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Oxford University Hospitals NHS Foundation Trust

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Gynaecology referrals and clinic list

Referrals to Gynaecology at the JR - important request

The Women's Centre Outpatients Department has experienced a few episodes recently where a patient has come to a clinic and then refused to be seen, examined or have a procedure performed because there was not a female doctor in the clinic. We would be grateful if, at the point of referral, GPs could ask their patient whether they have a particular preference to see a female doctor, and then advise this on the referral request.

Please let your patients know that every effort will be made to accommodate the request. but that if the appointment is urgent (i.e. a 2 Week Wait appointment) the next available slot will be given to them.

Gynaecology referrals

Oxford University Hospitals offers a number of Gynaecology services based at the John Radcliffe Hospital Women's Centre and Churchill Hospital, Oxford, the Horton General Hospital in Banbury and the Alec Turnbull Clinic, Oxford.

Directly Bookable Service for Gynaecology

The GP surgery will generate an appointment referral request with appropriate priority (urgent or routine) for the service on e-Referral and UBRN in the usual way.

To select a directly booked appointment, please see the guide at the link below, which shows how to use the system.

An electronic proforma or appropriate letter needs to be attached to the e-Referral system by the surgery within 48 hours for a routine or urgent appointment.

In the case that the Trust cannot provide an immediate appointment, 'Defer to Provider' can be selected and Trust processes will be in place to contact the patient within 48 hours for an urgent or routine appointment.

18WW clock will start on the date the GP or patient makes the appointment booking.

GPs should check their patients have appointments on their e-Referral worklist. This applies to all appointment requests made through e-Referral.

Please note exclusions:

  • 2WW Gynaecology to remain as existing process.
  • Fertility Clinic to remain indirectly bookable as existing process, but will be directly bookable in the near future (January 2015).
  • Emergency clinic to remain as existing process.

For further information please visit 'e-Referral':

General and specialist gynaecology services

General and specialist gynaecology services are summarised below. For detailed referral information and guidelines for GPs, please follow links.

Breast lumps and breast cancer

Breast lumps and breast cancer are managed by the breast screening service at the Cancer Centre, Churchill Hospital

Breast screening

Colposcopy

The Colposcopy service is for patients with abnormal cervical smear tests who need further testing or treatment. After an abnormal smear result, women will automatically receive an appointment with Colposcopy. If a GP practice has had difficulties in obtaining a smear test, this may be done by the Colposcopy service. Referral for difficult smears can be made via Choose & Book.

This service is led by Dr Karin Hellner and is based at the Churchill Hospital.

Colposcopy

Contraception Services

Oxfordshire Sexual Health Service offers a drop-in and appointment service for contraceptive advice, emergency contraception and coil-fitting, including hormonal coils.

The service also provides testing and management of sexually transmitted infections, including HIV and other genital conditions.

This service is based at the Churchill Hospital, Oxford and Orchard Health Centre Banbury, but also runs clinics across Oxfordshire.

www.sexualhealthoxfordshire.nhs.uk

Counselling service

This service is for women needing support after termination / early loss of pregnancy, or help coping with chronic gynaecological problems / pelvic pain. A GP referral is required.

Cytology requests and HPV testing

It is now recognised that high risk Human Papilloma Viruses are responsible for cervical cancer.

The NHS Cervical Screening Programme is moving over to the use of HPV testing as part of the national cervical screening system in the UK.

All cervical sample takers are required to undergo training on the implications of the HPV test results that will be issued in conjunction with the cytology report - the HPV status of the woman will affect how her repeat tests are managed, which will naturally cause some distress for patients.

For further information please contact the Cytology Laboratory: 01865 220490

Day Surgery Unit

The Gynaecology Day Surgery Unit is an annexe to the Gynaecology Ward on Level 1 of the John Radcliffe Hospital Women's Centre. Women having simple surgical procedures that do not require an overnight stay may be admitted to this unit.

Further information is available in our patient information leaflet library.

Gynaecology information leaflets

Early Pregnancy Assessment Unit at Rose Hill

Early Pregnancy Assessment Unit (EPAU)

Endometriosis Clinic

The Women's Centre at the John Radcliffe Hospital is a national referral centre for the management of endometriosis, and in particular for severe cases.

Endometriosis Clinic

Fertility clinic

Referrals can be made to the John Radcliffe NHS Fertility Clinic for patients who have been actively trying to conceive for over a year, are in a same-sex relationship or are known to be suffering with a pre-existing fertility-related condition.

Fertility Clinic

General Gynaecology

General Gynaecology clinics are run at the John Radcliffe Hospital Women's Centre, (Consultants Mr Vic Rai, Ms Natalia Price, Mr Simon Jackson) and the Horton General Hospital, Banbury (Mr Jonathan Nicholls, Mr Kirana Arambage, Miss Uloma Okwuosa, Mr Mohammed Raheem and Mr Hikmat Naoum).

General Gynaecology clinics are for women with the following conditions.

  • Abnormal vaginal bleeding including irregular bleeding
  • Abnormal bleeding in HRT users
  • Inter-menstrual bleeding
  • Post-coital bleeding
  • Heavy periods under 45 years
    Heavy or irregular bleeding over 45 years should be referred to the Menstrual Clinic; post-menopausal bleeding should be referred for urgent pelvic ultrasound scan via the 2 Week Wait system.
  • Fibroids
  • Ovarian cysts
  • Severe pre-menstrual syndrome
  • Prolapse including ring/shelf pessary fitting (where attempts have failed by GP)
  • Cervical polypectomy (if GP unable)
  • Sterilisation
  • Vulval/labial cysts
  • Endometrial polyps
  • Cervical ectropion

For information for patients, please see our Women's Services section.

