Women bearing brunt of indirect impacts of Covid-19 pandemic as new analysis shows gynaecology waiting lists have shot up by 60% in three years

• Gynaecology waiting list has increased by 34% since the pandemic began, the largest percentage increase across all specialties.
• Waiting list sizes at April this year were 60% higher than in April 2018, equating to over a third of a million women currently waiting for treatment.
• Six times as many women waiting for treatment in worst performing compared to best performing CCGs.
• LCP launches a new accessible and interactive tracker to explore how waiting lists vary across England.

Analysis using a new NHS waiting list tracker has revealed the stark rise in waiting times for gynaecology services and massive regional disparities across England, with 382,000 women currently waiting for treatment. Since April 2018, the increase in gynaecology waiting list sizes has outstripped all other medical specialties consistently, and in April this year the waiting list size was 60% larger than it was in 2018. Over the past year the number of women waiting for access to gynaecology services has also grown by over a third.

The new tracker, launched by LCP’s Health Analytics team, tracks and analyses the monthly figures released by the NHS to estimate how waiting lists vary across the country by both region and specialty. LCP found that 14 out of 19 medical and surgical specialities have experienced an increase in waiting list size since the pandemic began.

The tracker reveals that while over the course of the pandemic the overall number of people across all waiting lists has increased by 16% this has been felt unequally across different medical specialities, with gynaecology services being most impacted. The tracker shows that between February 2020 and April 2021:

• Gynaecology experienced the largest percentage increase in waiting list size across medical specialities, standing at 34% since the pandemic began.
• Gynaecology also has the second largest absolute increase in waiting list size - a 96,000 increase, up from 286,000 to 382,000 - behind trauma & orthopaedics which has seen an overall 116,000 increase. Taking into account this is generally a female only speciality it means that has been the hardest hit by the pandemic with regards to waiting list size, in both percentage terms and absolute increases.
• There are stark disparities across England. CCGs in the North and Midlands feature heavily in the bottom 10 of poor performers for gynaecology treatment wait times. This includes Manchester, Trafford and Liverpool. The CCGs with the lowest waiting times were more spread across the country, including Herts Valleys, Barnsley and East Sussex.
• There is a postcode lottery when it comes to waiting times with a 40-fold difference in the number of patients currently on waiting lists across CCGs which threatens to worsen existing health inequalities. In Bassetlaw and Barnsley there are approximately 400 and 700 people waiting compared to approximately 16,000 in North East London and North West London.
• When adjusting for population size, the difference in waiting lists is slightly less with six times as many women waiting for treatment in the worst performing CCGs compared to the best.
• Women in some parts of England are more likely to have to wait over a year for referral to see a gynaecological specialist. In Barnsley, there were just 4 people per 100,000 waiting more than a year to see a gynaecology specialist. In Manchester, this number is 56 times higher, at 226 per 100,000.

Rajiv Gogna, Partner at LCP and co-author of the analysis, commented: “Our analysis is telling a story that has not yet been told, that women are bearing a greater share of the burden of longer waiting lists. While Covid-19 has exacerbated this, gynaecology wait lists have been disproportionately increasing since 2018 so it is clear there is a longer term trend that needs addressing urgently.”

Dr Jonathan Pearson-Stuttard, head of LCP’s Health Analytics team, said: “The Government must take a data-driven approach to targeting recovery resources in order to prioritise areas with the highest unmet need to prevent health inequalities worsening further. Combining population and anonymised patient-level data can help decision makers understand inequalities in demand and outcomes to inform more effective levelling up measures and ultimately relieve health pressures. If we harness the potential of health-related data this could transform how we deliver health and care services.”

Dr Rebecca Sloan, Consultant at LCP who also co-authored the analysis added: “Every month the increase in waiting lists represents discomfort, pain and a real impact on the daily lives of hundreds of thousands of women, and this problem has been steadily worsening. This is a very immediate issue that will severely impact women who are currently trying or will be trying in the near future to access gynaecological services.

Operations considered ‘non-urgent’ have been cancelled, understandably due to the strain on the NHS during the pandemic. However, resources now need to be urgently diverted to the parts of the country where waiting times are at crisis point to prevent the worsening of conditions and to help improve the quality of life for those patients sooner rather than later.”

You can read the full analysis here.

Appendix

Table 1: 10 CCGs with most and fewest patients waiting per 100,000 population for gynaecological services

Table 2: 10 CCGs with most and fewest patients waiting more than 52 weeks per 100,000 population for gynaecological services

Table 3: 10 CCGs with most and fewest patients waiting for gynaecological services

Table 4: 10 CCGs with most and fewest patients waiting more than 52 weeks for gynaecological services

Table 5: 10 CCGs with most and fewest percentage of patients on gynaecological waiting list waiting more than 52 weeks