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Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. Opening hours: Mon-Fri 7.30am-8pmwith scanning facilities from 9am-5pm. Validation, Roles PLOS ONE promises fair, rigorous peer review, If it is decided that you need outpatient care,the Emergency Department will send an electronic referral to the EPAU nurse, and you will be contacted either the same dayor the next working day. 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. There are 21 Parent and Child Bays available on this level. MASS (NK) was commissioned by and became a member of the VESPA co-applicants group to provide the required workforce modelling expertise and knowledge. Having collected detailed data on the opening hours of all participating EPAUs over the weekend, we were able to identify that one hours increase in the weekend opening hours of an EPAU resulted, as expected, in an increased probability of a woman with first trimester complications being admitted to hospital from the EPAU, but decreased the chance of an admission to hospital from the Emergency Department. From the west of the city Southampton General Hospital can be accessed via several routes from the M271. There is a canopy or recess which provides weather protection at this entrance. Upon completion of data collection, we revisited the activity in all 44 units. Get contact details, videos, photos, opening times and map directions. The toilet roll holder can be reached from seated on the toilet. We are a very activeunit located in the Woodlands building (pink zone) at the Lister hospital and we see around 5,500 women every year. A hoist can be brought in from another department. Pregnancy Sickness Support website, here. Keeping an EPAU open over the weekend for an additional hour was associated with 2.4% (95% CI 0.1% to 4.7%) lower odds of an emergency admission from ED. 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. The clinic reception is located to the left as you enter. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. Assistance may be required because there is/are slopes/ramps. The lighting levels at the reception area/desk are medium. View Accessibility Symbols. Patients and members of the public were involved at several stages of the study, including the design, management, and conduct of the study. After 18 weeks, the patient is seen in the Emergency Obstetric Unit or Delivery Suite. Visualization, As you face the toilet pan the transfer space is on the left. Copyright: 2021 Memtsa et al. Staff do not need to be notified for use of the lift. Nausea and vomiting in early pregnancy affects up to 80% of pregnant women. The wash basin is placed higher than 74cm (2ft 5in). The lift does have a visual floor indicator. To keep our patients safe, we are currently offering a telphone advice, triage and referral service. Clinic 3 - Early Pregnancy Unit is approximately 35m from the lift. In addition to senior clinicians presence, we also explored the effect that weekend opening of an EPAU has on emergency admissions. There is a dark mat or floor marking at this entrance that might be perceived as a hole. The senior clinicians were actually spending less time in the EPAUs than expected. Both telephone and email applications will be coordinated by the UCH main reception team. There are several services which stop on Coxford Road outside the Princess Anne Hospital, they are the X11, U6C, the THREE and the 7 Bluestar and 17 Bluestar. The car park does not have a height restriction barrier. You will then have an ultrasound scan which is usually a transvaginal scan (internal scan), to assess your pregnancy. If you have had a previous miscarriage, we would you advise to contact the Early Pregnancy Assessment Unit if you experience bleeding. King's College Hospital Early Pregnancy Assessment Unit (EPAU) Address: Suite 8, Third Floor Golden Jubilee Wing Denmark Hill London SE5 9RS Telephone: 0203 299 3168 Usual Opening Times Location Map Get Directions This is a walk in service so you need no appointment, simply attend the unit. (2021) Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and weekend opening on emergency hospital admissions: Findings from the VESPA Study. Visit website. We see women in the first 17 weeks of pregnancy only (up to 14 weeks at Basildon University Hospital). There is a/are door(s) leading into the department/service. If you wish to book your pregnancy care with the Trust, please instead fill out our maternity self-referral form. Report a problem or suggestion using this facility. Methodology, Edna Keeney reports personal fees from Novartis Pharma, personal fees from Pfizer Inc., outside the submitted work. The median admission rate among 44 units was 2.8% (range 0% to 13.7%) (Fig 1). The details that will be required when requesting in advance are - Blue Badge serial number, date of expiry and issuing authority/council. The main door(s) open(s) towards you (pull). The main car park for the Princess Anne Hospital is called the Yellow car park. We are closed in Bank holidays. There are also several bus routes which stop at the Southampton General which is a short walk from the Princess Anne Hospital on Tremona Road. Units were divided into eight mutually exclusive strata based on these characteristics, and 5 or 6 EPAUs were randomly selected from each stratum to a total of 44 for inclusion in the VESPA study. Get contact details, videos, photos, opening times and map directions. There are windows, glazed screens or mirrors behind the reception point which could adversely affect the ability of someone to lip read. Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. These associations did not markedly change after further confounder adjustment. There is a dropdown rail on the transfer side. The Early Pregnancy Unit assesses women with complications such as pain, bleeding and excessive vomiting. The lighting level in the lift is medium. here. Yes, however bleeding does not necessarily mean there is a problem. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. Funding acquisition, The reception area/desk is clearly visible from the entrance. There is not a flashing fire alarm beacon within the room. The department/service does play background music. For more information about what these symbols mean, view our Accessibility Symbols Guide. Once the sonographer is ready to scan you, we will ask you to call your partner to accompany you into the scan. You're adding a service to your CPD log. 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. We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. See below link for maternity web page if need more information needed regarding these concerns. Many of our studies are currently recruiting and women attending the EPAGU will be invited to participate. The drop-off point is located on Beaumont Place. 33 days (IQR 2447) was the median time for units to complete recruitment. The height of the intercom is 134cm (4ft 5in). The height of the soap dispenser is 97cm. Recurrent pregnancy loss A key is not required for the accessible toilet. Dementia friendly signage is not provided. This variable was also dichotomised for some analyses to indicate whether the annual number of patient visits for a unit was above or below the median. The lateral transfer space is 145cm (4ft 9in). If a family member or friend has accompaniedyou, the clinician will still request that a member of staff acts as chaperone for an intimate examination. The waiting room / area is approximately 7m from the clinic entrance. There was no apparent relationship between planned senior clinician presence and emergency admissions (Fig 2). Project administration, 1445/5464 (26.4%; 95%CI 25.3 to 27.6) women were admitted from ED. Otherwise, we will assume that you're OK to continue. These are further broken down by diagnosis in Tables 3 and 4. https://doi.org/10.1371/journal.pone.0260534.g001, https://doi.org/10.1371/journal.pone.0260534.t002, https://doi.org/10.1371/journal.pone.0260534.t003, https://doi.org/10.1371/journal.pone.0260534.t004. The Early Pregnancy Unit is classified as an Emergency Service and you may be invited to attend the unit for an appointment. This site is intended for healthcare professionals only. Wall mounted grab rails are available for the toilet. Print this page The clinic is open from 08.30 to 11.00 Monday to Saturday. View on a map. There is not a red flashing fire alarm beacon within the toilet. There is not a Patient Advice and Liaison Service (PALS) at the hospital. There are 4 consultation/treatment rooms in this department/service. Opening Hours for patient assessment and care planning. Validation, The contrast between the wall-mounted grab rails to the right of the toilet and wall is fair. The Blue Badge bay(s) is/are signposted but have no markings. Scans appointments are every weekday morning and afternoon. Data curation, This national study has been realised thanks to the participation and hard work of 44 Early Pregnancy Assessment Units and their supporting research staff, a large number of patients who took the time to advise us before and during the study, as well as complete questionnaires and take part in interviews, and a number of organisations and individuals, to which we are extremely grateful. We appreciate that this is a very difficult and painful time, this leaflet aims to answer some of the many questions you will have about what has happened. If you experience vaginal bleeding and/or abdominal pain you can be seen for assessment up to 19+6 weeks gestation. View our cookie policy. