UK Gynaecology Waiting Lists Soar, Causing Prolonged Patient Suffering

Research conducted by the BBC indicates that waiting lists for gynaecology appointments across the United Kingdom have more than doubled since February 2020. Current records reveal approximately three-quarters of a million (755,046) women’s health appointments are pending, a significant increase from 360,400 recorded just prior to the pandemic. This data suggests that at least 630,000 individuals are awaiting consultations for conditions ranging from fibroids and endometriosis to incontinence and menopause care. While health ministers throughout the UK state they are developing strategies to alleviate the situation, healthcare leaders contend that women are being inadequately served. Anna Cooper, a 31-year-old resident from the vicinity of Wrexham in North Wales, has endured severe endometriosis since her teenage years. This condition, characterized by tissue resembling the womb’s lining growing outside it, has resulted in permanent organ damage for her. She has undergone 17 surgical procedures, including a hysterectomy to remove her womb. Furthermore, she lives with two permanent stomas due to the extensive removal of parts of her bladder and bowel. She shares her home with her partner and young daughter. “The disease controls my social life, my work life and my ability to function every day. “It is not just a period problem – it is a whole body problem. It ripples through your body,” she states. The BBC interviewed her in 2023 regarding the establishment of her charity, Menstrual Health Project. A year later, she reports still experiencing pain and is once again on the NHS waiting list because of post-hysterectomy bleeding. Anna manages her daily pain with a morphine patch. However, she recounts that for years, medical professionals dismissed her concerns, telling her the pain was “in her head” and that she needed to “just get used to it”. She believes an earlier diagnosis would have transformed her life: “The delay in my care has cost me some of my major organs. “Doctors have told me that if they’d caught it sooner, I wouldn’t have ended up the way I am, living with two stomas and being in early menopause at the age of 31.” Over the past three years, she opted to spend £25,000 on private operations, securing loans to cover the costs. While she considers herself fortunate to access private treatment, she feels she was “almost left with no choice” due to the extensive waiting lists: “I can be a mum who isn’t just in her bed constantly because she is crippled with pain.” Endometriosis has “mentally tormented” her for most of her adult life. “It is really difficult dealing with a condition where I look absolutely fine from the outside, but internally, I’m just in despair.” Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG), asserts that “Women are being let down” and that change is “urgently needed”. A recent report from the college examines the impact on individuals awaiting care. Dr Thakar highlights, “Gynaecology is the only elective speciality that solely treats women and has one of the worst waiting lists across the UK. “This reflects the persistent lack of priority given to women and women’s health.” She adds, “Women are suffering. We know it is affecting their mental health. They are not able to go to work, they are not able to socialize.” Dr Thakar further notes that earlier intervention for these women would have prevented their conditions from advancing as severely, enabling them to continue contributing to society. An NHS Confederation-led report recently indicated that absences from work due to conditions such as heavy periods, endometriosis, fibroids, and ovarian cysts incur an annual cost of nearly £11 billion for the UK economy. The RCOG advocates for governments to commit to increased long-term funding to ensure individuals receive necessary assistance. There are some indications of improvement in waiting lists; the rate of increase has slowed this year, and the latest figures from NHS England show a reduction of over 4,700 individuals on the waiting list compared to the previous month. Nevertheless, the situation remains considerably worse than pre-pandemic levels. In February 2020, 66 gynaecology waits exceeded one year, whereas currently, this figure stands at over 22,000. Dr Sue Mann, NHS England’s national clinical director for women’s health, acknowledged that some women face excessive waits for vital gynaecology appointments, despite the diligent efforts of staff to attend to more patients. She suggests that specialist teams operating outside hospital settings offer a potential solution. “Some of these conditions can be managed very well by specialist healthcare teams in the community, which is why we are expanding neighbourhood women’s health hubs in every local care system across the country.” In Wales, the government intends to release a women’s health plan next month. A Welsh Government spokesperson stated, “A 10-year Women’s Health Plan is being developed to drive the improvement needed to provide good quality health services to women throughout their lifetime.” Regions in Northern Ireland are developing strategies to enhance gynaecology services, incorporating the 20 recommendations from a recent report. The department of health indicates that some of these initiatives will necessitate “additional funding and lead-in time.” Scotland’s Women’s Health Minister Jenni Minto declared that excessively long waits are unacceptable and confirmed that more funding is being allocated to women’s health. “That is why one of the initial priorities of the women’s health plan is to improve access for women to appropriate support, diagnosis and treatment.” Anna Cooper expresses her hope that ministers will “follow through with their words”. She emphasizes that when governments pledge to prioritize women’s health, they must demonstrate tangible action. “Currently they are not showing it, and this is people’s lives we are rolling the dice on… And having a daughter, I really fear for young girls’ and women’s futures,” she concludes. To determine the estimated size of the gynaecology waiting list for the UK, the most recent available figures from all four nations, as tracked by the RCOG, were aggregated. This compilation includes waits for gynaecology appointments and scheduled procedures, but excludes urgent appointments for conditions such as suspected cancer. While this provides the total waiting list size, it is noted that some patients may require more than one appointment. The estimated number of individuals awaiting care is at least 634,239, with the potential for this figure to be considerably higher. This calculation was derived by analyzing data from the NHS in England, which indicates an approximate 16% discrepancy between the number of appointments and the number of people waiting across various waiting lists. This percentage was then applied to the gynaecology waiting list. It is possible that this method may underestimate the true scope of the issue, as gynaecology patients are less likely to be waiting for two appointments compared to patients in certain other specialities.