TO SEE OR NOT TO SEE? POST-OPERATIVE FOLLOW-UP IN GENERAL GYNAECOLOGY

Background: There is no convincing evidence of benefit to routine post-operative follow-up appointments in general gynaecology; evaluation of comparable health care systems suggests this may be omitted without detriment. This may open up avenues for improved efficiency of outpatient clinics with decreased expense to the patient. Aims: This study sought to describe the burden of post-operative follow-up and provoke discussion on alternative models of care. Materials and Methods: This retrospective audit was conducted of 767 patients attending their first post-operative outpatient appointment following benign gynaecological surgery in 2017. Demographic and clinical details were recorded as was patient travel, histology, presence of complications or complaints and closing outcome. Results: Seventy-three per cent of the time there was no clear benefit to the post-operative appointment. All cases of pre malignant or malignant histology were reliably suspected pre-operatively. There was no clinical information that had a significantly increased risk of complication, complaint or need for further input. Conclusions: This study indicates that conventional post-operative care may add cost to both system and patient without demonstrable benefit in a large proportion of cases. Formulating a virtual clinic for telephone follow-up in benign gynaecology would require co-ordination from multiple stakeholders but may considerably improve the efficiency of our service.