OBJECTIVES:

The Covid-19 pandemic had a large and lasting impact on healthcare systems. This impact has been felt unequally by geography and speciality. Redeployment of gynaecological healthcare professionals over the pandemic has further impacted the delay in elective care. We aimed to: characterise the overall gynaecology waiting list by geography, estimate the number of additional patients who would have sought care had the pandemic not occurred (‘hidden referrals’) and identify how hospital care for gynaecological conditions has changed since the pandemic.

METHODS:

We used publicly available National Health Service data to estimate the number of known patients on the gynaecology waiting lists at small geographical level from April 2018 to January 2021 across England. We estimated the number hidden referrals by calculating the number of fewer referrals to treatment during the pandemic compared to 2019. We used NHS admission and outpatient data to identify the trends in admissions pre and post pandemic by condition.

RESULTS:

The gynaecology waiting list has increased at the fastest rate of all specialities in England (60% increase) rising to nearly 460,000 as of 31 January 2022. We estimated a further 400,000 hidden referrals still to join the waiting list. There were significant geographical disparities, with the largest number of waits in North West England (over 1,000 per 100,000 population). Urogynaecological conditions appeared to be most impacted by the pandemic with a 60% reduction in admissions for prolapse or incontinence compared to 55% or less for other gynaecological conditions.

CONCLUSIONS:

Gynaecology waiting lists have increased substantially across the UK, with large inequalities geographically. Policy change is required to address geographical disparity and prioritise gynaecology as a speciality to limit the widening of these inequalities.