NHS gynaecology crisis deepens as 750,000 women wait without proper tracking

A new report from the Medical Technology Group has warned that widespread failures to collect data and monitor best practice in gynaecology services are leaving women facing longer delays to diagnosis and treatment.

Analysis of Freedom of Information (FOI) responses from 42 Integrated Care Boards reveals that gynaecology remains one of the least monitored and least accountable areas of NHS care.

Unlike better-resourced and planned specialties, most ICBs lack basic information on referral pathways, waiting times, diagnosis, treatment or outcomes for women's health conditions.

The findings come as part of the MTG's Commission on NHS Culture, an investigation into how organisational culture across the NHS affects the adoption and spread of innovation and technology to improve the delivery of services.

The report, A System that Learns: Embedding Best Practice Across the NHS looked at four clinicals areas: diagnostics, orthopaedics, gynaecology, and continence care to assess variation in the quality of services. It found that:

• In diagnostics, official data show that nearly a quarter of patients in England waited six weeks or more for key diagnostic tests in August 2025, far above the standard of under 1%. While some areas have well-established Community Diagnostic Centres, many lack proper integration, outcome tracking, and consistent oversight.
• More than 750,000 women are currently waiting for hospital gynaecology services in the UK. Most local health systems do not routinely track diagnoses, treatments, or outcomes, and few monitor whether care meets NICE guidance, leaving leaders without a clear picture of need or performance.
• Waiting times for hip and knee replacements in England remain around 50% longer than before the pandemic, with the UK falling behind comparable countries. Use of the National Joint Registry (NJR) is inconsistent in influencing commissioning decisions, and there is variation in rehabilitation pathways and referral criteria contributing to unequal access.
• An estimated 14 million people in England have bladder problems and a further 6.5 million have bowel problems, yet continence services often lack basic data, audit, and oversight. FOI findings show minimal accountability and major gaps in understanding service quality.

The MTG warns that this lack of data and governance is directly contributing to a 'postcode lottery' in women's health and across other clinical areas, where access to timely diagnosis and effective treatment depends more on geography than clinical need.

The MTG is now calling for the introduction of a National Best Practice Framework to standardise data collection, governance, and learning across all ICBs.

It also calls for systematic sharing of best practice across the NHS, with high performing areas as the NHS designated by 'gold standard' to allow best practice to be shared nationally.

Barbara Harpham, chair of the Medical Technology Group, said: "Our findings show that, in many parts of the NHS, system leaders simply do not have the data, governance or oversight needed to understand how key services are performing or how to improve them.

"This is particularly evident in gynaecology, where women's health is suffering because of major gaps in data collection and strategic planning across ICBs.

"Robust data and governance are essential to support the adoption and spread of best practice, making it easier for women to access and choose less invasive medical technologies that can reduce time to treatment and ensure safer outcomes.

"At present, too much accountability sits solely with providers, while NHS leaders and commissioners lack the information and levers they need to monitor performance and drive the adoption of best practice."

The full report, A System that Learns: Embedding Best Practice Across the NHS, is available here.