There is a/are door(s) into the consultation / treatment room. The entrance door(s) does/do contrast visually with its immediate surroundings. We have links to excellent onsite gynaecological oncology and endometriosis services across sites. As our hospitals are teaching hospitals, medical or midwifery students may be present during your appointment. The height of the intercom is 134cm (4ft 5in). There is sufficient space for a wheelchair user to manoeuvre within the imaging room. To obtain mobility aids please contact a member of staff. The intercom is in a suitable position to allow wheelchair users to gain access. https://doi.org/10.1371/journal.pone.0260534.g003. The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. gpit@camdenccg.nhs.uk to carry out the upgrade. The details that will be required when requesting in advance are - Blue Badge serial number, date of expiry and issuing authority/council. The main car park for the Princess Anne Hospital is called the Yellow car park. 08.30am - 7.00pm Monday - Friday; 9.00am - 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day) Ultrasound services If you have a non-urgent concern not related to your pregnancy such as chest/urine/ear infections, skin complaints, viral infections, exposure to infections i.e chickenpox, you should see your GP for advice as they are better placed to help with these problems. 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. The dimensions of the lift are 176cm x 270cm (5ft 9in x 8ft 10in). The variable Emergency admission indicates whether a patient had an unplanned admission to hospital following any visit for investigations or treatment of first trimester pregnancy complications. The shelf is not higher than 95cm (3ft 1in). The senior clinicians were actually spending less time in the EPAUs than expected. The EPAGU at Queen Charlottes is well-known globally for its research output. Early Pregnancy Assessment Units are highly valued by women but aspects of their care experiences, particularly around sensitive management of pregnancy loss, could be improved. This information is for the entrance located on the lower ground floor. The reception area/desk is approximately 6m (6yd 1ft) from the clinic entrance. Validation, Referrals are either from GP or the emergency department. The Unit is open at all times. As you face the toilet the wall-mounted grab rails are on both sides. be as descriptive as possible and include any specific error messages you may see. All rights reserved. The Early Pregnancy Clinic should be your first port of call. 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. Accident and Emergency Department/999 Visit website. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. There is written text and pictorial signage on or near the toilet door. Disposal facilities are available in the cubicle. The car park surface is a shared surface. Calls will be answered whenever possible but a voicemail facility will also be in place for times when the phone cannot be answered, including out of hours. The Early Pregnancy Assessment Unit (EPAU) is a nurse-run, consultant-led unit located at Junction 5 within the York Teaching Hospital. All units were asked to recruit a minimum number of 150 women each. 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]. In some cases additional treatment is needed such as: An early pregnancy loss can be a deeply distressing experience both physically and emotionally and we want to ensure that you are able to access the support you need during this difficult time. The emergency pull cord alarm is not fully functional. Writing review & editing, Affiliations 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. There are no chairs with armrests available. You will then have an ultrasound scan which is usually a transvaginal scan (internal scan), to assess your pregnancy. This technique was adopted to ensure that units of all configurations were equally represented in the final sample. Radiotherapy patients receive a dispensation notice directly from the Radiotherapy department. Funding acquisition, The width of the accessible toilet door is 87cm (2ft 10in). Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. There is ramped/sloped access at this entrance. EPAGU Level 2, Wellhouse Lane, Barnet, EN5 3DJ, 020 7472 6374, 020 7794 0500 ext 38205 or 31468, EPAGU 5th Floor, Pond Street, London, NW3 2QG, 020 7472 6374 (RFH) 020 8216 5233 (Barnet), Emergency clinic for women with pain or/and bleeding in early pregnancy or pregnant women with high risk of ectopic pregnancy, For recurrent miscarriages and early pregnancy concerns, For women with problems during early pregnancy. To view other access guides that are related to this one please use the links below. The unit is open Monday to Friday from 7.30am-8pm with scanning facilities from 9am-5pm, and Saturday 9am-5pm (closed on Sunday). This is because women with an early pregnancy complication may not necessarily need to attend in-person or may be more suited for an assessment in different clinical or maternity service. Funding acquisition, Differences in the organisation of early pregnancy units and the effect Click here for a guide to help you assess your bleeding. 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. There are strong links with the Institute of Reproductive and Developmental Biology (IRDB) at Imperial College London run by Professor Phillip Bennett, with projects ranging from the study of the microbiome to novel biomarkers in early pregnancy. The VESPA study recruited from the EPAU population. Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom, Roles The door(s) is/are double width but one door is locked. We would advise you attend your local emergency department unitif bleeding worsens whereby you are having to change your sanitary pad more frequently and feel unwell, or ifyou are experiencing severe abdominal pain which is not improving with simple pain relief egparacetamol. There is dedicated team of trained sonographers and consultants who provide the ultrasound services. The room does not have background music playing. A moderate level of clustering within units (Intraclass Correlation Coefficient, ICC = 0.04) was assumed. Return to maternity and newborn services home, View our current vacancies and read about working with us, Read about our Media service and Communications Team, you are in significant pain despite simple pain killers such as Paracetamol, experiencing moderate to severe vaginal bleeding. Formal analysis, You can do this by calling theCentral Booking Line on 01282 804512 (available 9am - 12pm, Monday - Friday). We apologise for any inaccuracies in the following list of contributors, whose primary role has been described. Modelling and Analytical Systems Solutions (MASS) Ltd, Edinburgh, United Kingdom, Roles The median admission rate among 44 units was 2.8% (range 0% to 13.7%) (Fig 1). Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. Princess Anne Hospital is Located on Coxford Road to the north West of the city. MASS (NK) was commissioned by and became a member of the VESPA co-applicants group to provide the required workforce modelling expertise and knowledge. For more information about what these symbols mean, view our Accessibility Symbols Guide. It is not intended for public use. The drop off bays have a maximum 20 minute waiting restriction. Writing original draft, There is a space for a wheelchair user to manoeuvre. Parking spaces for Blue Badge holders do not need to be booked in advance. The wash basin is placed higher than 74cm (2ft 5in). The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks. The female toilet facilities that were surveyed are located to the left as you pass through the waiting area. Yell.com Yell Business. There are parking charges for the hospital car park. Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB. No, Is the Subject Area "Obstetrics and gynecology" applicable to this article? You can visit a walk in centre for any general illness or concern for which you may have visited your GP. 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. Methodology, Assessment is by appointment only following a consultation with a healthcare professional or telephone consultation with EPAU. The title of this entry will be Early Pregnancy Assessment & Gynaecology Unit: RFL. However, at the time of your scan, you can be accompanied by your partner. The closest station is Southampton Central which is approximately 2.3 miles from the Hospital. If you are unable to book an appointment, or need to see a GP out of hours, call your surgery and follow the advice provided. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical . For many people who have experienced pregnancy loss, finding out they are pregnant again can bring with it a mixture of hope and fear, along with a range of other feelings. King's College Hospital Early Pregnancy Assessment Unit (EPAU) When you attend an event booked through the North Central London GP Website, You can find more information about these on the patient information page. The Blue Badge bay(s) is/are clearly marked. The Pregnancy Sickness Support website has good advice. Treatments available for ectopic pregnancies includelaparoscopic surgery, medical treatment with methotrexate, or expectant management. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . You can also be referred by a clinician (doctor, midwife or advanced clinical practitioner) who will complete an electronic referral, or by yourGP who will email us directly. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Women may self-refer to the Royal Free EPAGU with early pregnancy problems. No, Is the Subject Area "Hospitals" applicable to this article? As a secondary outcome, we aimed to establish the number of emergency hospital admissions for women attending EDs in the same location as the EPAU for first trimester pregnancy complications. There is a/are door(s) into the consultation / treatment room. These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. We listen to patient feedbackto deliver patient-centred care. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. If our guide needs updating - just let us know using this form. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, Unfortunately, bleeding can also be associated with an ectopic pregnancy (where the pregnancy grows outside the womb) or a miscarriage. Continue along Grafton Way and rejoin the A400. The department/service does play background music. There is a dark mat or floor marking at this entrance that might be perceived as a hole. Take the lift to the lower ground floor and on exiting turn right and go through the double doors. However, there was little evidence of an association with unit volume (p = 0.647) or planned senior clinician time (p = 0.280). Once the sonographer is ready to scan you, we will ask you to call your partner to accompany you into the scan. Models were either unadjusted or adjusted for gestational age unit policy. Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. Funding: The VESPA study received funding from the NIHR Health Services & Delivery Research (HS&DR) programme grant number 14/04/41. 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. 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 IHE receives funding from, and collaborates with, government, academic, not-for-profit and private sector organisations. 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. Carole Johnston/ NickyHewitt, Clinical Nurse Specialists for early pregnancy. 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. Visualization, There is step free access at this entrance. https://doi.org/10.1371/journal.pone.0260534.t001. View photos. There is space for an assistance dog to rest within the seating area. There is step free access to Early Pregnancy Unit and Gynae Assessment Unit. Planned senior clinician presence was defined as the percentage of planned hours which they were expected to spend in the unit according to their weekly timetable, divided by the planned unit opening hours. In addition, obtaining good quality data on emergency admissions from the Emergency Department based on routine hospital databases proved to be challenging, and we were only able to confidently utilise the data obtained from a fraction of the participating units. Jeff Round reports grants from NIHR, during the conduct of the study; and Dr Round is currently employed by the Insitute of Health Economics (IHE). Writing review & editing, Affiliation There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. The unit characteristics were confirmed again immediately prior to commencing patient recruitment. Please call the ward to find out more. Standard toilet facilities are available. Therefore many women may prefer to monitor mild painless bleeding in early pregnancy (below 12 weeks and 6 days) and you may want to explore our information about bleeding and pain in pregnancy prior to contacting the unit, here. Access to Clinic 3 - Early Pregnancy Unit is via the Elizabeth Garrett Anderson Wing main entrance. Writing original draft. 