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, Affiliations Carole Johnston / Nicky Hewitt, Clinical Nurse Specialists for early pregnancy: 01924 541123, Gynaecology assessment unit: 01924 541135, Back to top of page The car park does not have a height restriction barrier. Occasionally, for both early pregnancyand emergency gynaecology you may need to be admitted into hospital for us to perform further investigations,monitor you, or initiate treatment but we will keep you informed of this and support you through this process. We have placed cookies on your deviceto help improve our website. A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. Access to Early Pregnancy Unit and Gynae Assessment Unit is via the Level D entrance. We apologise for any inaccuracies in the following list of contributors, whose primary role has been described. The Early Pregnancy Assessment Unit (EPAU) is for patients in the early stages of pregnancy up to 16 weeks. There is sufficient space next to the bed/couch for a mobile hoist to operate. Due to the current Covid-19 restrictions, we ask that you do not bring childrento your appointment. 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. Both units contribute to large multicentre research projects. Funding acquisition, Signs and universally accepted symbols or pictograms, indicating lifts, stairs, WCs, circulation routes and other parts of the building are not provided in the reception area. Final diagnosis (FD) was divided into five groups: 1) Normal intrauterine pregnancy including early and live pregnancies; 2) Abnormal intrauterine pregnancy including early embryonic demise, incomplete, and complete miscarriage; 3) Ectopic pregnancy at any site; 4) Pregnancy of unknown location; and 5) Other: molar pregnancy, multiple pregnancy, and not pregnant. Women are seen in order of clinical priority, which means that you may be in the department for longer than anticipated. we'll add the event details to your CPD section automatically. As you face the toilet the wall-mounted grab rail(s) is/are on both sides. Monday to Friday 8.30am - 4.30pm (excluding Bank Holidays). The door(s) open(s) automatically (towards you). There is a canopy or recess which provides weather protection at this entrance. Data curation, There is level access to the consultation / treatment room. If the outcome of your consultation is that you require an ultrasound then our ultrasound scanning appointment times are from 9:30am 4.00pm on weekdays. Clinic 24 is a small, but busy, unit based on Level 1 in the Rosie. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. The Pregnancy Sickness Support website has good advice. We ask that they call the unit so that we can book them a timed appointment. The unit characteristics were confirmed again immediately prior to commencing patient recruitment. d) previous tubal surgery Euston Road - no's 18, 27, 30, 88. In this national prospective cohort study, we aimed to determine whether higher participation of senior clinicians in the delivery of first trimester pregnancy care would result in better quality clinical care reflected in a lower risk of acute admissions to hospital for women presenting with first trimester complications. The height of the toilet seat above floor level is 48cm (1ft 7in). You should still contact the Early Pregnancy Unit on the phone number below, which will inform you of where to call in the event of an emergency. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. There are not separate entry and exit doors in the lift. There is not sufficient space to write or sign documents on the counter. When you attend the Emergency Department, you will be assessed by a doctor to see whether you need to stay in hospital and receive care as an inpatient, or whether you can be discharged and referred to to the EPAU as an outpatient. Neither planned senior clinician presence (p = 0.874) nor unit volume (p = 0.247) were associated with lower admission rates from EPAU, whilst EPAU opening over the weekend resulted in lower admission rates (p = 0.027). The Patient Advice and Liaison Service (PALS) is located on Level C of the Centre Block at the Southampton General Hospital. There is / are 4 consultation / treatment room(s) available. The toilet roll holder is placed higher than 100cm (3ft 3in). Volunteers can be found on the ground floor of the main University College Hospital building. 2018 37:1533-1538. pmid:29119588 . . From the north of the city there are several routes from the M27, from the north east the A33 offers the best route towards the hospital. You can also self-refer if you have had your booking appointment with your midwife in our hospital, or have a previous history of molar or ectopic pregnancy. You are accessing this website using a legacy browser. The closest station is Southampton Central which is approximately 2.3 miles from the Hospital. The hospital does have a dedicated car park. The upper gestational age limit was set at 13+6 weeks gestation in order to keep recruitment from all participating EPAUs consistent. There is a Patient Advice and Liaison Service (PALS) at the hospital. