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Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK
Samuel Oxley1,2, Ashwin Kalra1,2, Michail Sideris1,2
1Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Insights
Multiple COVID-19 waves significantly disrupted UK gynaecological oncology services, reducing staffing and urgent referrals. While services recovered, persistent staff shortages remained, impacting capacity.
Area of Science:
- Oncology
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
- Gynaecological oncology services, crucial for cancer patient care, faced significant operational disruptions.
- Understanding the impact of successive pandemic waves is vital for service resilience.
Purpose of the Study:
- To assess the impact of multiple COVID-19 waves on UK gynaecological oncology services.
- To quantify changes in staffing, patient referrals, theatre capacity, and working practices.
- To identify persistent challenges in gynaecological cancer care post-pandemic.
Main Methods:
- An online survey was distributed to members of the UK-British-Gynaecological-Cancer-Society.
- Data collection occurred across three COVID-19 waves between 2020 and 2022.
- Respondents represented 51 hospitals, including 32 dedicated cancer centres.
Main Results:
- Wave 1 saw a 50% median drop in urgent referrals, 40% reduction in theatre capacity, and 30% of operations postponed.
- Staffing reductions, particularly for trainee doctors (40% median), and shift to virtual multidisciplinary meetings (39%) and remote consultations (75%) were reported.
- Wave 2 showed service recovery, but Wave 3 indicated worsening staff shortages due to sickness, despite sustained referral and workload levels.
Conclusions:
- COVID-19 caused substantial disruption to UK gynaecological cancer care, affecting staffing, referrals, and capacity.
- While service disruptions eased, significant staff shortages persisted into 2022.
- These ongoing capacity constraints require strategic attention to ensure sustained gynaecological oncology service provision.
Background:
This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services.
Methods:
An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022.
Results:
In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity.
Conclusion:
COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.
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