Endometriosis Services

Luke Evans Excerpts

Tuesday 24th March 2026 Westminster Hall

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. Hon. Members have share powerful and distressing stories and experiences from their constituents. They are typified by Monica and I pay tribute to her for coming here to explain her story.

We must recognise the reality faced by many women and girls living with endometriosis. For too many, it means years of pain and possibly being dismissed, and it definitely means lives put on hold. From a GP’s perspective, the diagnosis is frequently delayed because symptoms overlap with other conditions such as fibroids, adenomyosis, irritable bowel syndrome, PCOS or pelvic inflammatory disease.

However, this debate is really about access, and there is a risk that current changes will make access worse, not better. The hon. Member for Ipswich (Jack Abbott) is a stalwart for raising that point as a central issue. The last Government drastically increased testing. They rolled out 161 community diagnostic centres across the country, which carried out ultrasounds, MRI and CT scans, and blood tests. That has helped with diagnosis by ruling in endometriosis and, equally importantly, ruling it out. That is not to mention the elective surgical hubs, 48 of which were delivering gynaecological procedures by March 2024. Those were important steps, but capacity remains constrained.

The first women’s health strategy, which committed to reducing diagnostic times for endometriosis, was also published in 2022. That strategy is now due to be renewed. In March 2026, the Women and Equalities Committee published a report from its inquiry into the menstrual health of girls and young women, which states that women’s health has not been “sufficiently prioritised” in recent proposed reforms to the healthcare system. The Government’s plan to renew the women’s health strategy is an opportunity to do so. Will the Minster confirm that those recommendations will be considered, and confirm when the renewed women’s health strategy will be published?

[Mims Davies (East Grinstead and Uckfield) (Con)]

The points my hon. Friend makes, as a clinician and an MP, are very important. Eleanor, my constituent from East Grinstead, has faced dismissal and delay. She has multiple issues, including pelvic congestion, which she says have ripped her life apart. Will my hon. Friend talk about the impact on A&E if that health strategy does not work? Far too many women see their symptoms as normal and extreme pain is dismissed too easily, which can lead to A&E trips.

[Dr Evans]

I am grateful to my hon. Friend for raising her constituent’s case; Eleanor must be suffering, and the aim is to try to get more people into primary care so they can get the support that they need. That view is shared by both sides of this House and that leftward shift into primary prevention would be helpful. Access will be crucial, which is why some of the Government’s changes to that access—which I will touch on later—are concerning.

Women’s health hubs were intended to improve access to care for menstrual problems. They were rolled out by the last Government with £25 million of investment and 39 out of 42 were in place. However, after Labour came in, it removed the national targets in January 2025, leading to an article from the Health Service Journal in April 2025 that stated:

“Most integrated care systems lack a women’s health hub offering full services—contrary to government claims—according to research seen by HSJ.”

It is not clear whether those numbers have improved and what the situation now looks like. I ask the Minister to provide any updates she has on those women’s health hubs, how they are functioning and whether they are fully operational; if she does not have that information—I know she is a new Minister—I would be happy to receive a letter on that.

That leads on to Endometriosis UK pointing out that there have been shortages in trained clinicians and diagnostic specialists. We know that as we expand community diagnostic centres, that will be really important. Under the last Government, there was a workforce plan. We have heard talk of a workforce plan, but it has been delayed multiple times by the Government. I wonder whether there is a date for when that will be finalised, because it is really important.

Finally, the heart of this debate is access to primary care. In a debate on endometriosis at the start of this month, the Minister for Secondary Care said:

“We have introduced Jess’s rule, which requires GPs to rethink diagnoses for their patients.”—[Official Report, 5 March 2026; Vol. 781, c. 1068WH.]

That rightly encourages GPs to rethink the diagnosis and refer when needed, but at the same time, every referral will now have to be routed through advice and guidance. In effect, it is moving to a single point of access, with a system explicitly aimed at diverting a significant proportion of referrals back to GPs. The new advice and guidance are aiming for about 25% of GP referrals to be diverted back to GPs for “10 high volume specialities”—of which gynaecology will be one—meaning one in four referrals will be bounced back under the neighbourhood health framework released 17 March.

On the one hand, GPs are told to refer; on the other hand, the system is designed to send those patients back, which risks patients being kept on waiting lists and away from secondary and specialist care. That really matters for endometriosis. It is a perfect test case, and the new NICE guideline is crystal clear. Recommendation 1.1.3 states:

“Gynaecology services for women with suspected or confirmed endometriosis should have access to: a gynaecologist with expertise in diagnosing and managing endometriosis, including training and skills in laparoscopic surgery; a gynaecology specialist nurse with expertise in endometriosis; a multidisciplinary pain management service; a healthcare professional with an interest in gynaecological imaging and fertility services.”

