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An email request option is offered where the completed dispensation will be emailed so the patient/carer can print prior to arriving for their appointment, email requests are via. There are accessible toilet facilities within the department/service. There is step free access to the reception area/desk. Data curation, No, Is the Subject Area "Nurses" applicable to this article? Formal analysis, Send email. Contact details will be put on all outpatient letters. The car parking facilities are for Blue Badge holders only. Validation, Opening Times. The unit characteristics were confirmed again immediately prior to commencing patient recruitment. t: 020 7472 6374during opening hours (Mon-Fri 7.30am-8pm with scanning facilities from 9am-5pm), Call switchboard 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. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. Investigation, Models were either unadjusted or adjusted for gestational age unit policy. 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. 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. All rights reserved. The tube stations are located at opposite ends of the hospital main building. You're adding a service to your CPD log. There is a space for a wheelchair user to wait within the seating area. 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. broad scope, and wide readership a perfect fit for your research every time. You might find it helpful to talk to your GP, midwife or early pregnancy staff if you are feeling anxious. 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. Contact. They will be asked to sign a declaration form and wait for you outside the department until you are called in for your scan. Email this page Yes You can find some more helpful advice regarding nausea and vomiting in pregnancy on the Pregnancy Sickness Support website, here. The Early Pregnancy Unit (EPU) provides care and support for women up to 21 and 6 days weeks gestation who may be experiencing problems in their pregnancy. Conceptualization, The toilet is not for the sole use of disabled people. There was no apparent relationship between planned senior clinician presence and emergency admissions (Fig 2). Assistance may be required because there is/are slopes/ramps. d) previous tubal surgery The width of the accessible toilet door is 87cm (2ft 10in). 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. Investigation, The contrast between the walls and floor is good. The contrast between the wall-mounted grab rails to the right of the toilet and wall is fair. By clicking any link on this page you are giving your consent for us to set cookies. 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. e) three or more previous miscarriages The total number of opening hours per weekend was used to illustrate weekend opening. Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. There are sofas and also a mixture of single seats with and without armrests. Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. The role of the commercial company MASS Ltd, as an elite researcher in workforce modelling, was advisory with regards to data collection and analysis. 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). 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. Walk-in Centres Data curation, This information is for the entrance located on Level D of the hospital, opposite the entrance to the car parks. All rights reserved. Carole Johnston/ NickyHewitt, Clinical Nurse Specialists for early pregnancy. The contrast between the towel dispenser and the wall is good. The dimensions of the designated Blue Badge parking bay(s) surveyed are 410cm x 440cm. Payment machines are located inside the hospital building. Institute of Health Economics, Edmonton, Canada, Roles Validation, Writing review & editing, Affiliation The EPAGU at Queen Charlottes is well-known globally for its research output. Telephone: 0161 922 6000 The contrast between the wall-mounted grab rail(s) and wall is fair. Clinic 24 is a small, but busy, unit based on Level 1 in the Rosie. A key is not required for the accessible toilet. Index of Multiple Deprivation (IMD) was calculated based on the home address postcode of the patient at the time of patient recruitment. Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. Peter Brocklehurst reports grants and personal fees from MRC, grants from MRC, NIHR HS&DR, NIHR HJTA, Wellcome Trust, personal fees from AG Biotest, outside the submitted work. We value all people andstrive to beopen, honest and accountable for the care provided. Introduction Pregnancy can be a turbulent time, both physically and emotionally, for women and their partners. The intercom is in a suitable position to allow wheelchair users to gain access. The drop off bays have a maximum 20 minute waiting restriction. 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. You can do this by calling theCentral Booking Line on 01282 804512 (available 9am - 12pm, Monday - Friday). Tameside and Glossop Integrated Care NHS Foundation Trust Fountain Street Ashton-under-Lyne OL6 9RW. 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. Conceptualization, Tommys Tommy's is a charity that funds research for pregnancy and babies. On entering via the Level D entrance continue ahead and the entrance to the Early Pregnancy Unit and Gynae Assessment Unit department is on the right. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles The car park does have a barrier control system. Access to the waiting area is unobstructed. f) Intrauterine Contraceptive Device in-situ. As you face the toilet the wall-mounted grab rails are on both sides. There is a changing place located on level C of the Centre Block at the Southampton General Hospital. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. Data for this observational study were collected as part of the VESPA study, a UK-wide prospective mixed-methods study on the Variations in the organization of EPAUs in the UK and their effects on clinical, Service and PAtient-centred outcomes. These responses were used to categorize the units according to three factors: planned senior clinician presence (yes or no); weekend opening (yes or no); and the annual volume of patients, as reported by the corresponding clinicians (low volume <3000 appointments per year vs. high volume 3000 appointments annually). Edna Keeney reports personal fees from Novartis Pharma, personal fees from Pfizer Inc., outside the submitted work. This information is for the entrance located on Grafton Way. 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. Treatments available for ectopic pregnancies includelaparoscopic surgery, medical treatment with methotrexate, or expectant management. Women with nausea and vomiting in pregnancy should contact their GP for an assessment of their symptoms to exclude other causes for nausea and vomiting in pregnancy such as urinary tract infections. The soap dispenser cannot be reached from seated on the toilet. The bollard(s) has/have a good colour contrast to prevent them being hazardous to visually impaired people. The lateral transfer space is 170cm (5ft 7in). If you have abdominal pain inearly pregnancy, we want to ensure that the pain is not caused bya miscarriage or anectopic pregnancy. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. Methodology, 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. We see women in the first 17 weeks of pregnancy only (up to 14 weeks at Basildon University Hospital). Carole Johnston / Nicky Hewitt, Clinical Nurse Specialists for early pregnancy: 01924 541123, Gynaecology assessment unit: 01924 541135, Back to top of page The title of this entry will be Early Pregnancy Assessment & Gynaecology Unit: RFL. Do not wait to be called by the EPAU team. There is not a red flashing fire alarm beacon within the toilet. 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. www.ectopic.org.ukSupporting people who have experienced an early pregnancy complication. You will be given a copy of your ultrasound report. Supervision, There is/are 10 designated Blue Badge parking bay(s) within the hospital car park. Yes, however bleeding does not necessarily mean there is a problem. 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. here. a new pregnancy and under the care of the recurrent miscarriage clinic. Miscarriage is the most common type of pregnancy loss. The height of the bell/buzzer is 134cm (4ft 5in). There is not a red flashing fire alarm beacon within the imaging room. The IHE does not currently receive funds for research related to the submitted work. The Unit is open at all times. The Early Pregnancy Assessment Unit (EPAU) is a nurse-run, consultant-led unit located at Junction 5 within the York Teaching 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. The width of the door is 88cm (2ft 11in). The designated Blue Badge parking bays are located at the rear of the hospital on Beaumont Place. The IHE receives funding from, and collaborates with, government, academic, not-for-profit and private sector organisations. The Early Pregnancy Unit assesses women with complications such as pain, bleeding and excessive vomiting. No, Is the Subject Area "Cohort studies" applicable to this article? The car park does not have a height restriction barrier. The upper gestational age limit was set at 13+6 weeks gestation in order to keep recruitment from all participating EPAUs consistent. This room is not accessed via a changing room. All women aged 16 years of age who attended the participating EPAUs presenting with first trimester pregnancy complications for the first time during the index pregnancy were included in the cohort study. The contrast between the wall-mounted grab rails to the left of the toilet and wall is poor. 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). Visit website. Please check the latest information before planning your journey. The primary outcome for the VESPA study was the number of emergency admissions as a proportion of women attending each participating EPAU. As you face the toilet pan the transfer space is on the left. Tel: 01793 605257 If you require an ultrasound we aim to offer this within 72 hours of referral. The door(s) is/are double width but one door is locked. Statistical models were adjusted for final diagnosis, maternal age at initial visit, deprivation score, and unit referral policy regarding gestational age, as these variables have a known effect on the rate of emergency admissions [1517]. We performed sensitivity analyses by refitting the regression models using the binary variables for planned senior clinician presence, unit volume and weekend opening hours. We have links to excellent onsite gynaecological oncology and endometriosis services across sites. A mobile hoist is not available on the department/service. 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. Site map. The car park does have a height restriction barrier. There is a/are wall-mounted grab rail(s) available. Writing review & editing, Roles There is a vertical wall-mounted grab rail on the transfer side. