This summer, the Government revealed the Women’s Health Strategy for England, marking an important step in ensuring that 51% of the population will start getting the care they need. Due to a ‘male by default’ system, women on average live longer than men but spend a greater proportion of their lives in poorer health conditions and disability, compared with men. To that end, the Strategy sets out 6-points for transformational change:
- ensuring women’s voices are heard;
- improving access to services;
- addressing disparities in outcomes among women;
- better information and education;
- greater understanding of how women’s health affects their experience in the workplace; and
- supporting more research, improving the evidence base and spearheading drive for better data.
In aid of implementing the Strategy, the Government has appointed its first ever Women’s Health Ambassador for England, Professor Dame Lesley Regan, who has an impressive track-record in everything gynaecology.
The 10-year plan with commitments to improve women’s* and girls’ health across the country did not just come out of the blue: it is based on the feedback of almost 100,000 responses from women**, over 400 written submissions from organisations and experts in health and care and a focus group study. Perhaps most concerning is that women felt that their voices were not always listened to, and even some medical professionals lacked awareness on health conditions that particularly affect women.
The Strategy looks at different actions across women’s lifecycles, from adolescence to older age. It focuses on a number of important areas: menopause, mental health and wellbeing (for which the Government is working on a Mental Health and Wellbeing plan, find out more here), cancers, health impacts of violence against women and girls, and healthy ageing and long-term conditions.
Two areas that have proven to be of particular concern are menstrual health and gynaecological conditions, and fertility, pregnancy (loss) and postnatal support.
Menstrual health and gynaecological conditions
Many stakeholders have identified conditions affecting the female reproduction organs, such as heavy menstrual bleeding, premenstrual syndrome, endometriosis and polycystic ovary syndrome (PCOS) as a priority for focus. The Government committed to updating the service specification for severe endometriosis in 2022 to 2023 to improve standards of care for women with this condition. The National Institute for Health and Care Excellence (NICE), which provides evidence-based guidelines for healthcare professionals on best practice, is reviewing its guidelines on endometriosis and is considering producing a guideline on PCOS.
The Government also lists some actions that had already been set in motion, including the introduction of relationships and sex education (RSE) and health education in schools, funding access to free period products in schools, plans to reduce waiting times and improve patient experience, implementing the rollout of surgical hubs for high-volume procedures and the development of standardised patient pathways, and the establishment of a network of specialist centres to provide comprehensive treatment, care and advice for those affected by implanted mesh. The Government is planning to set out actions for sexual and reproductive health later this year which will further dive into this issue.
Fertility, pregnancy (loss) and postnatal support
Contraception, preconception health, (in)fertility, pregnancy loss and stillbirth, birth trauma, and support for expectant and new mothers were also identified as needing further Government attention. Commitments made in this respect include improved access to and transparency on IVF treatment across the country, and removal of barriers for female same-sex couples in accessing IVF. Work will also be done with NHS England and the Human Fertilisation and Embryology Authority (HFEA), the regulator of the UK fertility sector, to improve information provision to women regarding fertility and improve understanding among healthcare professionals. In addition, parents who lose a child before 24 weeks can choose to receive a pregnancy-loss certificate if they deem it to provide them comfort and validation.
As for ongoing actions, the Government notes the NHS England Maternity Transformation Programme and NHS Long Term Plan provided good progress towards reducing stillbirths and neonatal deaths. Health disparities are addressed in guidance for local maternity systems and by the Maternity Disparities Taskforce. Several programmes are also supporting the expansion of personalised maternity care. The Government has provided funding in several areas and has as commissioned numerous research projects to close knowledge gaps.
A HFEA report about priorities for reform of the Human Fertilisation and Embryology Act 2008 is due at the end of 2022, which may prompt regulatory change. NHS England will also develop an updated plan for maternity and neonatal services. In addition, NICE is updating its guideline on fertility problems: assessment and treatment by 2024, to consider whether the current recommendations for access to NHS-funded treatment are still appropriate. The final report of the Pregnancy Loss Review and the recommendations in the Lancet series on miscarriage will be also be reviewed by the Government. The forthcoming plans for sexual and reproductive health, as highlighted in the previous section, will also address contraception and abortion rights.
While the Strategy is a big leap and promises to change the healthcare system to be more fit for women, the Royal College of Obstetricians & Gynaecologists raised concern that lack of dedicated funding might impair the opportunity to make the Government’s ambitions a reality. Let’s hope they are wrong, and all involved will help make long-lasting improvements for women and girls’ health.
What’s happening on the other side of the Channel?
Whereas the UK sets bold ambitions to tackle systemic issues, the EU continues to take baby steps. One of our previous blogs set out what the bloc has done so far, highlighting that a big reason for being slower in this policy area is that health has historically been a Member State competence (i.e., laws related to health are passed at a national level).
Most recently, the European Commission started work on a new global health strategy to strengthen EU’s leadership in this area. The initiative, which is expected for adoption on 16th November 2022, particularly mentions women’s health as part of the strategy in relation to the EU’s commitment to human rights and health equity. In addition, the European Parliament continued raising its voice in women’s health issues, calling for the EU and its Member States to legally recognise abortion and defend response for the right to safe and legal abortion and other sexual and reproductive health and rights (SRHR) in response to the United States’ Supreme Court decision in June 2022 to overturn the Roe v Wade (1973) ruling which ended the federal constitutional right to abortion.
The Whitehouse team has considerable experience in health, human rights and equality, and education, supporting organisations, both large and small in having their voice heard in the United Kingdom, the European Union, its Member States and beyond. For more information, please contact our Chair, Chris Whitehouse, at email@example.com.
* While this blog focuses on cisgender men and women, Whitehouse acknowledges the existence of a number of other gender identities. Although ‘sex’ and ‘gender’ are two different concepts, for the sake of clarity, we have used these words interchangeably for this blog to refer to those whose gender identity matches their sex assigned at birth. More on this here.
** Whitehouse Communications organised a discussion on this topic back in June 2021 as the consultation came to a close – watch it back here.