Gynaecological Rapid Access Clinic

This page gives details of the services the clinic provides and what you can expect when you attend.

Location of the Rapid Access Clinic

You will find us in the Gynaecology Department of the Women and Children’s Hospital.  When you arrive please check in with the receptionists at the desk on the ground floor, they will be able to tell you if your appointment is on the ground or first floor.

Why Have I Been Referred to the Rapid Access Clinic?

The purpose of gynaecological Rapid Access Clinic is to ensure patients whose symptoms might be caused by a serious problem, (which can occasionally be cancer), will be seen as quickly as possible.  This avoids you waiting with routine clinic referrals so that those who do not require further treatment (about 90% of cases referred) can be quickly reassured, and those who do require further treatment can have it organised without further delay.

How Long Will I Be in Clinic?

We try not to keep you waiting for your appointment, but delays can sometimes happen.  You may be in clinic for 1-2 hours, depending on the tests and examinations that need to be performed.  You are welcome to sit with a friend or relative during this time.

Who Will I See in the Clinic?

You will be seen by an experienced gynaecological practitioner.  They will either be a doctor or one of our specialist nurses, they may be any gender.  They work under the supervision of a specialist gynaecological cancer consultant. 

Wirral University Teaching Hospital is a teaching hospital where medical students and nursing students come to learn.  The practitioner will ask you if students can be present during your appointment.  If you do not want students there, please let us know.  Your wishes will always be respected

What Will Happen at The Clinic?

When you arrive at the clinic you will see the receptionist who will book you in and ask you to take a seat in the waiting area.  You will then be called through to a clinical support worker who will record your height, weight, pulse and blood pressure.

If a pelvic scan is required before your appointment, you will be directed to the scanning department for this. 

Afterwards you will see the doctor or the specialist nurse who will ask you a number of questions about your symptoms and past medical history (this may have already been completed via a telephone consultation and so may not be required on the day).

Next the practitioner will ask for your consent to proceed with an examination and take biopsies if necessary.

There will be a female chaperone present, she is there to support you and assist the practitioner.

Should I Still Come to the Clinic if I Have my Period?

Yes, please do attend so that we can do an initial assessment of your symptoms.  You may need to come back for some tests, but this will be explained to you.

What Sort of Tests and Procedures Might I Have in This Clinic?

The tests you need will depend on your symptoms.  We have listed the types performed in this clinic over the next few pages.  You may need more than one and some may be arranged for a later date.

Pelvic examination

This is an examination of your abdomen and pelvis.  The practitioner will use their hands to feel your abdomen, to check that there is nothing unusual.  Your GP may have done a similar examination already.  The practitioner may also need to place their fingers inside your vagina or back passage whilst carrying out this examination.

Speculum examination

This is an examination to look inside your vagina.  An instrument called a speculum is used to open the vagina.  This is the same instrument that is used when you have a smear test.

It may be an uncomfortable feeling for some women, but it is not usually painful.

Ultrasound scan

You will need a relatively full bladder for an ultrasound scan, so we suggest you do not pass urine for at least an hour before the time of your scan and try to drink 1-2 pints of liquid an hour before.

 Ultrasound uses soundwaves to show a picture of the organs inside your body.  There are two types of scan and you may have both tests.

1.      Abdominal ultrasound, a probe is put on your tummy

2.      Transvaginal ultrasound, a probe is placed inside your vagina

Endometrial biopsy

Simple pain relief such as Paracetamol or Ibuprofen can be helpful, you could take these

about 1 hour before the procedure.

If you have been having abnormal bleeding or a scan has indicated an abnormality within the lining of your womb (endometrium) a biopsy (a sample of tissue) will be taken from this area for this test .

A thin flexible instrument (like a straw) called a Pipelle is inserted through the cervix (neck

of the womb) and sucks away a small sample of the womb lining.  This procedure can cause unpleasant period-like pains but these should not last for long.

You may still need simple pain relief over the next few hours after the biopsy.

