Determining local service levels for a hysterectomy service
Benchmarks for a standard population
Available data suggest that the standard benchmark rate for hysterectomy is 0.143% per year, or 143 per 100,000 female population; 23 per 100,000 (0.023% of the female population) of these would be for the treatment of heavy menstrual bleeding (HMB).
For a standard primary care trust with a population of 250,000, assuming 50% are female the average number of women requiring a hysterectomy would be 179 per year (0.143% of the female population), of which 29 per year (0.023% of the female population) would be for the treatment of HMB.
For an average practice with a list size of 10,000, assuming 50% are female the average number of women requiring a hysterectomy would be 7 per year (0.143% of the female population), of which 1 per year (0.023% of the female population) would be for the treatment of HMB.
HMB is one of the leading indications for hysterectomy, and based on primary diagnosis accounts for 20% of all hysterectomies. However, hysterectomy is also indicated for the treatment of other conditions such as malignancy and genital prolapse. Commissioners need to be aware that HMB may be a secondary diagnosis in women who have a hysterectomy; this has been indicated in around 50% of all hysterectomies[1].
This service is likely to fall under the programme budgeting category 218X (maternity and reproductive health).
Examine the assumptions used in estimating these figures.
Use the hysterectomy service commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
Further information
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- Department of Health Delivering quality and value - focus on benchmarking.
- NICE Health equity audit - learning from practice briefing.
- The Health impact assessment (HIA) gateway provides access to HIA-related information resources, sources of evidence and networks.
- Delivering the 18 week patient pathway: 18 week commissioning pathways.
- The ‘No delays achiever' provides access to service improvement tools aimed at reducing time between referral and treatment.
- The Practice-based commissioning comparators reporting service provides access to a range of indicators and activity data at practice level, enabling a better understanding of local commissioning activity, referral patterns and outcomes.
References
- Department of Health (2006) The Chief Medical Officer on the state of the public health. Annual report 2005. London: Stationery Office
This page was last updated: 02 March 2012
