Criteria to be referred to a BSGE centre

[SarahMow]

What is the criteria you have to meet before you are supposed to be referred to a specialist centre? xx

[Afrohair]

Look on nice guidelines

[Lewisisgreen]

For my own research I copied some information from a post yesterday, that had been deleted the next time I checked!

The lady Lindle who wrote it knows her stuff😊

Unfortunately there isn't a right to a referral to a specialist centre as these are in tertiary care and there are referral criteria to be met.

Referral is initially to a gynaecologist with a special interest in endo in secondary care unless there is evidence of severe disease from internal exam, scans and symptoms in which case referral is direct to a tertiary centre.

Hope it's ok to leave it here and that it helps.

[Lindle in reply to Lewisisgreen]

Oooh, that's interesting about a comment of mine being deleted. It would be shocking if admin deleted such critical info. I wonder if my replies on this post will be too...

[Lindle]

Treatment in BSGE accredited centres (or other centres that might not be on the list but fulfill their standards) represents tertiary care so a step up from routine secondary care in gynaecology departments. Care in centres is expected to apply to relatively few women who are treated by relatively few advanced surgeons with the skills to treat complex cases so it is lifted out of secondary care and, crucially, in England commissioned differently so that all women in the UK have equal access and are not dependent on local funds. Commissioning in England is directly and centrally by NHS England and they have to approve referrals based on criteria being met.

The treatment specification is below:

england.nhs.uk/commissionin...

and the referral criteria are on page 10:

'3.4 Any acceptance and exclusion criteria and thresholds

The service will accept referrals from GPs and secondary care clinicians in Gynaecology,

Colorectal surgery and Urology. The service will also accept referrals from other providers,

particularly when the referring service is not accredited to undertake the clinical care the

patient requires.

The service will accept referrals for patients who meet one of the following criteria:

 Women with a diagnosis of severe endometriosis

 Non-severe endometriosis refractory to treatment

Referrals into the service will be assessed by a named Consultant.

Eligible women will be referred using a defined referral system that can be audited for

waiting times.

Appropriate referrals to specialist colleagues will be documented and GP informed of any

transfer of care

Exclusions:

 Patients that have pelvic pain but do not have endometriosis.

 Non-severe endometriosis that is responding to treatment.

 Patients with gynaecological cancer; their care is covered in the cancer services

specifications'

Note that this gave rise to a grey area in terms of those with suspected severe endo but no confirmed diagnosis - so those with nodules felt on clinical exam, detection of deep endo on scans in association with high suspicion from symptoms. The 2017 NICE guideline covers this at:

'1.4.2 Refer women to a specialist endometriosis service (endometriosis centre) if they have suspected or confirmed deep endometriosis involving the bowel, bladder or ureter.'

Whilst the NHS England spec doesn't strictly apply to the devolved boards, the RCOG Standards do and they require that all women wherever they are in the UK must be treated equally with national guidelines applied.

rcog.org.uk/en/guidelines-r...

[SarahMow in reply to Lindle]

Thank you so much. That’s so helpful. I had a laparoscopy and cystoscopy just over a week ago where they found endo inside my bladder so was just curious as to whether they would refer me or not. Thanks again for responding xx

[Lindle in reply to SarahMow]

Yes with deep endo inside the bladder you MUST be referred, it's not an option for doctors but a requirement.

[Lindle]

Maxyy93 see above reply to this post.

[Maxyy93 in reply to Lindle]

Thank you so much. This is very helpful

[Hidden]

So glad to see Linda's response here. I see a LOT of misinformation on here and people advising that you should always be seen at a bsge centre without even having a diagnosis. It's really not that easy. And honestly there are a LOT of decent surgeons that are not bsge accredited. Many can do exceptional surgery for women with less advanced disease. The key is just ensuring you research them first and ensure they have a special interest in endo. Good luck.

[Lindle in reply to Hidden]

I'm not allowed to post the link to my group, but we are establishing a list of such non-BSGE accredited surgeons with very high training. What we look for is an endo specialist who has sub specialism in Reproductive Medicine and works on the surgical side - this training module includes substantial endo training.

[Hidden in reply to Lindle]

That's great to know. I wasn't quite sure what we should be looking for. Thanks for clarifying