AQW 2105/22-27
Mr John Blair
Alliance Party
South Antrim
Tabled Date: 24/06/2022
Answered On Date: 07/07/2022
Priority Written: No
Question:
To ask the Minister of Health what steps he is taking to secure an endometriosis specialist in the Northern Health and Social Care Trust, as recommended by the National Institute for Health and Care Excellence.
Answer:
The National Institute for Health and Care Excellence Recommendations state that specialist endometriosis services (endometriosis centres) should have access to: Gynaecologists with expertise in diagnosing and managing endometriosis, including advanced laparoscopic surgical skills A colorectal surgeon with an interest in endometriosis A urologist with an interest in endometriosis An endometriosis specialist nurse A multidisciplinary pain management service with expertise in pelvic pain A healthcare professional with specialist expertise in gynaecological imaging of endometriosis Advanced diagnostic facilities (for example, radiology and histopathology) Fertility services. Generally, endometriosis services across Northern Ireland are provided on an ad hoc basis as a sub–specialty within gynaecology services. There are no specific endometriosis services within the Northern and Southern areas and there is a limited service within the South Eastern Trust. Patients in these areas are usually referred to services within the Belfast and Western Trust. Due to the changes over the past 6-7 years with regards to the treatment of endometriosis the Belfast Trust has indicated to the Strategic Policy Planning Group that it would like to submit a business case to develop and establish a Regional Endometriosis service in Northern Ireland, which is likely to request at least 1 whole time equivalent Consultant Gynaecologist with specialist interest/sub-spec training in Endometriosis plus a full multi-disciplinary support team. There are currently two Consultants employed in the Western Trust with the skill set to carry out Endometriosis surgery at Altnagelvin. It has been confirmed that South West Acute Hospital is not a suitable site to carry out this surgery as it is essential to have a Urologist and Colorectal surgeon available. The Western Trust has applied for preliminary revalidation as an Endometriosis Centre, but in order to receive full accreditation the Trust must be able to demonstrate that they are undertaking this surgery on a regular basis, and this will require additional funding. Whilst the direction of travel is to develop specialist endometriosis care so as to comply with National Institute for Health and Care Excellence Guidance this cannot be provided in each Trust area and therefore there are currently no discussions open with the Northern Trust as the current approach is to develop specialist centres in both the Belfast and Western Trust. This two centre approach will require new investment. However, there is no indication at this stage that there will be any monies available in 2022/23 to allow for investment and/or service development and therefore I am unable to give a confirmation of details regarding timescales, additional funding and recruitment to enhance the local endometriosis service. As Minister, I will continue to do the best I can to deliver for the public with the resources I have available. Amid ongoing budget uncertainty, I am on record as warning that funding pressures in health may be significant by the second half of 2022/23. The financial situation will undoubtedly be constrained whatever the final budget settlement. My ability to plan strategically is being significantly impaired by the ongoing budgetary uncertainty.
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