Yn ddiweddar (Rhagfyr 2013), mae GIG Lloegr wedi rhoi rhagor o gyngor i glinigwyr ynglŷn â’r mater hwn i dynnu eu sylw at ganllawiau a ddiweddarwyd a chrynhoi nifer o gamau y tynnir sylw atynt isod, ac mae’r canllaw diwygiedig hwn yn cael ei gyhoeddi ar hyn o bryd i Gyfarwyddwyr Meddygol y GIG yng Nghymru, gan gynnwys yr angen i ddangos arfer dda yn glinigol mewn:Caniatâdsafoni’r holl brosesau caniatâd er mwyn cydymffurfio â’r dystiolaeth ddiweddaraf a rheoli risg ar bob lefel o’r unigolyn, GIG lleol ac ar lefel y DU hefyd.Archwiliocydymffurfio ag argymhellion NICE y dylai gosod rhwyll fod yn rhan o archwilio rheolaidd; a bodpobgweithdrefn a llawdriniaeth anymataliaeth, ond yn enwedig y rhai sy’n cynnwys rhwyll, yn cael eu cofnodi ar fas data cydnabyddedigAdrodd am ddigwyddiadau niweidiol: adrodd am bob digwyddiad niweidiol yn ymwneud a Rhwyll a ddefnyddir mewn llawdriniaeth wrth yr Asiantaeth Rheoli Cynnyrch Gofal Iechyd (MHRA)Llawdriniaeth i dynnu rhwyll: dangos lefelau perthnasol o ofal arbenigol (drwy archwiliad o nifer a chanlyniadau llawdriniaethau)
NHS England have recently (December 2013) issued further advice to clinicians on this issue drawing their attention to updated guidance and summarising a number of actions highlighted below and this updated guidance is currently being issued to NHS Medical Directors within Wales, covering the need to demonstrate good clinical practice in:Consent:standardisation of all consenting processes to comply with up to date evidence and risk management at all levels from individual, local NHS and also at UK level.Audit:compliance with NICE recommendations that mesh insertion should be part of regular audit; and thatallprocedures and incontinence operations, but particularly those involving mesh, are recorded on a recognised database.Adverse event reporting: reporting of all adverse events involving Mesh used operatively to the Medicines and Healthcare Products Regulatory Agency (MHRA)Surgery for removal of mesh: demonstrating that any surgery for removal of TVTs or prolapse mesh, or repeat surgery for incontinence or prolapse is to be performed in units which can demonstrate relevant levels of specialist care (through audited volume and outcome of surgery)