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NHS gynaecology backlog reflects ‘grim’ underfunding and gender-biased neglect
Experts in England raise the alarm over the “deprioritisation” of women’s health
The NHS gynaecology backlog reflects “grim” underfunding and gender-biased neglect, experts have said, after new figures revealed that almost 600,000 women in England are waiting for gynaecological treatment.
New data has unveiled that 33,000 women in England are waiting more than a year for gynaecological treatment.
The research, which found that no region in England meets the government’s target for cervical cancer of 80 per cent coverage, has labelled the patchy access to cervical screening and gynaecological treatment as a “postcode lottery”.
Experts and women’s health campaigners, however, said the findings only reconfirm the “deeply worrying ” inequalities women are facing.
“The statistics sadly reinforce that gynaecological health is at the back of the queue,” Athena Lamnisos, CEO of leading gynae cancer charity The Eve Appeal, told Femtech World.
“We know that cervical cancer is a largely preventable disease, but to eliminate it in the UK we need to meet targets. We need to ensure everyone has accessible information about HPV and the benefits of vaccination to enable every young person to get vaccinated when it is offered to them.
“We need to make sure that everyone with a cervix has the information and support they need to access cervical screening, and to reduce the postcode lottery around the UK.”
Kate Muir, women’s health campaigner and author of Everything You Need to Know About the Pill, said: “The gynaecology backlog reflects grim underfunding and gender-biased neglect.
“Why is it acceptable to be left to bleed heavily and incomprehensibly for a year, to have a prolapsed womb, and just accept being incontinent when action can be taken?
“Just because these conditions are largely unseen and silent does not mean we should not be shouting about them and deserve care.”
The “excruciatingly long” wait times, Muir said, reflect a lack of joined up thinking in the NHS, where women are sent for GPs to clinics to specialists and back.
“The new one-stop-shop Women’s Health Hubs could make a huge difference – if only the government would properly fund them.”
Gynaecological conditions on the elective pathway are often perceived as less urgent than their counterparts in other surgical specialties.
However, while waiting, women are left struggling with symptoms, such as extreme pain, heavy menstrual bleeding and incontinence. Long waits can also result in more complex treatment needs or emergency admission to hospital.
The Royal College of Obstetricians and Gynaecologists (RCOG) estimates that nearly nine in ten (89 per cent) healthcare professionals think gynaecology waiting times are impacting patients’ quality of life.
Bridget Little, head of support services at Jo’s Cervical Cancer Trust, said screening and early intervention could save lives.
“Two women are dying every day in the UK from a cancer that is largely preventable, yet the vast disparities in access to cervical screening, and the unmet coverage targets seen across the UK, are deeply concerning.
“We have an incredible opportunity to eliminate cervical cancer in the UK within a generation, but this will only be realised with effective strategies that recognise and rectify the widespread health inequalities across the UK.”
Little said urgent measures must be implemented to ensure that everyone who is eligible has fairer access to cervical screening and that all patients who need treatment for cervical cell changes receive the right treatment at the right time.
“It is vital that the government firmly commits to tackling health inequalities, and to providing appropriately resourced NHS services,” she added.
Venkatesh Subramanian, consultant in obstetrics, gynaecology and reproductive medicine at King’s College Hospital, said: “Currently, the UK has the largest gender health gap in the G20, which is deeply worrying.
“Gender inequalities in healthcare need to be aggressively challenged, with a comprehensive strategy focusing on improved allocation of resources and funding, prioritisation of research and development in the field and an end to the stigma and paternalism that enshrouds women’s healthcare.”
Dr Nitish Narvekar, fertility consultant at King’s Fertility and clinical director gynaecology at King’s College London, acknowledged the “distressing” health inequalities, but argued that the pandemic is also to blame for the long NHS waiting times.
“We know, for example, that some NHS organisations had to allocate resources based on greatest need and which may have disproportionately impacted those who are relatively ‘healthy’ but nevertheless suffer in other ways from waiting longer,” he explained.
“The NHS is responding to the challenges in different ways. For example, care is increasingly being organised and delivered sector-wide rather than just at level of individual organisations.
“However, patients will continue to be affected till all the service-delivery issues are resolved locally and nationally.”
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You have until Friday to nominate your femtech company of the year.
The award is one of 10 featuring at Femtech World’s third annual awards event, which attracts entries from across the UK, EU and Europe.
The Company of the Year Award is for companies that have demonstrated exceptional leadership in tackling women’s health needs through groundbreaking products, services or platforms that are shaping the future of global femtech.
If your company is driving innovation, impact and growth in this space, this award was made for you.
About the sponsor: Femovate
The category is backed by Femovate, the global femtech incubator using design to fuel innovation across every stage of a woman’s health journey, from proactive prevention through to personalised treatment.
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The startups it supports have collectively raised US$120 million, launched 30 products, and secured seven FDA clearances.
Why enter?
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Winners and shortlisted companies receive extensive coverage across all Femtech World platforms.
Winners will also receive a trophy and the opportunity to be featured in an interview for the publication.
Find out more about the Femtech World Award and enter here by 4pm BST on Friday 17.
