Diagnosing Adenomyosis and Endometriosis in a Primary Care Women’s Hub
By Borsha Sarker, Collette Maria Coppack, Yasmin McGrady, Kerry Barnett, Saira Malik, Ruth Thompson, Fadi Khalil, Sunderland Women’s Hub
Introduction:
The NHS ten-year plan focuses on shifting care delivery closer to the community from hospital settings, leveraging digital technology and prioritising disease prevention to improve health outcomes. The government funding of regional and sub-regional Women’s Hubs supports a centralised and targeted approach to women’s healthcare.
Aim:
We set out to utilise this opportunity to meet the unmet needs of women, potentially underdiagnosed with Adenomyosis and Endometriosis, with a 30-minute appointment including assessment of the Uterine Sliding Sign as routine.
Methods:
We assessed the uterine Sliding Sign in the Pouch of Douglas and attempted as much of the BMUS advanced assessment for deep endometriosis (as set out in their poster “Ultrasound for Endometriosis” distributed in December 2024) as possible in the time allocated We set out to train a GP and an Advanced Nurse Practitioner in Gynaecology ultrasound, and teach them these techniques as part of their primary learning curve. They were enrolled on a CASEaccredited
course but exposed to the full advanced technique at Intermediate Level 2.
Results:
We audited our data quarterly and will present our 12-month findings of the disease incidence detected in a primary care population of undifferentiated Gynaecology ultrasound referrals from a deprived background population. We also surveyed our patients for satisfaction, as well as creating a focus group for potential service evaluation and research.
Conclusion:
Endometriosis and Adenomyosis are long-term conditions, and primary care is the first contact point, and thus is integral to holding care and providing support before, during and in between episodes of specialist input. We will present the numerical and qualitative data, including investigation and treatment outcomes of these patients in the context of primary care; discuss potential research opportunities and the wider opportunities for training, and assess some of the barriers that still need
addressing for the NHS ten-year plan to succeed for Gynaecology ultrasound.