Andalusian regional health ministry to draw up protocol to ensure that all patients with endometriosis receive equal treatment

On 21 October, the president of this organisation, Ana Ferrer, met with the new director of the SAS (Andalusian health service), María de los Ángeles García Rescalvo, to take this step.

Following the meeting, the regional health ministry promised "to begin work" to "provide standardised care for all patients". This future protocol will be modelled on the programme at the Virgen de las Nieves hospital in Granada, which has demonstrated the "best practices in patient care".

Women with endometriosis are satisfied with the outcome of the meeting. For them, it is a "basic clinical tool that Andalucía still lacks".

"It is a combination of clinical guidance and a mandatory protocol for healthcare professionals that standardises medical practice in Andalucía across both primary care and specialist hospital care. It is the document that guarantees the quality of care for a particular condition. To give an example, the PAI for breast cancer has just been updated. This means that the entire SAS will now follow the same approach," Ferrer said.

In each province, certain diagnostic tests are prescribed for patients. This would be standardised under this PAI, which would also be binding on all healthcare professionals in Andalucía.

Endometriosis, a chronic gynaecological condition that can cause debilitating pain and fertility problems, affects around 84,000 women in the province of Malaga, according to the estimates of patient organisations. This figure is based on a prevalence of ten to 15 per cent among women of reproductive age. It does not, therefore, correspond to the number of diagnosed cases.

It would take around two years to draft the PAI. In the meantime, Ana Ferrer said, the regional government has refused to adopt the guidelines of the SAGO (Andalusian society of gynaecology and obstetrics). According to the organisation, there is already a previous set of guidelines within the SAS, although Ferrer says that these have now become obsolete: since then, leading scientific literature has demonstrated that the condition is not merely a gynaecological problem, but a clinical reality that the WHO (World Health Organization) recognises.

Endosur highlights that "this condition, if poorly managed or left untreated, can lead to peritonitis, sepsis or severe bleeding". "It is a life-threatening condition," Ferrer said.

Endosur Fem wants to avoid problems such as those they previously experienced at the Malaga Hospital Materno Infantil, where the endometriosis unit was facing delays of over a year in women's surgeries. The members of the organisation also complained that the multidisciplinary team responsible for treating their condition and carrying out their operations was not functioning properly.

They are also calling for improvements to the training of gynaecologists in endometriosis, both in terms of treatment and surgical procedures.

There are different stages that a woman with endometriosis goes through before she is referred to the specialist units in Malaga and Seville or to the Virgen de las Nieves hospital in Granada.

In Torrecárdenas, Almeria, "there is one consultation a month", and in the western part of the region, particularly if the patient is in Cadiz, it is more difficult to refer patients to specialist units.

"We also discussed the state of the two major flagship infrastructure projects in the region. In the case of the Materno Infantil hospital, we have secured a commitment to begin a gradual recovery process that will restore it to the position of excellence and clinical leadership it once held," Ferrer said after the meeting with the SAS.

As for the Virgen del Rocío University hospital in Seville, "we agree on the urgent need to undertake a far-reaching reorganisation". "The aim is to effectively structure a unit that has the institutional duty to be a regional benchmark, a status which it has not yet managed to consolidate in practice. To take this step forward, we have already scheduled a working group meeting with its management for next month."

At the same time, Endosur Fem wants to push for a regional law. "We are already in talks with the various groups in the Andalusian parliament and the response has been very positive. We are in no doubt: when the underlying aim is to safeguard women's health, understanding is the best tool, the association states in a press release," Ferrer concluded.

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