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. Opening Hours for patient assessment and care planning. Mobility aids are available to help patients move around and include; wheelchairs and crutches. There is not a flashing fire alarm beacon within the waiting room / area. 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 and acute gynaecology unit (EPAGU) is an emergency unit. We received input from patients who had experienced first trimester pregnancy complications in the design and timing of the study materials, and management oversight through membership of the study steering committee. The toilet roll holder can be reached from seated on the toilet. Opening Times (Early Pregnancy Unit and Gynae Assessment Unit) Department / Service (Early Pregnancy Unit and Gynae Assessment Unit) Reception Consultation / Treatment Room (3) Imaging Room Day Room / Lounge Area (Quiet Room) Accessible Toilet (s) Related Access Guides Getting To The Hospital (Princess Anne Hospital) Collapse all By Road View 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. Our study has several limitations. The height of the wash basin is 86cm (2ft 10in). Twenty-three units were open during weekends. The towel dispenser cannot be reached from seated on the toilet. 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. Please note: Dispensations are only issued to outpatients with Blue Badges who are attending hospital appointments. We care for women with acute early pregnancy problems and acute gynaecology issues. We obtained clinical data from 6,606 women. We have a dedicated gynaecology team of doctors and nurse practitioners to care for you and to make a full assessment of your symptoms. https://doi.org/10.1371/journal.pone.0260534.t001. 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. Formal analysis, Do you want to change or cancel an appointment? Accident and Emergency Department/999 There is some flooring in the department/service which is shiny and could cause issues with glare or look slippery to some people. Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. The main door(s) open(s) automatically (away from you). Referrals are accepted direct to the unit from GPs, Midwives and the Emergency Department. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm. Location and opening times The EPU is based in the gynaecology clinic on the ground floor of Lanesborough Wing. The main object of the service is to minimise unnecessary hospital admissions, which benefits both patients and the staff. Writing review & editing, Roles Visualization, The contrast between the dropdown rail(s) and wall is good. You can at any time read our cookie policy. Writing review & editing, Roles All units were asked to recruit a minimum number of 150 women each. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . The contrast between the toilet roll holder and the wall is good. Yes Women may self-refer to the Barnet EPAGU only if they have had a previous ectopic pregnancy or recurrent miscarriages. The following buses are used to access the University College Hospital (UCH): Tottenham Court Road - Northbound (Warren Street station) - no's 10, 73, 24, 29, 134. Many of our studies are currently recruiting and women attending the EPAGU will be invited to participate. This site is intended for healthcare professionals only. This analysis was based on the 29 units (5,464 patients) that were able to provide us with reliable data regarding the attendances to Emergency Department and emergency admissions out of hours. Data curation, 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. Always inform the staff in the department you are pregnant. There is a/are door(s) into the consultation / treatment room. The height of the toilet seat above floor level is 48cm (1ft 7in). The hospital entrance is not clearly visible from the car park. The Patient Advice and Liaison Service (PALS) is located on the ground floor of the main University College Hospital building. You can catch the Bluestar 17 and City Red Three buses from the station - both continue to Southampton General Hospital and Princess Anne Hospital. The wash basin is placed higher than 74cm (2ft 5in). After 18 weeks, the patient is seen in the Emergency Obstetric Unit or Delivery Suite. View our cookie policy. There is not a/are not Blue Badge parking bay(s) available. The email address for the Patient Advice and Liaison Service (PALS) is. All rights reserved. The door does not have a horizontal grab rail. This showed substantial variations in the proportion of in-patient emergency admissions with 8.5% in units without, and 3.5% in those with, senior clinician presence. 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. The height of the intercom is 134cm (4ft 5in). 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. Software, This maynot always possible depending on service demand and the type of investigation, monitoring or treatment you may need. Funding acquisition, Copyright 2023 AccessAble. Referral: patients are mainly referred to the Unit by their GP, but also from Gynaecology wards, by Midwives and other medical routes. Actual senior clinician presence was defined as the percentage of hours they spent in EPAUs delivering care divided by the unit opening hours. 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. The height of the reception desk is high (110cm+). Guidelines: care is provided to women following guidelines that have been produced by the department. The funder provided support in the form of salaries for authors MM, VG, GA, PB, EK, SS, ZA, JR, NK, JH, GB, JS, DJ; however, the funder and sponsors of the study did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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). Disposal facilities are available in the toilet. We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. Copyright: 2021 Memtsa et al. Euston Road - no's 18, 27, 30, 88. 