned senior clinicians presence, we found that in only 3/19 units (16%) did senior clinicians spend more than 15% of their time actively delivering clinical care, and in 13/19 units (68%) their actual documented presence was less than 5%. The reception point is located ahead of the Early Pregnancy Unit and Gynae Assessment Unit entrance. The dimensions of the accessible toilet are 156cm x 241cm. When you attend an event booked through the North Central London GP Website, It is also unclear whether completion of the module is a requirement locally for appointment to EPAU leadership roles. Non-identifiable demographic and routine clinical data were collected for all women attending the participating EPAUs, and if women gave their written consent to participate to the VESPA study, their clinical data were linked. Dementia friendly signage is not provided. For more information about PLOS Subject Areas, click In view of this, we revised our cut-off and used 2500 instead of 3000 visits to describe the units as high or low volume in the final data analysis. Writing review & editing, Affiliation Princess Anne Hospital is Located on Coxford Road to the north West of the city. There is space for an assistance dog to rest within the seating area. The height of the soap dispenser is 99cm. Formal analysis, There are several possible explanations for our findings. During working hours, women needing EPAGU services who attend A&E will be sent directly to the unit. Click here for a guide to help you assess your bleeding. There is step-free access to the accessible toilet. People can self-refer to the unit by contacting 01924 541135 or through their GP, midwife, hospital doctor, Emergency Department staff if they have: If you are referred to the unit, an appointment will be offered for the next available clinic based on the following set criteria: Women between 6 - 13 weeks of pregnancy with a . Investigation, The drop-off point is located on Beaumont Place. You can at any time read our cookie policy. Many of our studies are currently recruiting and women attending the EPAGU will be invited to participate. It is not intended for public use. For some analyses, this variable was also dichotomised to indicate whether a unit was open at weekends (yes/no), whilst a three-level weekend opening variable was defined: None/Saturday only/Saturday and Sunday. This is an important finding for health providers as the cost of employing senior clinicians is much higher compared to nurses and other healthcare professionals. If our guide needs updating - just let us know using this form. We found that, in general, the actual amount of time spent by the senior clinicians in the units was less than planned, and in only five units, they were present for more than 5% of the time (Fig 3). Urgent GP referrals are seen on the same day. You will have a telephone assessment with a specialist EPAU nurse, and they will advise whether you need to attend a booked appointment for a face-to-face assessment and/orscan. We see women in the first 17 weeks of pregnancy only (up to 14 weeks at Basildon University Hospital). There is level access to the consultation / treatment room. You will often be seen at around 6 -7 weeks for a reassurance scan. If you are not under the care of the EPAU, please contact your GP. Five working days should be allowed by patients/carers to receive their dispensation notice in the post, to allow time for the request to be processed and received in by second class post. Validation, Writing review & editing, Affiliation There is a canopy or recess which provides weather protection at this entrance. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. The lateral transfer space is 170cm (5ft 7in). This venue does not play background music. The drop off bays have a maximum 20 minute waiting restriction. 020 3456 7890. Writing original draft, The toilet roll holder can be reached from seated on the toilet. There is a small lip on the threshold of the entrance, with a height of 1.5cm or below. Writing review & editing, Roles The contrast between the wall-mounted grab rails to the right of the toilet and wall is fair. Clinic 24 is a small, but busy, unit based on Level 1 in the Rosie. Conceptualization, There is step free access to Early Pregnancy Unit and Gynae Assessment Unit. This accessible toilet is located to the right as you pass through the waiting area. Writing review & editing, Affiliation Supervision, For more information about PLOS Subject Areas, click The details that will be required when requesting in advance are - Blue Badge serial number, date of expiry and issuing authority/council. Yes EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. GPs wishing to make a referral should complete the Early Pregnancy Unit (EPAU) referral form below and send it to the correct email address. The VESPA study recruited from the EPAU population. About the EPAU The Early Pregnancy Assessment Unit (EPAU) is a nurse-led service which provides specialist care for women who have, or who have had the following: Vaginal bleeding and/or pain in early pregnancy up to 16 weeks Conceptualization, This technique was adopted to ensure that units of all configurations were equally represented in the final sample. