Women's Health Strategy For England Released

Published on: 20/07/2022

FIRST WOMEN’S HEALTH STRATEGY FOR ENGLAND TO TACKLE GENDER HEALTH GAP 

  • Major new research on women’s health issues to increase understanding of female specific health conditions and tackle the data gap to ensure diagnosis and treatment work for women.
  • Ensuring all doctors are trained to provide the best care to women by introducing mandatory specific teaching and assessment on women’s health for all incoming graduating medical students and incoming doctors.
  • £10 million for breast screening programme to provide 25 new mobile breast screening units for areas with the greatest challenges of screening uptake.

Women and girls across England will benefit from improved healthcare following the publication of the first ever government-led Women’s Health Strategy for England today (Wednesday 20 July).

The strategy includes key commitments around new research and data gathering, the expansion of women’s health-focused education and training for incoming doctors improvements to fertility services, ensuring women have access to high quality health information and updating guidance for female specific health conditions like endometriosis to ensure the latest evidence and advice is being used in treatment.

Women live on average for longer than men but spend more of their life in poor health, often limiting their ability to work and participate in day to day activities. Closing the gender health gap and supporting women to live well will not only benefit the health and wellbeing of women, but the health of the economy.

Responses to the call for evidence highlighted a need for greater focus on women’s specific health conditions including fertility and pregnancy loss, and gynaecological conditions such as endometriosis which affects 1 in 10 women. To support progress already underway in these areas the strategy aims to:

  • Invest £10 million funding for breast screening programme will provide 25 new mobile breast screening units to be targeted at areas with the greatest challenges of uptake and coverage. This will provide extra capacity for services to recover from the impact of the pandemic, boost uptake of screening in areas where attendance is low, tackle health disparities and contribute towards higher early diagnosis rates in line with the NHS Long Term Plan.
  • Remove additional barriers to IVF for female same-sex couples. There will no longer be a requirement for them to pay for artificial insemination to prove their fertility status, and NHS treatment for female same-sex couples will start with 6 cycles of artificial insemination, prior to accessing IVF services if necessary.
  • Improve transparency on provision and availability of IVF so prospective parents can see how their local area performs to tackle the “postcode lottery” in access to IVF treatment.
  • Recognise parents who have lost a child before 24 weeks through the introduction of a pregnancy loss certificate in England.
  • Ensure specialist endometriosis services have the most up to date evidence and advice by updating the service specification for severe endometriosis, which defines the standards of care patients can expect, to ensure. This sits alongside the National Institute for Health and Care Excellence (NICE) review of its guideline on endometriosis.

The strategy also commits to:

  • Transforming the NHS website into a world-class, ‘first port of call’ for women’s health information by updating existing content and adding new pages – including on adenomyosis, a gynaecological condition where endometrial tissue grows into the muscle of the uterus – and bringing together third party new and existing content.
  • Encouraging the expansion of Women’s Health Hubs around the country and other models of ‘one-stop clinics’, bringing essential women’s services together to support women to maintain good health and drive efficiency in the NHS, helping clinicians as they work to tackle the Covid backlogs.
  • Publishing a definition of trauma-informed practice for use in the health sector and encouraging its adoption in health settings, to help address barriers to accessing services that people affected by trauma such as domestic violence or psychological abuse can experience, ensuring they can access the care they need.

Feedback from thousands of women across the country revealed that they feel their voices were not always listened to, and there was a lack of understanding or awareness amongst some medical professionals about health conditions which affect women. To address this, the strategy commits to:

  • Commissioning urgent research by the National Institute for Health and Care Research (NIHR) into healthcare professionals’ experiences of listening to women in primary care, with a focus on menstrual and gynaecological symptoms to inform policy to ensure women’s voices are heard.
  • Introducing specific teaching and assessments on women’s health in undergraduate curricula for all graduating medical students from 2024 to 2025 and for all incoming doctors.
  • Major investment via the NIHR into research on women’s health issues including a new policy research unit on reproductive health, and plans to address data gaps, identify barriers to women participating in research, and improve the quality of data collected by the NHS. This will include running a new reproductive health experience survey every two years to continue to listen to women and gather insight on their experiences of services including for contraception and menopause.

By tackling the gender data gap through increased research, building understanding through training and tackling the root causes of why women’s voices are not always listened to, both women and clinicians should feel empowered to have more informed discussions over their care.

The publication of the Strategy is the latest action taken by the government to address the issues and disparities many women face. This includes appointing the first ever Women’s Health Ambassador for England earlier this year, the creation of a network of family hubs in 75 upper-tier local authorities across England, and providing protections to the millions of people who experience domestic abuse through the Domestic Abuse Act 2021.

The Department of Health and Social Care have also taken action to increase access to Hormone Replacement Therapy (HRT) and reduce costs of this medication. The creation of a prepayment certificate will mean women can access HRT on a month-by-month basis if need be, easing pressure on supply, paying a one-off charge equivalent to 2 single prescription charges, currently £18.70, for all their HRT prescriptions for a year. This system will be implemented by April 2023.

To ensure women can reliably access HRT, decisive action has been taken including the appointment of Madelaine McTernan as chair of the HRT supply taskforce and issuing of serious shortage protocols to even out distribution and provide greater flexibility to allow community pharmacists to supply specified alternatives, where appropriate.

Health and Social Care Secretary Steve Barclay said: 

“Our health and care system only works if it works for everyone. It is not right that 51% of our population are disadvantaged in accessing the care they need, simply because of their sex. The publication of this strategy is a landmark moment in addressing entrenched inequalities and improving the health and wellbeing of women across the country.”

Minister for Women’s Health Maria Caulfield said:

“When we launched our call for evidence to inform the publication of this strategy, women across the country set us a clear mandate for change. Tackling the gender health gap will not be easy – there are deep seated, systemic issues we must address to ensure women receive the same standards of care as men, universally and by default. This strategy is the start of that journey, but eradicating the gender health gap can’t be done through health services alone. I am calling on everyone who has the power to positively impact women’s health, from employers to doctors and teachers to industry to join us in our journey.”

Heidi Eldridge, MAMA Academy’s Chief Executive Officer, said:

“MAMA Academy welcomes the fact that the DHSC remains committed to improving outcomes for expectant parents and their babies. However, we have some concern that the year on year rate of stillbirth reduction has slowed significantly versus previous years. This may be in part related to the impact of the Covid-19 pandemic, as well as a range of other factors. We call on the DHSC and NHS England to redouble their efforts as we all work towards the 2025 target of a 50% reduction in stillbirth and neonatal death rates.

As an essential element of this, we urge the government to recognise that staffing levels in maternity services are at a serious crossroads. Understaffing compromises patient safety, and we are seeing an epidemic of low staffing levels in maternity across the country. This in turn negatively impacts staff morale, further increasing the impact of this. Whilst we welcome the funding that the government has already allocated to tackle this issue, we believe more funding and more focus still needs to be allocated to address the critical problem of staffing numbers, and more focus needs to be put onto this issue.

This needs urgent action without delay, and we call on the Secretary of State for Health to make it a key priority over the coming months. Failure to do so threatens to arrest the progress that has been made over recent years.”