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). The Early Pregnancy Unit (EPU) is a walk-in unit open and free of charge to any woman who is . Formal analysis, Abdominal pain can also be related to non pregnancy causes including muscular pain, pain related to fibroids, urinary tract infection and other surgical causes egappendicitis. Women's experiences of early pregnancy assessment unit services: a We chose to study the rate of emergency admissions which is a recognised quality outcome indicator for acute hospital units [19, 20]. 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. We also accept GP referrals for emergency gynaecology problems. The lighting levels at the reception point are good. J Ultrasound Med. This link takes you to the University College Hospital (UCH) page with information on travelling to the hospital. There is a Patient Advice and Liaison Service (PALS) at the hospital. This car park runs around the hospital building from the entrance on Level D to the rear of the hospital. General Practitioner (GP) Yes For more information about PLOS Subject Areas, click Early Pregnancy Assessment Unit (EPAU) - York and Scarborough Teaching There is not an assistance dog toilet or toileting area on the hospital site. Language interpreters can be provided on request. Supervision, The lighting levels in the imaging room are low to moderate. EPU and UGCC | NHS Frimley Health Foundation Trust 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. GPs wishing to make a referral should complete the Early Pregnancy Unit (EPAU) referral form below and send it to the correct email address. b) vaginal bleeding The day room/lounge area is not always open. Visiting restrictions are in place. Investigation, Future research is needed to assess whether increased participation of senior clinicians and actual time commitment in provision of early pregnancy care, a change in their training could have more significant impact on the rate of emergency admissions and other indicators of the quality of clinical care in early pregnancy. By clicking any link on this page you are giving your consent for us to set cookies. The designated Blue Badge parking bays are located at the rear of the hospital on Beaumont Place. Early pregnancy clinic | NHS Fife Payment signs do not make it clear if parking charges apply to Blue Badge holders. Call our hospital switchboard on 0118 322 5111 and ask for the On-call Gynae bleep 602. The unit is open Monday to Fridayfrom 7.30am to 8pm with scanning facilities from 9am-5pm. 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 toilet roll holder can be reached from seated on the toilet. Accessible toilet facilities are available. Discover a faster, simpler path to publishing in a high-quality journal. There is a/are Blue Badge parking bay(s) available. Yes A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. The unit has excellent links with the fetal medicine service, also based at Queen Charlottes. View Article PubMed/NCBI . Visit website. There is a shelf within the accessible toilet. We carefully assessed the burden and timings of the study participation and questionnaires on patients. Actual senior clinician presence was defined as the percentage of hours they spent in EPAUs delivering care divided by the unit opening hours. Opening times. Maternity Services | NHS Lanarkshire The mirror is not placed at a lower level or at an angle for ease of use. Early Pregnancy and Gynaecology Emergency Unit (EPU) Contact. EPAU opening times EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. The entrance door(s) does not/do not contrast visually with its immediate surroundings. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. Software, The hospital entrance is clearly visible from the car park. 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. The entrance area/door is clearly signed with the name of the service/department. Dispensation notices are issued at the main reception at the UCH site (07.00-20.00 Monday to Friday and 08.00-16.00 on Saturdays, Sundays and Bank Holidays). There is a clear unobstructed route to the reception point. There are not separate entry and exit doors in the lift. This maynot always possible depending on service demand and the type of investigation, monitoring or treatment you may need. 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. PLoS ONE 16(11): Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. Areas in Camden, south of the Euston Road, are not covered by the national Blue Badge disabled parking scheme. Mobility aids are available to help patients move around and include; wheelchairs and crutches. 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). 9.00am 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day), 10.00 to 12.00 Sunday and Bank Holiday except 25th December, Clinical assessment if you present with symptoms in early pregnancy, USS scan to assess pregnancy, pelvis, ovaries, Medical/surgical/conservative management for miscarriage orectopic pregnancy, Surgical management of miscarriage under Local anaesthesia (MVA), Outpatient Treatment for hyperemesis (vomiting in early pregnancy), Outpatient treatment for Bartholins abscess, Telephone advise and follow up regarding further investigations, assessment of symptoms and management plans. The reception point is located ahead of the Early Pregnancy Unit and Gynae Assessment Unit entrance. Early Pregnancy Unit (Day time): 0151 604 7450. . There is/are 7 designated Blue Badge parking bay(s) within the hospital car park. 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. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. The drop-off point is located on Beaumont Place. Women are seen in order of clinical priority, which means that you may be in the department for longer than anticipated. A member of staff is available to assist with opening the door if required. We performed sensitivity analyses by refitting the regression models using the binary variables for planned senior clinician presence, unit volume and weekend opening hours. Turn right onto Beaumont Place before reaching Warren Street tube station. 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. Wall mounted grab rails are available for the toilet. The car park does not have a height restriction barrier. The car park does have a barrier control system. f) Intrauterine Contraceptive Device in-situ. Cancer Centre dispensations that the UCH main reception team are unable to deal with will be forwarded to the Cancer centre team at. The height of the soap dispenser is 100cm. 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.

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