Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

Samuel Oxley, Ashwin Kalra, Michail Sideris, Nicole Itzkowitz, Olivia Evans, Emma Christine Atakpa, Adam R Brentnall, Nina Dworschak, Faiza Gaba, Rhian Gabe, Sudha Sundar, Nick Wood, Shibani Nicum, Alexandra Taylor, Stephen Dobbs, W Glenn McCluggage, Andy Nordin, Rosa Legood, Sean Kehoe, Sadaf Ghaem-MaghamiRanjit Manchanda* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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.

Original languageEnglish
Article number1273
Number of pages13
Issue number4
Early online date16 Feb 2023
Publication statusPublished - 16 Feb 2023

Bibliographical note

Funding: This research was funded by the British Gynaecological Cancer Society (EMSG1L5R) and Ovacome charity. It is supported by the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group and the British Association of Gynaecological Pathologists. The funding bodies had no role in the study design, data collection, analysis, interpretation or writing of the report, or decision to submit for publication. The research team was independent of funders.

Acknowledgments: The study is supported by researchers at the Barts Cancer Research United
Kingdom Centre for Excellence, Queen Mary University of London (C16420/A18066). We are grateful
for the endorsement and support from charities and patient support groups such as Ovacome, The
Eve Appeal, Target Ovarian Cancer, Ovarian Cancer Action, Jo’s Cervical Cancer Trust, and GO Girls.
We are grateful for the support received from the Royal College of Obstetricians and Gynaecologists,
the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group, and the British
Association of Gynaecological Pathologists.

Data Availability Statement

Supplementary Materials: The following supporting information can be downloaded at:, Table S1: COVID-19 Survey of Gynaeoncology Centres and Units.

Data Availability Statement: Publicly available datasets were analysed in this study. This data and R code used for analysis can be found here: survey (accessed on 31st October 2022).


  • COVID-19
  • multidisciplinary team
  • gynaecological cancer


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