Led by Hywel Dda UHB, the Enhanced Community Gynaecology Service (ECGS) is a new initiative in Wales designed to improve care for women experiencing irregular bleeding linked to hormone replacement therapy (HRT). Historically, many of these cases have been referred through urgent suspected cancer (USC) pathways, despite evidence showing that HRT users are at lower risk of endometrial cancer. This process has placed additional pressure on cancer services, with current evidence suggesting that 8% of the Welsh population on HRT will be referred to secondary care with irregular bleeding. The Bevan Commission highlighted that this would equate to approximately 2295 new cases a year that are being driven into cancer pathways.
ECGS offer an alternative route for care, with consultant-led clinics providing point-of-care diagnostics and treatments closer to home. The service includes dedicated HRT Irregular Bleeding Clinics, Mixed Gynaecology Clinics, and One-Stop Hysteroscopy/Ultrasound Clinics. These clinics allow for rapid diagnosis, management and treatment planning, and triage of high-risk patients onto cancer pathways.
At Claire’s Campaign, we welcome this development and its potential to ease pressure on gynaecological cancer services. We hope that, with proper safety netting and follow-up, this intervention will not only improve care for women with benign conditions but also lead to better, faster outcomes for those who do have gynaecological cancer. We encourage its expansion across Wales as every woman deserves timely, accurate gynaecological care – and this initiative is a step in the right direction.
For more information, please read here.