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, You can do this by calling theCentral Booking Line on 01282 804512 (available 9am - 12pm, Monday - Friday). Data curation, Accident and emergency patient information leaflets, Video consultations - frequently asked questions, Visiting and keeping in touch during Covid-19, Log in or register with Patients Know Best, Patients Know Best - frequently asked questions, Patients Know Best and NHS App integration, Yorkshire Regional Spinal Injuries Centre (YRSIC), Psychology department - Every Voice Matters, Complex Eating, Weight and Bariatric Psychology, Plastic, Reconstructive and Burns Surgery, Breast plastic and reconstructive surgery, Skin cancer plastic and reconstructive surgery, Trauma plastic, reconstructive and burns surgery, Population and people who use our services, Zero Tolerance - Abuse is not in a day's work, Genetic Links to Anxiety and Depression (GLAD) study, Providing Online guided Self-help for Eating disorders in adults with type 2 Diabetes (POSE-D) pilot study, General Data Protection Regulation (GDPR), Safe Nursing and Midwifery staffing levels, Medical Education & Simulation Hub (MESH), Visit the Miscarriage Association website, previous ectopic or molar pregnancy with a new pregnancy. If you have abdominal pain inearly pregnancy, we want to ensure that the pain is not caused bya miscarriage or anectopic pregnancy. The width of the door opening is 87cm (2ft 10in). Your local Accident and Emergency department can still be used if you have an emergency or accident not related to your pregnancy (chest pain, difficulty breathing, collapse, etc). An implantation bleed, when the pregnancy is settling into the womb lining, can be common at around 4-6 weeks. Opening times. Visit website. As part of this assessment, they may ask for investigations that may be performed on the same day or within urgent time frames and a management plan will be made for you. Writing original draft. https://doi.org/10.1371/journal.pone.0260534.g002. A 1-hour increase in the weekend opening hours of the EPAU was associated with 2.4% (95% CI: 0.1% to 4.7%) lower odds of an emergency admission from the Emergency Department. Please note: Dispensations are only issued to outpatients with Blue Badges who are attending hospital appointments. Our team isproudto provide compassionate care during anxious times in early pregnancy, when you may be experiencing pain and/or bleeding or have had a previous ectopic or molar pregnancy. The waiting room / area is approximately 7m from the clinic entrance. On arrivalyou will be booked in by our dedicated admin clerk anddirected to the EPAU waiting area with your referral form and a number. Formal analysis, Visiting restrictions are in place. For Pregnancy complications occurring beyond the first 16 weeks and up to six weeks post-partum or for Hyperemesis, contact: Maternity Day Assessment Unit. Tel: 0118 322 8741. However, there was evidence of an association between the emergency admission rate and weekend opening hours. The Early Pregnancy Assessment Unit (EPAU) provides care and support to women and anyone experiencing complications in early pregnancy, as well as their partners. There is room for a wheelchair user to manoeuvre. If you are over 20 weeks of pregnancy please contact Maternity Triage. Planned and actual senior clinician presence, unit size, and weekend opening. There is a dropped kerb from the drop-off point. To view other access guides that are related to this one please use the links below. From the west of the city Southampton General Hospital can be accessed via several routes from the M271. They are not issued to carers, relatives, visitors or friends who are Blue Badge holders bringing a non-Blue Badge holder patient to an appointment. This car park runs around the hospital building from the entrance on Level D to the rear of the hospital. If you experience vaginal bleeding and/or abdominal pain you can be seen for assessment up to 19+6 weeks gestation. Specialist nurses also provide advice by telephone on 020 7472 6374during opening hours. The car park does not have a barrier control system. Standard toilet facilities are available. Otherwise, we will assume that you're OK to continue. There are standard toilet facilities within this department/service. The maternity unit is situated on the second floor of the hospital (level2). To obtain mobility aids please contact the main reception. Is the Subject Area "Pregnancy" applicable to this article? This section describes the Ultrasound Room(s), located to the left along the department corridor. Fitting hierarchical logistic regression models for Emergency admission from EPAU, there was little evidence of an association between the admission rate and planned senior clinician presence or unit volume controlled for final diagnosis and maternal age, as shown in Table 5. Volunteers do not receive disability awareness / equality training. There is not a designated drop-off point. This information is for the entrance located on Level D of the hospital, opposite the entrance to the car parks. View on a map. There is / are 10 consultation / treatment room(s) available. Your health professional will assess to see if you require a referral to the Early Pregnancy Unit. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0260534, https://www.rcog.org.uk/globalassets/documents/guidelines/wprgynstandards2008.pdf, https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_022.pdf, https://www.aomrc.org.uk/wpcontent/uploads/2016/05/Seven_Day_Consultant_Present_Care_1212.pdf, https://www.england.nhs.uk/wp-content/uploads/2013/12/evidence-base.pdf, https://www.isdscotland.org/Health-Topics/Quality-Measurement-Framework/Emergency-Admissions/, https://www.kingsfund.org.uk/sites/default/files/Avoiding-Hospital-Admissions-Sarah-Purdy-December2010_0.pdf, https://www.rcog.org.uk/globalassets/documents/careers-and-training/atsms/atsm_acutegynae_curriculum.pdf. When you attend an early pregnancy appointment you can bring one adult support partner with you however no children are currently able to attend with you. Research that could potentially guide recommendations and policies on staffing and configurations of EPAUs has been scarce [69]. The email address for the Patient Advice and Liaison Service (PALS) is. Mirrors are not placed at a lower level or at an angle for ease of use. The unit is open Monday to Friday, from 9am-5pm. Conceptualization, If a scan is required and where it cannot be performed on the same day we will do our best to ensure that any wait is as short as it can be and we will endeavour to keep you updated of any delays.