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. Coping with problems in early pregnancy can be difficult, however unfortunately due to COVID 19 restrictions we are limited to the number of people who can be allowed into the department. The title of this entry will be Early Pregnancy Assessment & Gynaecology Unit: RFL. The Yellow car park is an underground car park on levels B and C of the Princess Anne Hospital with accessible Blue Badge Bays located on Level C. There are also 21 parent and child bays on level C of the Yellow Car park. Language interpreters can be provided on request. Research that could potentially guide recommendations and policies on staffing and configurations of EPAUs has been scarce [69]. There is not a hearing assistance system. Opening Times. Conceptualization, We accept GP, midwife and A&E referrals for assessment. This relatively low level of senior clinicians involvement could explain the lack of an observed association between their presence and emergency admissions in this study. 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. Twenty-three units were open during weekends. Writing original draft, If necessary, patients can be admitted under the on-call gynaecology team 24 hours a day, seven days a week. Call our hospital switchboard on 0118 322 5111 and ask for the On-call Gynae bleep 602. We also accept GP referrals for emergency gynaecology problems. If you have abdominal pain inearly pregnancy, we want to ensure that the pain is not caused bya miscarriage or anectopic pregnancy. The post code for the Sat-nav is SO16 5YA. Please send a referral letter with all patients. By clicking any link on this page you are giving your consent for us to set cookies. We chose to study the rate of emergency admissions which is a recognised quality outcome indicator for acute hospital units [19, 20]. However, there was evidence of an association between the emergency admission rate and weekend opening hours. Having collected contemporaneous data documenting the actual time that senior clinicians spent in the EPAU delivering early pregnancy care, we found no significant association whether we analysed for planned or actual presence of the senior clinicians in EPAU. If you are not under the care of the EPAU, please contact your GP. Getting To The Hospital There is a payment machine at a convenient height for wheelchair users. The Unit is open at all times. 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. The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. If you feel your symptoms require urgent assessment outside of these hours the wider medical team are here to support you 24 hours a day 7 days a week. The car park is located at the side of the Elizabeth Garrett Anderson Wing. Find Early Pregnancy Assessment Unit in Worksop, S81. For more information about PLOS Subject Areas, click We obtained similar results whether we analysed for senior clinician presence as a binary outcome or as a continuum. There is a/are wall-mounted grab rail(s) available. The name / number of the room surveyed was; D190. Opening times. Based on this study, the sample size of 44 units, each contributing 150 patients, was calculated to give us 90% power to detect a 5% absolute difference in the risk of an emergency admission. A mobile hoist is not available on the department/service. Hospital staff do not receive disability awareness / equality training. Copyright 2023 East and North Hertfordshire NHS Trust. There is sufficient space to write or sign documents on the desk. There is room for a wheelchair user to manoeuvre. Most models were adjusted using one of two sets of potential confounder variables: i) maternal age and final diagnosis (MA+FD) or; ii) maternal age, final diagnosis, IMD and gestational age policy (MA+FD+IMD+GAP). The Early Pregnancy Clinic should be your first port of call. Click here for a guide to help you assess your bleeding. We are open Monday - Friday 08 - 20:00 (last patient accepted 19:15) and Saturday -Sunday 08:30 - 14:00 (last patient accepted 13:15). During working hours, women needing EPAGU services who attend A&E will be sent directly to the unit. Weekend opening, however, may be an effective way of reducing emergency admissions from ED. Sexual health, contraception and HIV services, Vaginal bleeding and/or pain in early pregnancy up to 16 weeks, A loss of liquor before 16 weeks (watery vaginal loss), A positive pregnancy test and ascanresult showinga pregnancy of unknown location with pain, bleeding or other relevant symptoms, A previous ectopic pregnancy (at sixweeks gestation they can be referred for a scan). Contact us. For further advice about emergency gynaecology at Barnet Hospital, call the hospital. Find Early Pregnancy Assessment Unit in Worksop, S81. Formal analysis, They were also similar if we consider patients with normally-developing pregnancies (FD group 1) and abnormally-developing pregnancies (FD groups 25) (Table 6). The service is then located on the right. Competing interests: I have read the journals policy and the authors of this manuscript have the following competing interests: MM, VG, GA, ZA, NK, JH, GB, RBA, JS, DJ has nothing to disclose. Wakefield The service provides specialist care for the following: Where medically appropriate, we offer a range of management options for conditions in early pregnancy and acute gynaecology. gpit@camdenccg.nhs.uk to carry out the upgrade. There are bollards outside this entrance. The wash basin and tap(s) can be reached from seated on the toilet. Our research lead, Professor Tom Bourne, is a founding member of the International Ovarian Tumor Analysis (IOTA) group and sits in the steering committee of several large international trials. We have a dedicated team of nurse practitioners, doctors, sonographers and consultants who aim to offer seamless care to assess, diagnose and offer treatment and support if required. The towel dispenser can be reached from seated on the toilet. 