1st Edition

Gynaecology in Primary Care A Practical Guide

By Anita Sharma Copyright 2013

    Gynaecology in Primary Care comes at a time of great change in health service delivery. General practice is facing the challenges of developing Clinical Commissioning Groups, providing an ever greater range of primary care services and implementing NICE guidelines, whilst CCGs through their members will be under a legal duty to innovate. From a provider perspective, the book equips general practitioners with up-to-date knowledge of common gynaecological conditions, suggestions of best practice with regard to management and investigations to be undertaken within primary care, and guidelines for onward referral, where this is appropriate and necessary. From a commissioning perspective it provides an invaluable resource to CCGs, to inform their future pathways for gynaecology care. This highly practical book delivers the main aim of the RCP report - to ensure best care for female patients in the setting of their choice and where possible to develop streamlined one-stop services in primary care so that women do not have to take time off from their work and family commitments. It is ideal for general practitioners needing to be inspired and informed, and is also highly recommended for other healthcare professionals and medical students with an interest in women's health. 'Optimal patient care requires many connected features to synchronise effectively. This book describes how this could be achieved by focusing attention on well-crafted, evidencebased clinical pathways. This book advances our thinking on how we connect clinical, system and patient level perspectives on optimal care management.' Denis Gizzi, in his Foreword 'Written by a highly regarded, experienced and practicing GP, who has taken on the role as Clinical Director on behalf of the CCG for this programme area, this book is a valuable asset for both practicing GPs and developing CCGs to ensure that gynaecology services effectively commission, maximise the health of the population, improve the experience of the patient, and improve value for money.' Kath Wynne-Jones, in her Foreword 'An excellent guide to the management of gynaecological problems in primary care for not only clinicians in training, but for more experienced clinicians who look for straightforward and easily accessible advice to support their clinical management decisions. Look no further than this textbook. Dr Sharma's textbook will be a boon to developing organisations in delivering world-class services.' Dr Ian Wilkinson, in his Foreword

    Foreword by Ian Wilkinson. Foreword by Denis Gizzi. Foreword by Kath Wynne-Jones. Preface. About the author. Dysmenorrhoea. Premenstrual syndrome. Menstrual migraine. Dyspareunia. Pelvic pain. Vaginal dryness. Vulvodynia. Management of vaginal discharge in primary care. Pelvic inflammatory disease. Dysfunctional uterine bleeding. Postmenopausal bleeding. Postcoital bleeding. Intermenstrual bleeding. Genital prolapse. Pessary service in NHS Oldham. Infertility. Female urinary incontinence. Urinary retention: a primary care emergency. Endometriosis. Menopause. Polycystic ovarian syndrome. Uterine fibroids. Endometrial cancer. Ovarian cancer. Colposcopy. Index.


    Anita Sharma MBBS, MD, DRCOG, MFFP has been a general practitioner in Oldham for more than 24 years and loves every second of working as a GP. She is an undergraduate trainer attached to the University of Manchester and a trainer in family planning. She is the GP editor for the British Journal of Medical Practitioners. She writes regularly in various GP magazines on clinical and practice developmental issues. Anita has served as a Local Medical Committee locality member for the last 7 years and is a GP appraiser for Oldham Primary Care Trust. She is also the chairperson of BMA Rochdale Division where she organises various educational and social activities. With the help and support of her patient participation group, she organises various fundraising activities and raises money for Cancer Research. She has written three books, all aimed towards the primary care physician: COPD in Primary Care (Radcliffe Publishing, 2010), Peripheral Vascular Disease in Primary Care (Radcliffe Publishing, 2011), and Maximising Quality and Outcomes Framework Quality Points (Radcliff e Publishing, 2011). She donates her royalties raised by COPD in Primary Care to the 'Breathe Easy' group. She was a GP member of the NICE lower limb peripheral arterial disease guideline development group. She contributed on clinical audit tool and secondary prevention from a GP perspective. Anita is also the clinical director in vascular and medicine management of the Oldham Clinical Commissioning Group (CCG). She is actively involved in the setting up of one- stop gynaecological and early pregnancy assessment services in Oldham.