The role of early pregnancy assessment clinics

Abstract

The primary role therefore of the EPAC system is to improve patient management and satisfaction. The system provides a structured, open access, referral system for women with problems in early pregnancy which is sensitive to their needs. Communication at the primary-secondary care interface is improved; concentrating referrals to make more efficient use of the available resources, including: counselling, diagnosis and treatment with simultaneous savings and improved opportunities for teaching and research. This concentration produces a number of advantages for both the women, their families and the medical services, notably through the reduction in the number and duration of admissions. Patient anxiety and family disruption are minimised. Training for junior doctors can be more structured with increased levels of supervision, leading to reduced out-of-hours work intensity. Better use of counselling services can improve the patient's ability to make an informed choice about their treatment options, backed up with written information. A same day service can be offered for that treatment. EPACs may be used for reassurance, i.e. early scans after a history of recurrent miscarriage or ectopic pregnancy. The system can also be used as a platform for research into both diagnostic and treatment options.