NHS0033

Written evidence submitted by Royal College of Obstetricians and Gynaecologists

About us

The Royal College of Obstetricians and Gynaecologists (RCOG) is a professional membership organisation made up of over 16,000 members worldwide. We work to improve the health of women, by setting standards for clinical practice, providing doctors with training and lifelong learning, and advocating for women’s health care.

Introduction

The RCOG has been gravely concerned about the size, scale and impact of waiting lists in gynaecology since the pausing of non-essential services at the start of the pandemic[1]. In response to this, the College is currently undertaking a piece of research to understand waiting lists in more detail. The report is due to be published towards the end of January 2022, and we would be happy to share the findings with the Committee at that time. This call for evidence response will therefore provide a short summary of the research that is being undertaken, as well as outlining what we already know about gynaecology waiting lists in England.

The research report

The RCOG is working in partnership with health analytics and insight experts from LCP Health Analytics to analyse available data in relation to gynaecology waiting lists in England to understand the picture in as much detail as possible. This includes looking at:

• The number of people waiting, and the average waiting times, for gynaecology services
• The geographic variation of waiting lists
• The number of referrals in the system compared to previous years to understand the estimated ‘hidden’ referrals that are still to come forward to the waiting list
• Primary diagnosis codes (ICD-10) against admissions data and outpatient data to understand the impact on different gynaecological conditions over time

Alongside this, we are undertaking a survey of RCOG members working in gynaecology across the UK, to understand the barriers and enablers to reduce the backlog in gynaecology. This survey can be viewed here. Following the survey, we are undertaking a series of interviews with members to understand these issues in greater depth.

We are also undertaking a survey of women who have experienced being on a waiting list for gynaecological care since the start of the COVID-19 pandemic. This survey can be viewed here. The survey looks to understand the everyday impact of waiting for care, and gives women a chance to tell their stories. Following the survey, we are undertaking a series of in-depth interviews with women both to understand their experiences in full, and to hear from them what they think needs to change.

What we already know about gynaecology waiting lists

Analysis by LCP Health Analytics earlier this year showed that gynaecology waiting lists have seen the largest percentage increase across all specialties[2].The analysis also showed that gynaecology had the second largest absolute increase in waiting list size, only just behind trauma and orthopaedics.

The latest available data RTT data shows the following:

• Gynaecology waiting lists have grown by 48% since the start of the pandemic, from 286,008 in February 2020, to 422,303 in September 2021.
• The median wait time in September 2021 was 12.5 weeks, yet there were almost 20,000 waiting over 52 weeks for care.
• There is a large variation geographically in waiting times for gynaecology. By CCG:

-          The CCG with the highest waiting lists in terms of waiting list per size of population had over 5 times the number of people per 100,000 waiting on a gynaecology list than the CCG with the lowest waiting list size. NHS Manchester CCG had 1,589 people per 100,000 on a gynaecology waiting list, compared to NHS Herts Valleys CCG, which had 270 people per 100,000 on a gynaecology waiting list.

-          There is also a dramatic difference between the CCG with the longest overall waiting list, compared to the CCG with the shortest, with the shortest waiting list equal to less than 4% of the volume of the longest waiting list.

-          The CCG with the highest number of patients waiting more than 18 weeks, NHS Birmingham and Solihull CCG, currently has 14,891 people waiting, compared to the CCG with the least number of patients waiting more than 18 weeks, NHS Bassetlaw CCG, which currently has 636 people waiting.

December 2021ee