London School of Hygiene & Tropical Medicine

Patterns of Benign Gynaecology Care in English NHS Hospital Trusts, conducted by the Royal College of Obstetricians and Gynaecologists and the London School of Hygiene & Tropical Medicine, identifies a number of national indicators to provide an overview of benign gynaecological care in England. This includes inpatient care, emergency readmission and longer-term surgical outcomes.

Initial indicators suggest some variations in both care and longer-term outcomes, including:

• Significant variation in length of stay for procedures often considered ‘day cases’
• Emergency readmission rates varying substantially for all procedures
• One in six trusts sitting outside the limits for more than one indicator

Benign gynaecological services are a fundamental part of health services. Every year in England, around 28,000 women receive surgical medical treatment for heavy menstrual bleeding. Using routinely collected hospital data the report authors conducted a feasibility study on how to develop performance indicators for benign gynaecology care. Illustrating national variation in care will support NHS hospital trusts to identify causes at a local level and opportunities to improve care.

Edward Morris, Vice President of the Royal College of Obstetricians and Gynaecologists, said:

“The publication of this report is a significant step forward in providing a widespread picture of benign gynaecological services in England. It presents a strong opportunity for trusts to further review any variations in care and improve the quality of care in this area overall.

“We absolutely recognise that NHS hospital trusts are actively engaged in efforts to close any gaps in variations and improve care. These new findings should act as a further trigger to further review what more can be done to improve benign gynaecological care.”

Jan van der Meulen, Professor of Clinical Epidemiology at the London School of Hygiene & Tropical Medicine, said:

"In this report we show that routinely collected administrative hospital data can be used to develop robust indicators for benign gynaecology. Having access to comparative figures which take account of the different populations NHS Hospital Trusts serve provides an opportunity for hospitals to identify priority areas to review variation and improve care."

The RCOG adds that future analysis could be expanded to include measures of women’s experiences, including their health and quality of life before and after treatment. These measures currently do not exist.