All those services are gatekept as secondary care. Someone might have a normal scan in primary care, primary care treatments might fail and a GP might know that they will need to be referred to a specialist—yet they will not be able to get access. Women’s waits could become longer, not shorter. I have tabled multiple parliamentary questions on advice and guidance and have received only holding answers, despite the changes coming in on 1 April.

I ask the Minister three questions. First, does she accept that mandating advice and guidance risks delaying referral? Secondly, how will this system avoid conflicting with Jess’s rule? Thirdly, will GPs retain the ability to refer directly into secondary care when clinically necessary?

Endometriosis is already hard enough to diagnose and treat; for patients, it is harder still. If access is to improve, the Government must set out clearly how this new system will work. If they cannot do that, they risk making access worse, rather than better—and that is something none of us wants to see.

[The Parliamentary Under-Secretary of State for Health and Social Care (Mrs Sharon Hodgson)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for Ipswich (Jack Abbott) on securing this very important debate. I am honoured to respond to it on behalf of my hon. Friend the Minister for Secondary Care, who unfortunately cannot be here today—this area of policy would normally fall under her portfolio.

I want to start by thanking Monica for sharing her story with us today through her MP and—as we heard—friend, and for being with us today in the Public Gallery, along with a large number of women who are suffering from this most painful and debilitating condition. Monica’s distressing experience highlights that we still have more work to do to ensure that all women with endometriosis can access the care they need.

As we have heard, for too many years women with endometriosis have felt unheard or dismissed and have been left to cope alone. We recognise the wide impact the condition has on education, work, family life and wellbeing, as well as on mental health, as the hon. Member for Eastleigh (Liz Jarvis) said, and we acknowledge that that is unacceptable.

This year’s Endometriosis Awareness Month theme is “endometriosis doesn’t wait”. That highlights the urgent need to reduce diagnosis times, improve care and address the impact of this debilitating condition. The Government are not waiting: we have already taken action to ensure that women with endometriosis have access to the services that they need. Many women spend years seeking answers, as we have heard today, being misdiagnosed, having symptoms minimised or being passed from service to service. The experience highlighted by all hon. Members who have spoken in the debate and by Endometriosis UK’s recent report underlines why earlier diagnosis and consistent, compassionate care must be central to our approach.

That is why we have introduced Jess’s rule, requiring GPs to reconsider diagnosis where symptoms persist, as the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) mentioned. We are also rolling out Martha’s rule, giving in-patients in acute hospitals in England the ability to initiate a rapid review of their case by someone outside their immediate care team. Those measures will help ensure that women’s concerns are not dismissed.

[Dr Evans]

Those were the words that the Minister’s colleague read out in the previous debate, but I have no gripes about the Department saying the same thing. My question is about Jess’s rule and its interaction when there is a single point of referral. There will be a rub between GPs who say that someone needs to be seen because they might have a diagnosis of endometriosis and the system saying that those patients will be bounced back. I would be grateful if the Minister could clarify what that rule will look like in practice, because endometriosis is a good example to demonstrate it.

[Mrs Hodgson]

I was going to come on to what the hon. Gentleman said about that, as well as his request for an update on women’s health hubs. I will take the opportunity to write to him about that update and his specific question on how referrals will work. I am aware that colleagues have raised issues with referrals and, as the hon. Gentleman says, endometriosis will be a good example of whether that system is working as it should. I do not have the answer to hand, but I commit to writing to him on that.

We are also expanding access to diagnostic services. Community diagnostic centres are being rolled out countrywide for women on gynaecological pathways. Last month, 106 centres offered out-of-hours appointments so that women could get vital tests around work and caring responsibilities.

We are modernising how specialist care is delivered. In September, we announced the new online hospital NHS Online, which will be unconstrained by geographical boundaries. It will better align clinical capacity with patient demand so that patients will be seen and triaged faster. Earlier this year, we confirmed that menstrual problems, often a sign of conditions such as endometriosis, will be among the first nine conditions available for referral from 2027. Details are being worked through ahead of next year’s launch. Additionally, we are supporting integrated care boards to expand women’s health services at neighbourhood level, building on the successful pilot of women’s health hubs, so that good practice is spread and services are improved everywhere.

NHS England is currently updating the service specification for severe endometriosis, which will improve the standards of care for women with severe endometriosis by ensuring specialist endometriosis services have access to the most up-to-date evidence and advice. That will be published in due course.