The first ever national report by the Royal College of Obstetricians and Gynaecologists (RCOG) into benign gynaecological care shows some variations between NHS trusts across England.
The report, carried out in collaboration with the London School of Hygiene and 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.
The RCOG argues that findings in Patterns of Benign Gynaecology Care in English NHS Hospital Trusts present a strong opportunity to improve gynaecology services across the country.
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.
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.
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About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.
This report represents a feasibility study on the derivation of national performance indicators for benign gynaecology in England. We present a suit of seven indicators, focusing on inpatient care, emergency readmission and longer-term surgical outcomes. These indicators are risk-adjusted for key differences between populations of patients (case-mix).
There is currently insufficient data available to present a complete picture of quality of care throughout the benign gynaecology care pathway in England. Measures of women’s experience and quality of life before and after treatment, as well as data from outpatient care would be particularly valuable.
Our aim is to illustrate national variation, not to identify individual trusts as ‘outliers’, and to demonstrate the feasibility of using routinely-collected hospital data to define performance indicators for benign gynaecology care. This report is intended as a supportive tool to empower trusts in their existing efforts to identify causes of variation at a local level and opportunities to improve care.