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. The email address for the Patient Advice and Liaison Service (PALS) is. There is a small lip on the threshold of the entrance, with a height of 1.5cm or below. In the submitted paper, there are no competing interests and MASS has no claim of ownership for any IP arising from or related to this paper. There is a/are manual, heavy, double door(s) between the lift and the department/service. Miscarriage Association, 2023 Northern Ireland Maternity and Parenting. 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 lighting levels are moderate to good. Formal analysis, We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. The car park is located on Level C of the hospital building. Investigation, There are bollards outside this entrance. Discover a faster, simpler path to publishing in a high-quality journal. Find Early Pregnancy Assessment Unit in Worksop, S81. 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. The Blue Badge bay(s) is/are signposted but have no markings. Forfurther advice aboutemergency gynaecology at Barnet Hospital, call020 8216 5233. The unit is open Monday to Fridayfrom 7.30am to 8pm with scanning facilities from 9am-5pm. . You can find your nearest walk-in centre at www.nhs.uk. There is a canopy or recess which provides weather protection at this entrance. BSL interpreters can be provided on request. The Early Pregnancy Assessment Unit (EPAU) is a nurse-led service which provides specialist care for women who have, or who have hadthe following: Whilethis is NOT a standardmaternity triage form, if neededyou can self-refer to the EPAU by filling out our EPAU self-referral form. The contrast between the walls and floor is good. It is likely that the caller ID will show as a private number orwithheld number. Women are often contacted on the same day, or the next working day if the referral is received after 3pm. On arrivalyou will be booked in by our dedicated admin clerk anddirected to the EPAU waiting area with your referral form and a number. There is a Patient Advice and Liaison Service (PALS) at the hospital. There is a payment machine at a convenient height for wheelchair users. (include Trust leaflet get the updated version), medical management which involves taking medication, surgical management with either a general or local anaesthetic. The female toilet(s) is/are approximately 20m (21yd 2ft) from the clinic entrance. There is sufficient space for a wheelchair user to use the waiting area. If you experience vaginal bleeding and/or abdominal pain you can be seen for assessment up to 19+6 weeks gestation. The nearest standard toilets are located on the ground floor of the Elizabeth Garrett Anderson Wing. The unit is open Monday to Friday from 7.30am-8pm with scanning facilities from 9am-5pm, and Saturday 9am-5pm (closed on Sunday). Your local early pregnancy unit is still available but opening times and appointment availability may have changed. You should contact the Early Pregnancy Unit if you have a positive urine pregnancy test, and are experiencing pain and or bleeding from 5 to 20 weeks of pregnancy. There are 4 consultation/treatment rooms in this department/service. There are 21 Parent and Child Bays available on this level. Conceptualization, It is not intended for public use. Please contact your midwife or maternity triage urgently if your symptoms relate to fetal movement. The Patient Advice and Liaison Service (PALS) is located on Level C of the Centre Block at the Southampton General Hospital. Non-urgent referrals seen on the same or next day. Patients and members of the public were involved at several stages of the study, including the design, management, and conduct of the study. There is step free access into the imaging room. There is a/are clearly marked/signposted Blue Badge parking bay(s) available. Access to the building between 21:00 - 07:00 is via intercom. Yes There is level access into the day room/lounge area. You are accessing this website using a legacy browser. Methodology, We obtained similar results whether we analysed for senior clinician presence as a binary outcome or as a continuum. The bollards do not restrict access to the entrance. Supervision, Aberford Road There is a clear unobstructed route to the reception point. 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. Continue along Grafton Way and rejoin the A400. 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 reception point is approximately 5m (5yd 1ft) from the Early Pregnancy Unit and Gynae Assessment Unit entrance. We listen to patient feedbackto deliver patient-centred care. This was due to the changes in provision of medical cover which occurred between the site initiation visit and the start of recruitment. There is a dropdown rail on the transfer side. GAU is a 24 hour service and can offer advice and . new North Central London GP Website do not work as expected. 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. You can also call020 7794 0500 ext 38205 or 31468. The drop-off point is located to the right of the Level D entrance. Site by daysix. Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. Early Pregnancy Assessment & Gynaecology Unit: RFL - North Central London GP Website Find out about the Early Pregnancy Assessment & Gynaecology Unit: RFL service in North Central London Find out about the Early Pregnancy Assessment & Gynaecology Unit: RFL service in North Central London Your browser is out of date!