Improving Diagnostic Pathways for Postmenopausal Bleeding: A Retrospective Audit of the One-Stop Clinic Model in University Hospitals Bristol Emily Cox ST1, Sarah Quinn ST7, Sarah Cowey Consultant Gynaecologist University Hospitals Bristol and Weston

Delays in the diagnostic pathway for two week wait post-menopausal bleeding were identified at University Hospitals Bristol, prompting the introduction of a one-stop ultrasound-led clinic. This aimed to streamline diagnosis/exclusion of endometrial cancer by integrating clinical review, ultrasound, and hysteroscopy into a single visit. This audit aims to compare the time taken to diagnose or exclude endometrial cancer under the one-stop clinic system compared to NHS England's Faster Diagnostic Pathways - implementing a timed gynaecology cancer diagnostic pathway.

A retrospective review was conducted for 98 patients seen in the one-stop postmenopausal bleeding clinic between February and March 2024. Data was collected ontimelines, outcomes, and compliance with faster diagnostic pathway standards. NHS England’s Faster Diagnostic Pathways - implementing a timed gynaecology cancer diagnostic pathway was used as a standard.

The one-stop clinic model has improved diagnostic timelines for select patient groups; however, significant delays persist for patients requiring general anaesthetic hysteroscopy. Recommendations include increasing capacity, improving pre-procedural planning to identify likely failures of outpatient hysteroscopy or improving information for general practitioners surrounding post menopausal bleeding to reduce referrals.