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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

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  • 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

Top 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways per 100k population

1

NHS East Sussex CCG

               261

2

NHS Barnsley CCG

               298

3

NHS Herts Valleys CCG

               336

4

NHS Bassetlaw CCG

               361

5

NHS Kernow CCG

               372

6

NHS Vale of York CCG

               383

7

NHS Oxfordshire CCG

               395

8

NHS North Staffordshire CCG

               413

9

NHS Derby and Derbyshire CCG

               438

10

NHS Morecambe Bay CCG

               442

     

Bottom 10 

   

Rank

Clinical Commissioning Group

Number of incomplete pathways per 100k population

106

NHS Manchester CCG

            1,577

105

NHS Trafford CCG

            1,369

104

NHS Liverpool CCG

            1,260

103

NHS Knowsley CCG

            1,166

102

NHS Birmingham and Solihull CCG

            1,154

101

NHS Salford CCG

            1,153

100

NHS South Sefton CCG

            1,142

99

NHS Stockport CCG

            1,118

98

NHS Leicester City CCG

            1,060

97

NHS Tameside and Glossop CCG

            1,052

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

Top 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways waiting more than 52 weeks per 100k population

1

NHS Barnsley CCG

                   4

2

NHS Berkshire West CCG

                   4

3

NHS Frimley CCG

                   5

4

NHS Northumberland CCG

                   5

5

NHS Sunderland CCG

                   7

6

NHS Herts Valleys CCG

                   7

7

NHS South Tyneside CCG

                   7

8

NHS South West London CCG

                   7

9

NHS Surrey Heartlands CCG

                   8

10

NHS Bassetlaw CCG

                   8

     

Bottom 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways waiting more than 52 weeks per 100k population

106

NHS Manchester CCG

               226

105

NHS Trafford CCG

               179

104

NHS Leicester City CCG

               169

103

NHS Hull CCG

               149

102

NHS Heywood, Middleton and Rochdale CCG

               122

101

NHS Bury CCG

               122

100

NHS Brighton and Hove CCG

               120

99

NHS Norfolk and Waveney CCG

               117

98

NHS West Suffolk CCG

               110

97

NHS Oldham CCG

               106

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

Top 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways

1

NHS Bassetlaw CCG

               424

2

NHS Barnsley CCG

               736

3

NHS South Tyneside CCG

               808

4

NHS West Lancashire CCG

               813

5

NHS Southport and Formby CCG

               893

6

NHS North Staffordshire CCG

               906

7

NHS East Staffordshire CCG

               956

8

NHS Stafford and Surrounds CCG

            1,020

9

NHS Blackburn with Darwen CCG

            1,086

10

NHS Castle Point and Rochford CCG

            1,105

     

Bottom 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways

106

NHS North East London CCG

          16,642

105

NHS North West London CCG

          16,361

104

NHS South East London CCG

          13,765

103

NHS Birmingham and Solihull CCG

          13,620

102

NHS Kent and Medway CCG

          12,947

101

NHS South West London CCG

          10,202

100

NHS Hampshire, Southampton and Isle of Wight CCG

          10,047

99

NHS Black Country and West Birmingham CCG

            9,550

98

NHS Norfolk and Waveney CCG

            8,787

97

NHS Manchester CCG

            8,721

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

Top 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways waiting more than 52 weeks

1

NHS Bassetlaw CCG

                   9

2

NHS Barnsley CCG

                   9

3

NHS South Tyneside CCG

                 11

4

NHS North East Lincolnshire CCG

                 16

5

NHS Northumberland CCG

                 17

6

NHS Sunderland CCG

                 18

7

NHS Berkshire West CCG

                 19

8

NHS North Tyneside CCG

                 28

9

NHS Doncaster CCG

                 28

10

NHS St Helens CCG

                 33

     

Bottom 10

   

Rank

Clinical Commissioning Group

Number of incomplete pathways waiting more than 52 weeks

106

NHS Manchester CCG

            1,251

105

NHS Norfolk and Waveney CCG

            1,196

104

NHS North East London CCG

            1,167

103

NHS South East London CCG

               967

102

NHS Kent and Medway CCG

               763

101

NHS North West London CCG

               694

100

NHS Leicester City CCG

               598

99

NHS Coventry and Warwickshire CCG

               597

98

NHS Hampshire, Southampton and Isle of Wight CCG

               558

97

NHS Herefordshire and Worcestershire CCG

               523

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

Top 10

   

Rank

Clinical Commissioning Group

% of incomplete pathways waiting more than 52 weeks

1

NHS Berkshire West CCG

                0.7

2

NHS Northumberland CCG

                1.0

3

NHS Frimley CCG

                1.1

4

NHS South West London CCG

                1.1

5

NHS Barnsley CCG

                1.2

6

NHS North East Lincolnshire CCG

                1.4

7

NHS Sunderland CCG

                1.4

8

NHS South Tyneside CCG

                1.4

9

NHS Bedfordshire, Luton and Milton Keynes CCG

                1.5

10

NHS Surrey Heartlands CCG

                1.5

     

Bottom 10

   

Rank

Clinical Commissioning Group

% of incomplete pathways waiting more than 52 weeks

106

NHS Leicester City CCG

              15.9

105

NHS Hull CCG

              15.1

104

NHS Manchester CCG

              14.3

103

NHS East Leicestershire and Rutland CCG

              14.0

102

NHS Oldham CCG

              13.9

101

NHS Norfolk and Waveney CCG

              13.6

100

NHS Bury CCG

              13.2

99

NHS Trafford CCG

              13.1

98

NHS East Riding of Yorkshire CCG

              13.0

97

NHS Heywood, Middleton and Rochdale CCG

              12.9

NHS waiting list tracker

NHS waiting list tracker

Visualised by LCP

Explore our interactive tracker to see how waiting lists for NHS services vary across England.

Start here