Colposcopy

A colposopy is similar to a smear test and is usually painless.  A microscope with a light (colposcope) is used to look at your cervix (this stays outside of the vagina).  If there are any abnormal areas, the practitioner will take a cervical biopsy to be examined in the laboratory.

Cervical biopsy

This is performed as either

·       a small pinch of tissue or

·       a larger biopsy called a loop biopsy.  If this is to be done you will be given a small injection of local anaesthetic in the cervix, so that you should not feel any discomfort during the procedure

A small heated wire loop is then passed through the cervix to obtain the sample.

·       In either case a special liquid is often applied to the area afterwards to stop any bleeding.

 Vulvoscopy and Vulval biopsy

 These procedures will only be carried out if you have been having problems in this area.

The skin on your vulva (the folds of skin around the entrance to your vagina) will be thoroughly examined by the practitioner using a microscope.  If any abnormal areas are found the practitioner will take a biopsy to be examined in the laboratory.

If you have an area of itchy or sore skin, or a lump that does not go away on your vulva, the practitioner may wish to take a biopsy.

·       A small injection of local anaesthetic will be given to numb that part of the body.

·       Afterwards, a solution is applied to the area to stop any bleeding

Blood tests

You may need a blood test.  

This is normally done in phlebotomy; you will be given a request form to take with you .

You may need to ring to make an appointment.

Please ring the phlebotomy department direct on 0151 604 7382.

When Will I find out my Results?

This will depend on the investigation(s).

We will give you your results on the same day if we are able to.

·    If a biopsy was taken, it can take up to 3 weeks

·       A member of our team will telephone (Gynaecology Care Co-Ordinator) you with your results, please be aware that this may include results that are a cause for concern.  

·       We will be here to offer you all the support you need during this time.

·       We will also write to you and your GP.

 What if I Need Tests That Cannot be Done During the Clinic?

Some patients will need further tests or investigations, and these will need to be performed at another time.  If your tests could not carried out during your initial clinic appointment, you will receive an appointment by telephone or letter.  We have listed other types of investigations below.

CT (Computed Tomography) scan

A CT scan takes x-ray pictures of cross-sections of the inside of your body.  The scan takes longer than an x-ray but it is painless.  You may need an injection of a special dye to highlight any abnormal areas within your body.

MRI (Magnetic Resonance Imaging)

This test is like a CT scan but uses magnetism rather than x-rays to produce the pictures.   During the scan, you will lie down and pass through the scanner, which looks like a small tunnel.

Some people may feel claustrophobic during this scan and sedation may be offered to help to reduce your anxiety.

An injection of a special dye may also be needed to highlight any abnormal areas within your body 

Hysteroscopy

A very thin telescope is used to look inside the womb (uterus).  A sample of cells may be taken from the lining of the womb and checked under the microscope. 

What if I Feel Unwell at Home ?

If you have discomfort after your examination or biopsy please take simple pain relief such as Paracetamol and Ibuprofen if you have no contraindications.

If you begin to feel unwell, despite taking pain relief please contact us on one of the numbers below. 

If you have any questions or concerns, please ask a nurse or the doctor caring for you or ring one of the numbers below

Monday to Friday 09:00-17:00:

·      Clinic Clerks: 0151 604 7043

·      Specialist Nurse and Hysteroscopist: 0151 604 7043 (ask to be put through to the specialist nurse)

·      Nurse Colposcopist: 0151 604 7775

·      Macmillan Gynaecology Nurse Specialists:  0151 604 7556

·      Gynaecology Care Co-Ordinator: 0151 604 7556

Out of hours:

·      Gynaecology Ward : 0151 604 7132

 We know a referral to the Rapid Access Clinic can be an anxious time for patients; the Macmillan Gynaecology Nurse Specialists can provide extra emotional and psychological support, so please do not hesitate to get in touch.

If cancer is diagnosed, these nurses will provide ongoing support for you throughout your treatment and time with us.