Gynaecologists in Wales have raised concerns that specialist endometriosis centres are at risk of closure due to inadequate resources and new accreditation requirements from the British Society for Gynaecological Endoscopy. The Cardiff and Vale health board specialist centre has been added to a risk register, citing potential closure unless changes are made to meet accreditation criteria. Clinical staff argue that funding differences between England and Wales have exacerbated resource challenges, and without increased capacity and dedicated teams for endometriosis care, accreditation requirements cannot be met.
New accreditation standards require centres to allocate dedicated time for multidisciplinary teams in complex cases and ensure surgeons perform a minimum number of operations annually. Additionally, all accredited centres must have named specialists including gynaecologists, specialist nurses, colorectal surgeons, urologists and radiologists with time dedicated to endometriosis care at least six times per year. Some centres currently rely on informal arrangements rather than planned roles integrated into endometriosis services. Loss of accreditation would result in patients being referred to hospitals in England, increasing costs to NHS Wales and potentially causing a skills exodus from Welsh services.
One patient, a 32-year-old experiencing chronic pain, described multiple surgeries that were incomplete due to unavailable specialist team members or insufficient theatre time. She ultimately paid £20,000 privately for treatment after repeated disappointments with NHS procedures. Another woman experienced similar interruptions to her scheduled surgery. Both cases highlight operational challenges in delivering comprehensive care for complex endometriosis cases affecting multiple organs.
The Royal College of Obstetricians and Gynaecologists has urged the Welsh government to commit to sustainable resourcing of gynaecology services, including adequate workforce numbers, staff training and appropriate facilities. The deputy minister for women’s health in Wales acknowledged the current arrangement was “not sustainable” and is exploring options for establishing regional or national services. Gynaecologists presenting to a cross-party Senedd group indicated that Wales requires either a nationally commissioned service or a revised funding model reflecting the true cost of specialist care to prevent service downgrade.
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