I am advised that the majority of cases of endometriosis are within the scope of a general gynaecologist to see, diagnose and treat. A GP referral to a gynaecologist is the standard pathway of care for the management of endometriosis in Ireland. This is similar to the pathway in place for the management of other gynaecological conditions.
Information provided by the HSE indicates that endometriosis is a difficult condition to diagnose and treat because of the variation of presentations, impacting the physical and mental wellbeing of patients at varying levels. Treatment may include pain medications, hormone treatment and surgical interventions. The time to diagnose endometriosis varies by patient due to its varying and ambiguous symptom presentation. The HSE's National Women & Infants Health Programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services.
As such, I am advised that the Programme has developed a plan to increase the capacity and reduce waiting times for women awaiting general gynaecology, which includes patients with endometriosis. The plan aims to re-orient general gynaecology service to an ambulatory (see and treat) model rather than the traditional outpatient referral model. The HSE anticipates that funding available to the Programme in 2020 will support the establishment of three ambulatory services and future sites are envisaged.
The Programme has advised that the provision of training in the management and diagnosis of endometriosis forms an integral part of the specialist medical training programme provided by the Institute of Obstetricians and Gynaecologists. In addition, some clinicians may have developed a subspecialty interest in the disease and may treat patients who have a more complex form of the disease.