There is a daily Urgent Gynaecology Clinic for pregnant women with pregnancy-related concerns, such as pain and bleeding under 16 weeks' gestation, or for urgent general gynaecological problems, such as Bartholin's abscess.

Urgent gynaecology

Gynaecological Oncology

Cancer services for gynaecological cancers such as ovarian, endometrial and cervical cancers are run by the Gynaecological Oncology service which is based at the Churchill Hospital.

Women with suspected cancer should be referred via the 2 Week Wait bureau.

Women with any episodes of post menopausal bleeding should be referred via the 2 Week Wait bureau for an urgent ultrasound scan. After the scan they will be triaged towards the most appropriate clinic.

Smear tests are not done in routine gynaecology outpatients clinics.

Menopause Clinic

The Menopause Service provides expertise for women who cannot be managed in primary care. The Early Menopause Clinic is for women under 40 and provides long-term advice and support.

Menopause Clinic and Early Menopause Clinic referrals

Menstrual Clinic

To avoid repeated visits to the hospital and lengthy waiting times for investigations, women over 40 with heavy or irregular vaginal bleeding are able to have a scan, see a consultant, undergo a hysteroscopy if necessary and receive the results and plan of care immediately, all in a two hour appointment. This service is led by Gynaecology Consultant Mr Vic Rai and his team.

Oxford Rose Clinic

The team is led by Dr Brenda Kelly, Consultant Obstetrician and Clinical Lead for women with FGM in Oxfordshire.

Clinics run every two weeks on a Friday.

Women can refer themselves to the clinic or be referred by health visitors, GPs community midwives or other health professionals.

Paediatric gynaecology

This is a small and specialised service run by Gynaecology Consultant Mr Christian Becker and the Paediatric Department.

Girls under the age of 16 with problems such as congenital or anatomical disorders, menstrual disorders, premature puberty or other gynaecological problems may be referred to Mr Becker by their GP via the Choose & Book system.

The clinic is run on the fourth Tuesday of the month in Paediatric Outpatients.

Pelvic Pain Clinic

Pelvic Pain Clinic

Detailed information for doctors can be found on the OCCG website.

Oxfordshire Clinical Commissioning Group

Polycystic Ovary Syndrome Clinic

This clinic, run by the Nuffield Department of Obstetrics and Gynaecology, offers advice on the management of menstrual irregularity and related problems associated with PCOS.

Polycystic Ovary Syndrome Clinic

Post-menopausal bleeding

This is also a one-stop service at the John Radcliffe Hospital with urgent biopsies when necessary and close liaison with the Gynaecological Oncology MDT. A GP referral is required.

Post Menopausal Bleeding / Hysteroscopy Clinic referrals

Recurrent Miscarriage Clinic

Women with recurrent miscarriage (three consecutive pregnancy test positive miscarriages) are seen by Nuffield Department of Obstetrics and Gynaecology reproductive medicine specialists in this clinic.

Recurrent Miscarriage Clinic

Sexual health (GUM Clinic)

The Sexual Health Service carries out screening for anyone with symptoms or concerns about sexually transmitted infections including HIV. This is a drop-in service, i.e. a GP referral is not necessary. This service is based at the Churchill Hospital and the Orchard Health Centre in Banbury, but also runs clinics across Oxfordshire.

www.sexualhealthoxfordshire.nhs.uk

Termination of pregnancy

In Oxfordshire routine NHS terminations (abortion) are managed by the British Pregnancy Advisory Service (BPAS). For a few women with medical problems BPAS will refer to the John Radcliffe Hospital but all initial assessments are carried out by BPAS.

An advice leaflet has been produced for patients referred to the John Radcliffe Hospital for a termination.

What to expect at your termination of pregnancy consultation

Urgent Gynaecology Clinic - Horton General Hospital

GPs refer patients to this clinic who are having concerns such as pain and bleeding under 16 weeks' gestation.

Urgent Gynaecology Clinic - Horton General Hospital

Urogynaecology

This sub-specialty investigates conditions such as stress incontinence and continence related problems. Surgery is considered if other treatments have not been successful. Physiotherapists and clinical nurse specialists support this service with the community bladder and bowel service. A holistic approach is taken to these disorders.

If surgery is required, referral is made by a GP to one of the specialist consultants. The service at the John Radcliffe Hospital and at the Horton General Hospital, Banbury, specialises in laparoscopic reconstructive surgery and also treats uterovaginal prolapse.

Urogynaecology referrals

Pelvic floor clinic

This is a multidisciplinary clinic with urogynaecologists, physiotherapists and specialist nurses, which means it can quickly offer patients the appropriate treatment for their condition.

Vulval clinic

Consultant Dermatologist Dr Sue Cooper runs a dermatology vulval service at the Churchill Hospital, Oxford for inflammatory conditions such as:

  • eczema
  • lichen sclerosis
  • lichen planus
  • vulval pain.

Once a month she also runs a joint Gynaeoncology and Dermatology clinic, also at the Churchill Hospital, for women with:

  • vulval dysplasia
  • VIN
  • Paget's
  • squamous cell carcinoma.

Visit our Dermatology Department website:

Dermatology

DEPARTMENTS AND SERVICES