London Complex Mesh Centre (LCMC) - Psychological Wellbeing Service : University College London Hospitals NHS Foundation Trust

Introduction

This leaflet is for patients under the care of the London Complex Mesh Centre or seeking a referral to the centre. We aim to provide you with information about the psychological wellbeing service and how the team are here to support you through your treatment pathway for mesh complications.

What is the mesh psychological wellbeing service?

We are a group of psychological practitioners (psychologists and specialist counsellors) who specialise in Women’s Health and psychological treatment approaches that may be relevant to your care. These include approaches to trauma, living with complex health conditions, sex and intimacy problems and relationship difficulties. Our aim is to support you at the different points along your treatment pathway in a variety of ways, including:

Giving you the additional opportunity to think through the benefits and potential limitations of surgery, with someone other than your treatment provider. This process can often help clarify any additional information or support that you might need for you to make an informed decision to proceed with surgery.
An opportunity to consider what else you might need to improve your overall well-being and quality of life. Our team will focus not only on surgery, but on all aspects of your life.

The service has been designed with careful consideration of the findings of the Baroness Cumberlege “First Do No Harm” report. This report outlines patients’ experiences of their healthcare following the effects of mesh complications.

It is important to note that this service is not in place to prevent people from having additional surgery; this is a decision for you and your surgeon to discuss. Every patient referred to the London Complex Mesh Centre (LCMC) is offered an appointment with the psychology team to complement your decision to explore and potentially pursue surgery.

What will happen at my appointment?

Each appointment lasts approximately 50 minutes, where you will have the opportunity to discuss the areas mentioned above and other matters that are relevant to you. This conversation is confidential, and we would only break confidentiality in circumstances where we became concerned about your imminent safety or that of another person. You are welcome to bring a partner or friend to these meetings if you feel that this would be helpful, although we would normally suggest that the meeting starts with you on your own and additional people are invited in at an appropriate point.

In line with NHS and UCLH policies, we will write notes after all meetings which are uploaded to the UCLH patient record system. Only those with clinical involvement in your care would view these notes. Following your initial review, we will write a letter to you, your surgeon and GP summarising the conversation. This letter can be useful for both you and the team to understand your current situation and we would be happy to discuss the information it should include with you at your consultation.

How often will I be seen?

We recommend that everyone has at least one appointment prior to surgery, with follow-up appointments offered if you decide to proceed (up to five appointments in total). It may also be useful for some of these appointments to focus on whether other onward referrals for additional psychological support in your local area could be helpful to you.

Do I have the right to refuse?

Yes, you have the right to refuse to meet with us and this will not affect your care. However, we do hope that you will take up the offer.

Many women have told us that they have found the appointments helpful, sometimes in unexpected ways. Research also suggests that psychological preparation for surgery and the opportunity to debrief afterwards can improve well- being and outcomes from treatment. If you decide not to take up the offer of an appointment before your surgery, but subsequently feel it would be useful, please let us know and this can be arranged. Finally, if you feel you need some more information before an appointment is booked, a brief phone call with one of the team can be organised.