VESPA study

  • Research type

    Research Study

  • Full title

    Variations in the organisation of Early Pregnancy Assessment Units (EPAUs) in the UK and their effects on clinical, service and patient-centred outcomes (VESPA)



  • Contact name

    Davor Jurkovic

  • Contact email

  • Sponsor organisation

    University College London

  • Duration of Study in the UK

    0 years, 7 months, 30 days

  • Research summary

    Early Pregnancy Assessment Units (EPAUs) are dedicated units within NHS hospitals that provide specialist care to women in the first three months of pregnancy. Women who experience pain or bleeding in the first weeks of pregnancy or women with a previous miscarriage or ectopic pregnancy are routinely seen in EPAUs. While most NHS hospitals in the UK have an EPAU, there are considerable variations between them in the levels of care they provide and their accessibility to women. In addition, staffing levels vary considerably between the units. The most cost-effective organisational model for an EPAU is unknown.

    Early pregnancy problems are very common with 20% of recognised pregnancies ending in miscarriage and 2% of pregnancies being complicated by an ectopic pregnancy. Given the variation amongst units, women are likely to have different experiences of the services and the care provided.

    We propose to collect information about all women who present to a sample of EPAUs, with suspected complications of early pregnancy, for initial or follow-up visits.

    The main outcome of interest is the number of women who require emergency admission and stay in hospital. This could be either because of the diagnostic process cannot be concluded on outpatient basis or because there is a need for in-patient treatment.

    We have estimated that we need to include 44 EPAUs nationwide. We based our calculations on our findings from a pilot study we conducted. We will ensure that the units included in the study represent a good mixture of units located within both different types of hospitals and different geographic areas within the UK.

    The information obtained from this study will help to better organise EPAUs nationwide in order to ensure optimal clinical outcomes in the most cost effective way.

  • REC name

    North West - Greater Manchester Central Research Ethics Committee

  • REC reference


  • Date of REC Opinion

    20 Sep 2016

  • REC opinion

    Further Information Favourable Opinion