In this blog from Dr Ranee Thakar, RCOG President, shares the key headlines from the College’s new report Waiting for a way forward: Voices of women and healthcare professionals at the centre of the gynaecology care crisis.
This week, the College published an in-depth report on waiting lists for non-cancer gynaecology care across the UK titled Waiting for a way forward. This has been a critical area of work since the publication of our 2022 report, Left for too long.
Since then, gynaecology waiting lists have increased by nearly a third. There are long waiting times for gynaecology across all parts of the UK, and it is often one of the most challenged specialities.
It is also unacceptable that women and people waiting in the areas of highest deprivation across the UK typically experience the longest waits for gynaecology care. Life expectancy for women living in the most deprived areas in England is already eight years shorter than those in the least deprived areas, and longer waiting lists for gynaecology care will entrench these health inequalities further.
This is putting the RCOG membership, wider healthcare professionals and crucially, women and people waiting for care, in an increasingly worrying position. As part of our report research, we listened closely to both the women waiting for care, the College membership and wider professionals working to deliver gynaecology services. We wanted to understand both the impact of waiting lists but also what those on the frontline feel could be done to help find a way forward.
The College is extremely grateful to everyone who took the time to provide this invaluable feedback. The results were sobering and reflect what many of us delivering care on the ground grapple with on a daily basis in caring for women with serious gynaecology conditions.
Over 80% of respondents to the secondary care survey reported being gravely or very concerned about waiting lists. In primary care, things were no different, with 93% of our primary care colleagues describing the impact on GP practices of longer waits for hospital gynaecology services as severe or very severe. As women and people are left waiting without definitive treatment or support for longer, their conditions are becoming more severe and complex to treat and more women are requiring emergency care such as blood transfusions. This is having a devastating impact on women, going beyond their physical health but also impacting their mental health and quality of life.
It is also crucial to consider the impact of long lists on the future of our specialty. The report found that training and development opportunities have been severely impacted, with professionals at all levels across the system reporting that they often had severely limited capacity to access training or continued professional development due to the pressures of delivering services. Without suitable space and time to train, we risk a decline in the number of new trainees pursuing O&G as a specialty.
The College is therefore recommending that the government builds, enables and incentivises protected training time for gynaecology as part of any elective recovery plan or package. As part of this, we believe the UK government must also set out how it plans to deliver the NHS Long Term Workforce Plan. This should include plans to recruit professionals but also deliver retention measures to encourage professionals to stay in the NHS.
The RCOG report also recognises the impact on the health and wellbeing of staff in both primary and secondary care. Over two thirds of professionals said waiting times had a negative impact to the health and wellbeing of themselves or their colleagues. Feelings of stress, fatigue and exhaustion across the NHS are well reported and greatly concern me in my role as RCOG President.
“The adding of ‘just one’ extra patient in each list, preventing time for lunch or a drink. The extra hours spent in the hospital to try and catch up with admin and not being able to spend time with my family…”
Survey response
"I am constantly answering complaints from patients who are waiting for several months, a lot of my time is wasted juggling lists. I feel helpless due to long waiting lists and limited theatre availability."
Survey response
I want to extend my thanks to the College membership and all the wider healthcare professionals working hard to deliver the best care they can in challenging circumstances. We know that available resources are often insufficient to manage the growing demand for care. One of the key recommendations from our report asks the government to immediately provide health services with the resources needed to protect gynaecology services against operational pressures, in particular by ensuring greater theatre capacity.
The College has campaigned ferociously for gynaecology to be prioritised and put higher on the political agenda for the last two years. While we have seen some positive progress including women’s health plans and strategies published England, Wales, Scotland and Northern Ireland, progress has not been quick enough for the women and people waiting for gynaecology care, nor for the professionals across the system. As part of this, we will continue to recommend that Women’s Health Hubs are expanded in an equitable and sustainable way to ensure all women, wherever they live, can access care and support to manage their health across their whole life course.
As President of the RCOG, I am calling on governments across the UK to urgently address the recommendations made in this report. They must deliver a ‘help now’ package to tackle the immediate lists alongside longer term sustained funding to address more complex systemic issues. Women deserve access to the care they need, when they need it and professionals deserve to have the time, tools and training to deliver that care.
- Read our full report here.