Community tier 2 gynaecology service procurement

Overview

NHS Lancashire and South Cumbria Integrated Care Board (ICB) is set to procure a new community tier 2 gynaecology service for people living in the region.

The ICB is being supported by NHS Shared Business Services to undertake a competitive procurement process in line with the Provider Selection Regime (PSR) regulations.

A prior information notice (PIN) has been published and can be viewed here: Community Tier 2 Gynaecology Service for NHS Lancashire and South Cumbria Integrated Care Board - Find a Tender. Further information about PSR can be found on the NHS England website: NHS England » The Provider Selection Regime: statutory guidance

Providers will be invited to bid for the new three-year contract, with an option to extend for a further two years, as part of the competitive tender process which is expected to launch on 3rd July 2026. The new contract is set to go live from 1 January 2027.

The service, which has been developed using patient engagement insights, will provide a non-consultant led, community-based service, designed to bridge the gap between primary care and hospital-based secondary care for routine benign gynaecology conditions.

About the service

The community tier 2 gynaecology service has been developed in response to rising demand, long waiting lists and increasing referrals. The service aims to provide care closer to home by managing suitable cases in community settings, reducing pressure on hospital services and improving access, experience and outcomes for patients.

The service will accept referrals from GPs for people aged 16 and over who are registered with a GP in Lancashire and South Cumbria and who have routine benign gynaecology conditions that can be safely managed outside hospital. This includes conditions and procedures such as:

  • complex menstrual disorders,
  • pelvic pain,
  • urinary incontinence,
  • pelvic floor disorders,
  • endometriosis,
  • complex hormonal problems, menopause, polycystic ovary syndrome, premenstrual syndrome, Hirsutism
  • vulval conditions,
  • complex pessary care,
  • complex coil procedures, and
  • difficult cervical smears

It will offer triage, advice and guidance, face-to-face and remote appointments, and one-stop care where possible, while ensuring that anyone with suspected cancer, complex pathology or other excluded conditions is fast-tracked or referred into the appropriate secondary care pathway.

Overall, the service is intended as a long-term transformational response to sustained pressure on gynaecology pathways. Its goals are to shorten waits, reduce unnecessary secondary care referrals, improve consistency of provision across Lancashire and South Cumbria, and support earlier intervention, self-management and better quality of life.

Engagement and involvement

The ICB is committed to putting the needs of people living in Lancashire and South Cumbria at the heart of all we do. There is a collective ambition to do this by working with residents and communities and our partners to co-produce and improve health and wellbeing services.

To support the development of the community tier 2 gynaecology service for Lancashire and South Cumbria, patient and public insights from various engagement exercises – which spoke to more than 5,000 women in total – were taken into consideration.

Engagement findings point to a clear need for a community tier 2 gynaecology service that is easier to access, more personalised and better able to manage routine benign conditions before hospital referral is needed. Below are the main themes taken from several engagement exercises:

Access and waiting times

  • Women often described long waits and difficulty getting help at the right time.
  • Many felt they were passed between services or referred to hospital for issues that could have been managed earlier in the community.
  • This supports a service that offers earlier assessment, clearer pathways and community-based care closer to home.

Feeling heard and respected

  • Women repeatedly said they want to be listened to, believed and treated with empathy.
  • Many described feeling dismissed, especially when symptoms were long-term or affecting daily life.
  • This highlights the need for good communication, continuity and shared decision-making.

Expertise and confidence

  • Women reported variable knowledge and confidence among professionals.
  • They valued staff who could explain symptoms clearly, offer treatment options and avoid unnecessary escalation to hospital care.
  • This suggests the service needs practitioners with clear expertise in routine benign gynaecology and agreed escalation routes where specialist input is needed.

Local and flexible care

  • Women wanted care in local, familiar and easy-to-reach settings.
  • Travel, parking, privacy, work, caring responsibilities and transport all affected access.
  • This suggests the service should use accessible community settings and offer flexible appointment options.

Clear information

  • Many women said they were unclear about what support was available or how to access it.
  • Lack of information contributed to anxiety, delay and confusion.
  • The service should be supported by clear, plain English information on what it offers, how to access it and when onward referral may be needed.

Inclusive by design

  • The engagement highlighted barriers linked to culture, language, disability, neurodiversity and trauma.
  • Women also raised the importance of privacy, reasonable adjustments and access to female clinicians for intimate care.
  • This means the service should be inclusive, trauma-informed and sensitive to personal and cultural preferences from the outset.

Joined-up support

  • Women often described overlap between gynaecology, menopause, pelvic health, mental wellbeing and wider life pressures.
  • This suggests the service should sit within a wider women’s health pathway rather than operate in isolation.
  • Strong links with primary care, diagnostics, pelvic health, menopause support, mental health services and community support will help provide more joined-up care.

Conclusion

Overall, the engagement supports a service that provides timely, local, expert and compassionate care for routine benign gynaecology conditions. It should help women get the right support earlier, reduce unnecessary hospital referrals and offer a better experience between primary and secondary care.

You can read all of the engagement reports which have contributed to service development in full by clicking the links below:

We have also recruited a member of our Influence Panel to support the procurement evaluation process.

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