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. This video animation tells the story of one couples experience of miscarriage. clinic appointment letter. Planned and actual senior clinician presence, unit size, and weekend opening. The entrance door(s) does/do contrast visually with its immediate surroundings. There is a/are manual, heavy, double door(s) between the lift and the department/service. Traffic light controlled pedestrian crossing points are located adjacent to each tube station. 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]. MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. Tommys Tommy's is a charity that funds research for pregnancy and babies. We could therefore calculate the actual amount of time senior clinicians spent in EPAU delivering clinical care. Miscarriage is the most common type of pregnancy loss. The door does not have a horizontal grab rail. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical . The entrance door(s) does not/do not contrast visually with its immediate surroundings. on the right to withdraw consent, can be found in the website's privacy policy. On your first visit to UCH or the UCH Macmillan Cancer Centre you need to park your car and bring the following to the reception desk - your valid Blue Badge, your vehicle registration document or Motability documents, proof of hospital attendance, showing appointment time and date e.g. The main door(s) open(s) automatically (away from you). You can find your nearest walk-in centre at www.nhs.uk. The width of the accessible toilet door is 87cm (2ft 10in). Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, Current constraints on health expenditure have compelled providers to explore ways of delivering a greater proportion of care in outpatient settings whilst maintaining good clinical outcomes and high levels of patient satisfaction. The height of the towel dispenser is 106cm (3ft 6in). Supervision, The nearest designated Blue Badge parking bay is approximately 25m (27yd 1ft) from the Elizabeth Garrett Anderson Wing main entrance. 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. There are sofas and also a mixture of single seats with and without armrests. Copyright 2023 AccessAble. Project administration, View Article PubMed/NCBI . on the right to withdraw consent, can be found in the website's privacy policy. During the day you can access the maternity unit by entering the hospital through the main entrance. https://doi.org/10.1371/journal.pone.0260534.t001. As you face the toilet pan the transfer space is on the right. Water bowls for assistance dogs are available on request. The VESPA study received a favourable ethical opinion from the North West Research Ethics Committee (REC reference 16/NW/0587) in the UK, registration number ISRCTN 10728897. This accessible toilet is approximately 17m (18yd 1ft) from the clinic entrance. The reception area/desk is approximately 6m (6yd 1ft) from the clinic entrance. Both provide consultant-led care for women who experience problems in early pregnancy. Methodology, c) previous ectopic pregnancy View on a map. 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 over Cardiff and the Vale of Glamorgan. This is based on 6397 women that had complete information on the outcome and key characteristics. There is not a play area or toys/books for a child to play with. 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. . If your condition may affect your pregnancy, you will be referred to the appropriate department. The lateral transfer space is 170cm (5ft 7in). Child Emotional Wellbeing & Mental Health, Learning Disabilities & Neurodevelopmental Disorders (NDD), Gastroenterology, Colorectal, Renal & Urology, Care Home Training & Development (Islington), Data quality/standard referral form programme, 020 7472 6374(RFH) and 020 8216 5233 (Barnet), 020 7472 6374 (rfh: specialist nurse advice during opening hours) or020 7794 0500 ext 38205 or 31468, Early Pregnancy Assessment & Gynaecology Unit: RFL, assessment and management of women with pain and bleeding in early pregnancy (up to 15 weeks and sixdays), assessment of women at high risk of an ectopic pregnancy, assessment and management of women with acute gynaecological problems.