A new service across Somerset that makes it easier to get checked for womb cancer has seen waiting times for a diagnosis reduce by 59 days.

Since Somerset NHS Foundation Trust (FT) launched the post-menopausal bleeding self-referral service in September 2023 as a UK first, the average wait for an appointment has gone down from 63 days to just four days.

So far over 150 patients have made a self-referral into the service, with two thirds meeting the criteria for an appointment, which they're contacted about by the NHS within 24 hours.

It has also led to a significant increase in the number of patients in Somerset being given a cancer diagnosis or an all-clear result within 28 days of their referral. This has increased from just 41% for gynaecology in April 2023 to 79% in January 2024 – which exceeds the national target of 75%.

Womb cancer, also known as endometrial cancer, is one of the most common cancers that affects older women and those with a womb who've been through the menopause.

The main symptom of womb cancer is vaginal bleeding or unusual discharge after menopause. Those who aren't using contraception or HRT who've not had a period for over 12 months, are classed as being post-menopausal.

This type of cancer is normally treated with a hysterectomy (surgery to remove the womb), with generally positive clinical outcomes, if found at an early stage.

Traditionally, people used to contact their GP if they had concerns about vaginal bleeding or unusual discharge after the menopause.

The new service – a first of this kind in the UK – means that if they are not currently on HRT, or stopped taking HRT at least six weeks ago, they can now make a self-referral via the Somerset FT website, or by calling the trust's gynaecology booking team.

It has meant that most patients no longer need to visit their GP for a referral to the service, with practice receptionists able to signpost patients direct to the service – helping to free up the time of GPs.

So far, every patient who has filled in a survey after their appointment has said that they were very satisfied with their overall experience.

Mr David Milliken, a consultant gynaecological oncologist at Somerset FT, said: "This new service is great news as it means people are getting a diagnosis for womb cancer much earlier than before. Once the service is fully established, we estimate that we'll see up to 50 patients a week at our clinics.

"We are seeing a year-on-year increase in referrals to our gynaecology cancer services for those who potentially have cancer – mainly those who're experiencing post-menopausal bleeding.

Much quicker via self-referral

"In fact, over the last year we've seen more than a 30% increase in the number of patients needing our care and treatment.

"We know that our GP colleagues have tended to refer their patients to our service if they have post-menopausal bleeding symptoms anyway, so by allowing patients to access our service direct via a self-referral, we're avoiding any unnecessary delays and getting them an appointment much quicker. It also has the added bonus of freeing up our GP colleagues to see patients with other conditions.

"More than nine out of every ten patients referred to our service will not have a cancer. We hope this service is helping to reassure the majority of people more quickly and help identify those who do need further treatment sooner.

"The idea is that if anyone has symptoms and wants to be seen, they can either access our service through our website, or by calling us. Whichever route they take to reach us, they'll get asked a number of questions to determine whether our service is right for them, or whether we need to direct them to their GP practice.

"A practitioner will provide an initial assessment at the clinic, which involves an ultrasound scan. Then, depending on the result of the ultrasound, there are a number of different options, from reassurance that there's nothing wrong, to an examination, biopsy, or referral into hospital for treatment.

"Before we set about developing the service, we asked our patients how they'd like it to run through a series of surveys. The overwhelming feedback was that people would prefer to be seen at a community hospital closer to where they live than having to travel into the larger district general hospitals.

"We've therefore made it easier to get to an appointment by running the clinics across the whole of Somerset. Appointments are available at Yeovil District Hospital and the community hospitals in Bridgwater, Minehead, South Petherton, Wellington, West Mendip (Glastonbury) and Wincanton.

"It means that patients only need to attend a single appointment that covers a consultation with a clinician, ultrasound and outpatient appointment, instead of three separate appointments as before.

"Another added bonus of promoting this new self-referral is being able to raise awareness of womb cancer symptoms, and encouraging those in this age range to come forward sooner so we can potentially catch cancer sooner and give them a chance of a better outcome.

"Our advice to people who are experiencing post-menopausal bleeding is to make a self-referral as soon as possible by going to the Somerset FT website (https://www.somersetft.nhs.uk/cancer/cancer-services/post-menopausal-bleeding/) and filling out a referral form, or call our booking office on 01823 213567."