VR-enabled Hysteroscopy improving women’s choice and experience

This CW Innovation Fellowship case study explores the use of virtual reality (VR) during ambulatory hysteroscopy to enhance patient experience and procedural efficiency. The digital transformation project is led by Irina Stankeviciute, Hysteroscopy Lead Nurse and CW Fellow.

Virtual Reality as an Adjunct to Analgesia in Outpatient Hysteroscopy

Project summary: Use of virtual reality (VR) during ambulatory hysteroscopy to enhance patient experience and procedural efficiency.

Story of the project

Women’s health has historically been underfunded and under-researched, prompting clinicians to seek innovative approaches to improve women’s experiences during procedures that are often painful and anxiety-inducing.

Hysteroscopy is an internal examination of the womb (uterus) using a thin tube with a small camera inside it. It is used to diagnose and treat health issues, including heavy bleeding associated with periods or menopause, fibroids and fertility challenges. The procedure is currently performed either under general anaesthetic, with conscious sedation, or in an outpatient setting, but can be uncomfortable, or associated with pain and anxiety for some patients. While general anaesthesia avoids procedural discomfort, it is resource-intensive and carries additional risks.

Since leading hysteroscopy services across multiple sites and caring for thousands of women, I recognised that we were not offering enough choice to support patients’ pain, anxiety, and overall experience during outpatient procedures. Listening to patient feedback consistently reinforced the need for more effective, patient-centred interventions. This inspired me to explore innovative ways to expand our toolkit…

Ambulatory hysteroscopy using VR has the potential to bridge this gap by reducing discomfort and anxiety without the need for general anaesthesia or intravenous sedation. This would offer a more patient-centred approach while improving operational efficiency.

The project has been implemented within an outpatient ambulatory hysteroscopy service at Chelsea and Westminster Hospital, where virtual reality (VR) is offered either alone or alongside established pain relief options, including inhaled analgesia. Challenges included integrating new technology into busy clinical pathways and securing staff engagement, which were addressed through collaboration, training, and continuous patient feedback. Irina also secured funding for the Smileyscope VR headsets through the CW+ grants programme.

The early response from both patients and staff has been overwhelmingly positive, confirming that this approach met a genuine unmet need. The key principle is to offer women choice, enabling care to be tailored to individual preferences, needs and clinical circumstances.

Local pilot, national benchmark

Every woman should have equitable access to a full range of pain relief and anxiety-reducing options, regardless of where she lives or receives her care. By developing a standardised, evidence-based approach to incorporating VR into outpatient care, this project has the potential to reduce unwarranted variation in practice and help eliminate the current postcode lottery in access to innovative pain management.

Importantly, VR should not be viewed as a replacement for existing pain management strategies, but as an additional option that can be used alongside inhaled analgesia, local anaesthesia, oral analgesia, or other established methods to further enhance patient comfort and optimise outcomes.

Chelsea and Westminster is one of the few NHS hospitals to pilot the use of virtual reality (VR) during outpatient hysteroscopy. This positions the service as a benchmark site, so learnings, implementation experience, and results can be shared with other organisations. This will be supported by the presentation of findings at national meetings and conferences to support wider adoption across hysteroscopy services.

The project has recently been showcased at the 2026 Research, Innovation and Quality Improvement (RIQI) event, which celebrates staff-lead improvement and transformation at Chelsea and Westminster Hospital NHS Foundation Trust. Irina has also featured on BBC Radio 4 Woman’s Hour, highlighting Chelsea and Westminster Hospital’s pioneering conscious sedation service for gynaecological procedures.

Outcomes

Between July 2025 and July 2026, 61 participants were recruited across seven treatment groups, evaluating different approaches to pain management. Early findings are encouraging:

• 4.3/10 average pain score, compared with 5.2/10 for standard outpatient hysteroscopy.
• 2.7/10 average anxiety score after the procedure, falling from 5.5/10 before the procedure.
• 9.9/10 overall patient satisfaction score.

The best outcomes were seen with the combination of VR and Penthrox® inhaled analgesia, achieving a mean pain score of 2.5/10 and an anxiety score of 2/10 during the procedure.

These results highlight VR as a promising, innovative intervention that could improve the quality of outpatient gynaecological care while addressing an important unmet need in women’s health.

Advancing the project through CW Innovation Fellowship collaboration

CW Innovation Fellow: Irina Stankeviciute

Role: Hysteroscopy Lead Nurse
Organisation: Chelsea and Westminster Hospital NHS Foundation Trust

Through the Fellowship, the project has evolved from a service improvement idea into a robust evaluation of VR’s impact on pain, anxiety, and patient satisfaction. The mentorship, networking opportunities, and practical guidance on innovation, evaluation and implementation have directly strengthened the project and increased its potential for wider adoption.

I applied for the CW Innovation Fellowship to gain the knowledge, skills and support needed to transform a promising clinical idea into a sustainable innovation that could improve women’s healthcare. I will take forward skills in innovation, leadership, project evaluation, stakeholder engagement and translating evidence into meaningful improvements in patient care.

The Fellowship also fostered a culture of innovation, collaboration and shared learning, giving me the confidence and practical tools to navigate implementation, evaluate outcomes and build a strong case for sustainable change. It has strengthened both Irina’s leadership skills and ambition to continue driving improvements in women’s healthcare.

The CW Innovation Fellowship exceeded my expectations by providing a structured yet practical programme that empowered me to develop an innovative idea into a project with measurable clinical impact.

Next steps

The outcomes demonstrate clear benefits in reducing pain and anxiety while maintaining exceptionally high patient satisfaction, providing a strong case for sustainable implementation.

The next step is to secure approval through a business case to embed virtual reality (VR) as a permanent part of the outpatient hysteroscopy service at Chelsea and Westminster Hospital.

There are also plans to expand the use of VR to other outpatient gynaecology procedures, such as colposcopy, smears, IUD fittings, and vulval biopsies. The model will also be shared nationally, support wider adoption of this VR-enabled approach, ensuring more women have access to innovative, personalised care regardless of their postcode.

For more information on the CW Innovation Fellowship, which was previously called the Horizon Fellowship, visit the CW+ website. Visit the Innovation Directory to see this year’s Fellows and read more about their projects.