Ireland to introduce national endometriosis framework

Ireland has announced the development of a national endometriosis framework which sets out for the first time a defined clinical care pathway for women with endometriosis.

Developed by the Health Service Executive’s National Women and Infants Health Programme (NWIHP), the framework will be implemented on a phased basis, commencing this year.

It is built around the principle of “right care, right place, right time”, and its model of care proposes that women with symptoms of endometriosis be treated on the basis of presumed diagnosis.

Endometriosis is one of the most common gynaecological conditions in Ireland and affects approximately one in ten women.

It is estimated that 47 per cent of women who experience fertility issues have endometriosis and in many cases, it may be suspected or diagnosed when a woman undergoes fertility investigations.

The vast majority of cases can be managed successfully at primary care level with the assistance of GPs, says the Irish Department of Health.

Some patients will require additional multi-disciplinary support at secondary care level. This is being facilitated with the setting up of five interdisciplinary teams to support the holistic treatment of endometriosis in each of the maternity networks.

A small number of women with more complex cases will require expert treatment in two supra-regional endometriosis specialist centres which are currently in development.

“The model of care of presumed diagnosis puts women’s needs to the fore, ensuring that they receive timely, effective treatment that can have a transformative impact on their lives,” said Minister for Health, Stephen Donnelly.

“Since 2019, the Women’s Health Taskforce has heard testimony from women with endometriosis, who have described their experiences of the disease as ‘painful, isolating, misdiagnosed, lonely and dismissed.’

“This framework, along with investment in holistic treatment teams and in two supra-regional hubs for complex cases are important steps towards improving their experiences and outcomes.”

Clinical director for the National Women and Infants Health Programme, Dr Cliona Murphy, said: “This framework is a significant development in our efforts to improve endometriosis care, and it aligns with NWIHP’s overall aim of improving women’s access to quality services.

“Together with the establishment of other specialist women’s health services such as “see and treat” ambulatory gynaecology services, specialist menopause clinics and regional fertility hubs, we are delivering tangible improvements in women’s healthcare.”