Women with osteoporosis may be more likely to carry a gene linked to Alzheimer’s, according to new research.
Scientists found that APOE4, the most common genetic risk factor for Alzheimer’s, can weaken bone quality in women, even when standard scans appear normal.
The study, carried out by researchers at the Buck Institute for Research on Ageing in California, US, and UC San Francisco, suggests the gene may damage bone at a microscopic level long before any visible signs.
These changes can emerge as early as midlife and remain invisible to routine imaging tests used to assess bone strength.
The findings suggest a link between Alzheimer’s risk and skeletal health and could help pave the way for earlier detection of both conditions.
Professor Birgit Schilling, a senior author of the study, said: “What makes this finding so striking is that bone quality is being compromised at a molecular level that a standard bone scan simply will not catch.
“APOE4 is quietly disrupting the very cells responsible for keeping bone strong – and it is doing this specifically in females, which mirrors what we see with Alzheimer’s disease risk.”
Doctors have long observed that people with Alzheimer’s suffer higher rates of bone fractures, while osteoporosis in women is known to be one of the earliest predictors of the disease.
Now scientists believe they may have uncovered why.
Researchers led by Dr Charles Schurman carried out a detailed analysis of proteins in aged mouse bone and found that tissue was unusually rich in molecules linked to neurological disease, including those associated with Alzheimer’s.
In particular, long-lived bone cells known as osteocytes showed elevated levels of APOE, with levels twice as high in older female mice compared with younger or male animals.
Further experiments using genetically modified mice revealed that APOE4 had a strong and sex-specific impact on both bone and brain tissue.
The disruption at the protein level was even greater in bone than in the brain.
However, the bone structure itself appeared completely normal under scans.
Instead, the gene interfered with a key maintenance process inside bone cells, preventing them from repairing microscopic channels that keep bones strong and resilient.
When this process breaks down, bones become more fragile even if they look healthy on standard imaging.
These results suggest bone cells could potentially act as early biological warning signs of cognitive decline in women carrying APOE4.
Professor Lisa Ellerby, another senior author, said: “We think targeting these cells may open a new front in preserving bone quality in this population.”
Experts say the findings highlight the need to view the body as an interconnected system rather than treating diseases in isolation.
Dementia, of which Alzheimer’s is the most common form, remains one of the UK’s biggest health challenges.
Around 900,000 people are currently living with the condition, a figure expected to rise to 1.6 million by 2040.
It is already the leading cause of death, responsible for more than 74,000 deaths each year.
Health secretary Wes Streeting has relaunched England’s women’s health strategy, vowing to stop women being “gaslit” by doctors.
Speaking before publication of the renewed strategy, the health secretary said the NHS was “failing women” and set out measures to help them access the healthcare they need.
The government said the strategy would include a new standard of care to ensure women were offered pain relief for invasive procedures, such as fitting a contraceptive coil and hysteroscopies.
Feedback would be directly linked to provider funding through a new trial, giving women more power to affect change if they have a poor experience.
Action would also be taken to ensure women no longer face long waits for diagnoses for conditions such as endometriosis, which can take a decade to diagnose.
Streeting said: “[Women] have for so long been let down by a healthcare system that too often gaslights women, treating their pain as an inconvenience and their symptoms as an overreaction.
“Whether it’s being passed from one appointment to another for conditions like endometriosis and fibroids, or a lack of proper pain relief during invasive procedures, through to having to navigate symptoms for years before receiving a diagnosis, it’s clear the system is failing women.
“Women’s voices must be central to delivering effective, respectful and empathetic care. We need to hit medical misogyny where it hurts – the wallet.
“Today’s renewed strategy will tackle the issues women face every day and ensure no woman is left fighting to be heard.”
A report last month by the women and equalities committee found that gynaecological and menstrual health had not been “sufficiently prioritised” by the government.
MPs said parts of the 10-year women’s health strategy, launched in 2022 by the Conservatives, were at risk of being scaled back or discontinued under wider changes to the NHS.
These included initiatives that had reduced waiting lists and improved women’s access to healthcare, such as women’s health hubs.
Sarah Owen, chair of the committee and a Labour MP, said: “This would be a disaster for girls’ and women’s menstrual healthcare, when it is in dire need of more support.
“It is a national scandal that nearly half a million women are on hospital gynaecology waiting lists when there are effective treatments that could be administered in primary and community care, if only they could access them.”
The report said women faced “medical misogyny” and were left to “suck it up” and suffer in pain for years because of a lack of awareness of women’s health conditions.
A redesign of clinical pathways for some women’s health issues will aim to speed up diagnosis and treatment, and there will be a review of support for families who experience repeated baby loss.
The government also promised a “single referral point” to ensure women were directed to the right place the first time they sought help.
Dr Sue Mann, NHS England’s women’s health director, said too many women were dismissed for “serious symptoms” that affected every part of their lives.
“The renewed women’s health strategy will build significantly on the work the NHS has been doing to ensure women are heard and get the specialist care they need,” she said.
Women’s health groups cautiously welcomed the renewed strategy. Emma Cox, chief executive of Endometriosis UK, said decisive action would be vital to improve women’s healthcare in England.
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