Provision of obstetrics and gynaecology services during the COVID-19 pandemic: a survey of junior doctors in the UK National Health Service

Objective The coronavirus disease 2019 (COVID-19) pandemic is
disrupting health services worldwide. We aimed to evaluate the
provision of obstetrics and gynaecology services in the UK during
the acute phase of the COVID-19 pandemic.
Design Interview-based national survey.
Setting Women’s healthcare units in the National Health Service.
Population Junior doctors in obstetrics and gynaecology.
Methods Participants were interviewed by members of the UK
Audit and Research in Obstetrics and Gynaecology trainees’
collaborative between 28 March and 7 April 2020. We used a
quantitative analysis for closed-ended questions and a thematic
framework analysis for open comments.
Results We received responses from 148/155 units (95%), most
of the participants were in years 3–7 of training (121/148, 82%).
Most completed specific training drills for managing obstetric
and gynaecological emergencies in women with COVID-19 (89/
148, 60.1%) and two-person donning and doffing of Personal
Protective Equipment (PPE) (96/148, 64.9%). The majority of
surveyed units implemented COVID-19-specific protocols (130/
148, 87.8%), offered adequate PPE (135/148, 91.2%) and
operated dedicated COVID-19 emergency theatres (105/148,
70.8%). Most units reduced face-to-face antenatal clinics (117/
148, 79.1%) and suspended elective gynaecology services (131/
148, 88.5%). The 2-week referral pathway for oncological
gynaecology was not affected in half of the units (76/148,
51.4%), but half reported a planned reduction in oncology
surgery (82/148, 55.4%).
Conclusion The provision of obstetrics and gynaecology services in
the UK during the acute phase of the COVID-19 pandemic seems
to be in line with current guidelines, but strategic planning is
needed to restore routine gynaecology services and ensure safe
access to maternity care in the long term.