Women’s Health Group minutes: February 2020

Attendees and apologies

Present:

• Catherine Calderwood, Chief Medical Officer for Scotland (Chair)
• Colin Berry, University of Glasgow
• Alastair Campbell, Royal College of Obstetricians and Gynaecologists 
• Michelle Currie, Scottish Clinical Leadership Fellow
• Sigi Joseph, Royal College of GPs
• Jaki Lambert, Professional Advisor Midwifery and Perinatal Care, Scottish Government 
• Anne Lillico, Scottish Government, Women’s Health Plan 
• Corinne Love, Senior Medical Officer, Scottish Government (Vice-Chair)
• Denise McLister, Scottish Government, Women’s Health Plan        
• Lindsey Pope, Royal College of GPs
• Irene Oldfather, The Alliance
• Emma Ritch, National Advisory Council for Women & Girls
• Karen Ritchie, Healthcare Improvement Scotland
• Alison Scott, NHS Lothian

Apologies:

• Heather Currie, NHS Dumfries and Galloway
• Clare McKenzie, NHS Education for Scotland
• Dona Milne, Directors of Public Health
• Ann Holmes, Chief Midwifery Adviser, Scottish Government

Items and actions

Welcome, introductions and background

The Chair welcomed everyone to the first meeting of the group and there were introductions around the table. The group had been established following a commitment by Ministers in the Programme for Government to develop a Women’s Health Plan which would determine the future of women’s health care in Scotland and underpin actions to tackle women’s health inequalities. 

The intention was that sub groups would be formed to work on specific subjects and they could involve other people with a particular interest or expertise in that area. Whilst keen not to increase the size of the core group the Chair was happy to reconsider membership if others in the group felt that key representation was missing.

Remit of Group

Following discussion there were one or two suggested changes to wording in the draft remit. Members were invited to submit any further suggested changes by email following which a final version would be circulated.

Current Women’s Health landscape

Alison Scott and Corinne Love presented a summary of work currently being undertaken on women’s health across Scottish Government, and described some of the work being done in health boards including some specific initiatives which aim to address health inequalities. The following points were raised in discussion:

Contraception and Abortion: Accessibility is an issue, including accessibility of preconception care, and provision of information in accessible formats. There are opportunities to approach provision of care in a more holistic way, so that the wider needs of the individual are considered, including addressing issues other than health. The Women’s Health Plan should aim to harness these opportunities.

Menopause: Access to services is very variable, with most menopause care currently provided in a primary care setting. There is scope for better referral pathways for GPs, and for other specialties to consider menopause and its impact on areas such as cardiac health. Education and accessibility of information is important, including for women, health professionals, young people and men. Also information about self-management approaches and peer support, and education/information about HRT would be helpful.

Endometriosis: Issues around referral pathways, access to diagnosis and treatment, and length of time to diagnosis need to be addressed, along with education of GPs. Endometriosis UK have done much to raise the profile of the condition. 

Antenatal Care: There is currently much ongoing work across Scottish Government, including The Best Start: A Five year Forward Plan for Maternity and Neonatal Care in Scotland, published in 2017 and mid-way through implementation. This work has well defined programmes and support structure. PlGF testing is an area where action may be needed, as well as raising awareness of the longer term risks of pre-eclampsia in relation to cardiac health.

Women’s Heart Health: Areas for consideration might include data collection, public awareness and education, improved awareness in secondary care and improved support for those affected, as well as heart disease in younger women. It was agreed that the recently formed Women’s Heart Health sub group of the National Advisory Committee on Heart Disease should become a sub group of the Women’s Health Group. 

Moving forward

The Chair anticipated that the group would develop some short term solutions as well as longer term actions. It would not be practicable to look at every area of women’s health and the group would need to decide on priorities, taking more of a watching brief in areas where there was already much ongoing work, for example antenatal care. There would be an expectation that actions in the Women’s Health Plan would be delivered.

It was agreed that the following sub groups should be set up:

• Menopause and Endometriosis – Heather Currie to chair
• Sexual Health/Contraception/Abortion/Preconception care – Alison Scott to chair
• Women’s Heart Health – Chair to be identified
• Service User Group – Irene Oldfather to chair
• Gender and Health Group – Emma Ritch to chair

The role of the first three sub groups would be to:

• identify gaps in the provision of services, consider areas of best practice, and develop practical actions to address these gaps
• in doing so make appropriate links across NHS Scotland and Scottish Government policy teams
• ensure that service users have an opportunity to contribute to its work (through the Service User sub group)
• report and make recommendations to the core Women’s Health Group

The Service User Group would support and inform the work of the other sub groups by including input from those with lived experience, and the Gender and Health  Group would apply a gender analysis to draft recommendations from the other sub groups, and develop cross-cutting recommendations around gendering health policy and programme design.

The sub groups would want also to look at evidence and recommendations from a number of recent reports on women’s health, including the RCOG publication “Better for Women”.

Sub group chairs were asked to note that some assistance would be available if required from two Public Health Registrars on placements in Scottish Government. 

The Chair commented that whilst the group would develop the Women’s Health Plan it would be for others in Scottish Government, NHS Scotland and elsewhere to implement it. It was therefore important that the plan contained practical actions and proposals. It was likely that some of them would be included as commitments in the next programme for Government.

Communications

It was agreed that a list of group members would be published on the Scottish Government website, along with the group’s remit when finalised, and agreed minutes of meetings. A photo of this meeting would be tweeted in the next few days.

The Chair explained that Fiona Stalker had been invited to join the Women’s Health Group because of her experience as a journalist, not as a representative of the BBC. As many of the actions in the Women’s Health Plan would be around raising awareness her communications expertise and advice would be valuable.

Next meeting

The next meeting of the Women’s Health Group will be on 20 May 2020 at 2pm, then 26 August 2020 at 2pm. All sub groups will meet before the May meeting – dates to be arranged.

Actions:

• members to submit any further suggested changes to the draft remit by 14 February 2020 - all
• liaise with Scottish Government policy leads on arrangements for the Women’s Heart Health sub group - AL/DM
• suggested names for sub groups to be sent to relevant Chair - all
• relevant SG policy leads to be identified to join sub groups - AL/DM
• sub group meetings to be arranged - sub group chairs, AL/DM
• Scottish Government web page to be set up - AL/DM