Requirements to be a BSGE Accredited Centre

As endometriosis is a common condition and the aim of the BSGE is to improve treatment for all patients with the disease, it is expected that there will be many centres throughout the UK, and it will not just limited to a few of the larger hospitals.
 
The BSGE will accredit centres where Gynaecologists work in appropriate clinical teams, audit their outcome and have sufficient workload to maintain their surgical skills.
 
The requirements to be a BSGE Accredited Endometriosis Centre are:
 
1. A dedicated consultant lead endometriosis service run within a specialist outpatient clinic.

This is a clinic, which is specifically devoted to endometriosis patients and accepts referral for this named condition.  Ideally it is recorded as such for any respective referrer; whether they be primary or secondary care clinicians.  The clinic should be named The Endometriosis Clinic and advertise its referral criteria for use locally.  The purpose is to ensure local patients are aware of the specialist clinic and the advantages it will offer them.  There should be a lead consultant or team of consultants who run the service and these will be the named consultants accredited to run a BSGE Endometriosis Centre.

2. Workload

It is essential that there is sufficient throughput to maintain surgical skills for the most complex cases.  Whilst all degrees of severity of endometriosis may be treated within the service it is a requirement that at least 12 cases of recto-vaginal endometriosis are treated by surgery each year. This is defined by a procedure to remove rectovaginal endometriosis that requires dissection of the pararectal space and must be recorded on the BSGE database. Whilst this can include open surgery it is expected that this will usually be undertaken laparoscopically.
 

3. Supporting Surgeon

A named colorectal surgeon is required to support the service.  It is expected that he/she will attend complex surgery involving the bowel and operate with the centres gynaecologists.  The partnership will allow patients to receive the best advice, surgery and follow up where the pathology extends to the bowel.

4. Other supporting clinicians

A support network is required which includes urologists and pain management specialists who declare that they will provide active support to the service when needed.  This may involve intra-operative support or outpatient support.  It is expected that the names of consultants from these specialties will be recorded on the centres’ staff list.

5. Data collection 

A written agreement from the lead Gynaecologist in the Centre that all cases of recto-vaginal endometriosis (as defined by dissection of the pararectal space)  will be entered on to the database, and will be followed up for two years post surgery.

6. Endometriosis Specialist Nurse

This is not currently a requirement but it is expected that the benefits of a dedicated endometriosis specialist nurse will be evident to centres dealing with many patients.  Centres with a such a post have found that patients having direct access to a specialist nurse results in a considerable improvement in the quality of their service.  Specialist nurses can carry out primary patient contact to triage referrals, collect patient symptom questionnaires’ and perform selected patient follow up appointments.  It is an aspiration that centres should have an endometriosis nurse and in the future this is likely to become one of the requirement criteria.