Women’s Health Group minutes: November 2020

Attendees and apologies

Attendees 

• Marion Bain, Chair and Deputy Chief Medical Officer for Scotland
• Colin Berry, University of Glasgow
• Sharon Cameron, NHS Lothian
• Greig Chalmers, Scottish Government, CMO Directorate
• Nicola Cogan, Scottish Government, Women’s Health Plan Team
• Valerie Clarke, NHS Greater Glasgow and Clyde
• Heather Currie, NHS Dumfries and Galloway
• Sigi Joseph, Royal College of GPs
• Anne Lillico, Scottish Government, WHP Team
• Corinne Love , Senior Medical Officer, Scottish Government (Vice-Chair)
• Irene Oldfather, The Health and Social Care Alliance (for agenda item 3)
• Denise McLister, Scottish Government, WHP Team   
• Lindsey Pope, Royal College of GPs
• Emma Ritch, National Advisory Council for Women & Girls
• Maggie Simpson, Chair of the Scottish Obstetric Cardiology Network
• Alison Scott, NHS Lothian

Apologies

• Alastair Campbell, Co-Chair RCOG Scottish Committee
• Ann Holmes, Chief Midwifery Adviser and Deputy Chief Nursing Officer, Scottish Government  
• Dona Milne, Directors of Public Health
• Karen Ritchie, Healthcare Improvement Scotland

Items and actions

1. Welcome, Teams Housekeeping, Declaration of Interest and introductions

The Chair welcomed everyone to the third meeting of the Women’s Health Group and introduced Valerie Clarke, who will be representing Allied Health Professionals on the group.

The Chair highlighted best practice for using Teams and encouraged group members to use the chat function.  

The Chair confirmed with participants that all Declarations of Interest have been completed and are still accurate.   

2. Minutes of meeting held on 26 August 2020

The group agreed the minute of the previous meeting is accurate with no amendments required. The chair noted that this will be published on the SG website WHP pages.

3. Actions for early implementation

The Chair noted that while the intention is to publish the WHP after the Scottish Parliament elections, which are in May 2021, the Cabinet Secretary for Health and Sport and Minister for Mental Health have asked the WHP team to identify some actions which could be implemented by March 2021.

The Vice Chair outlined the following  actions identified, all of which align with the outcome of the lived experience survey and are expected to be completed, or well underway, by March 2021:

• development of NHS Inform as the main online platform for information on women’s health;
• “Women’s Heart Disease – Missing a Beat” conference on 9 December to promote awareness of the link between cardiac care and women’s reproductive health;
• awareness raising of  risk factors for and symptoms of heart disease through participation in a ‘Go Red for Women’ awareness campaign in February 2021 to coincide with National Heart Month;
• public consultation on enabling the current early medical abortion at home (EMAH) approval to continue post-COVID (already underway); and
• development of a support network for menopause specialists across Scotland.

4. Lived Experience

Irene Oldfather provided an overview of the lived experience survey analysis and plans for further engagement through a development day or days. There had been 405 responses to the survey, with a good geographical and age spread, and some positive and negative messages, many of which were reflected in proposed actions. There have been initial discussions with the team, with input from the Gender and Health subgroup, on the format and content of the Development Days including the importance of seeking a perspective from marginalised and minority groups as well as capturing feedback on the proposed actions developed by the sub groups. The Lived Experience subgroup and the WHP Team will continue to develop the format and content for the Development Days with a view to them taking place in January.

5. Summary of proposals so far

A summary of the proposals had been circulated prior to the meeting.  The Chair highlighted to the group that the proposed actions are very much in draft form at this stage and suggestions to strengthen them are welcomed, including by email to the WHP team following the meeting. The group was invited to consider whether there are any actions which should not be included, or  any obvious gaps where additional actions may be needed.

5.1 Cross Cutting Actions

Corinne Love introduced some proposed actions which have been identified by the WHP team as cutting across all subject specific sub groups

The group noted the Relationships, Sexual Health and Parenthood (RSHP) education action and that significant work is already underway, in other areas, to promote and expand use of RSHP. It was suggested that partnering with organisations such as YoungScot to promote these resources  outside formal education may be helpful.

It was also suggested that looking at lessons learned from the setup of the Social Security Experience panels might help inform longer term engagement of a lived experience group.

Support was offered by Primary Care representatives in wording and framing the actions directed to primary care, noting that often GPs will not be best placed to deliver on actions which were more appropriate for others in primary care such as advanced nurse practitioners.

5.2 Women’s Heart Health (Maggie Simpson)

Maggie Simpson introduced the Heart Health section and proposed actions from the Heart Health sub-group and invited comments from the group.  

There was discussion about whether the proposed actions around pregnancy and heart health should sit within the WHP given the other existing work streams and strategies across SG around maternal health. It was agreed that on balance the actions should remain in the WHP as part of the suite of proposals, whilst acknowledging that implementation and delivery may fall to those responsible for other existing strategies.  

The Women’s Health Research Fund was identified as potentially a strong action that could be globally significant.

5.3 Gender and Health (Emma Ritch)

Emma Ritch introduced the gender and health section and proposed actions from the sub-group and invited comments from the group, noting  

that work is still on-going to develop the proposed actions and that clinical input is particularly welcomed.

5.4 Abortion, Sexual Health, Contraception (Alison Scott)

Alison Scott introduced the abortion, sexual health, contraception and preconception section and proposed actions from the sub-group and invited comments from the group – noting the preconception actions developed since the last meeting and linkage between the heart health group in particular; and the positive discussions with pharmacy colleagues around the proposed pharmacy actions.

It was suggested that the preconception section should include an action around pre-pregnancy information provided to women who are on a complex medication regime, including a link to the BUMPS (Best Use of  Medicines in Pregnancy) website.

5.5 Menopause and Menstrual Health including Endometriosis (Heather Currie)

Heather Currie introduced the menopause and menstrual health, including endometriosis, section and proposed actions from the sub-group and invited comments from the group – noting recent discussions with NES on their education programme for health professionals, and a BMA report “Challenging the culture on menopause for doctors” which highlighted issues around menopause in the workplace.

The Chair highlighted the Minister's specific interest in incontinence.  and, whilst there are no plans to develop an incontinence strategy as part of the WHP, it was agreed that the importance of pelvic health and the need for wider pelvic health education, including in early years should be included in the context of the life course approach

 

6. Life of the plan

The group discussed timeframe for the Plan and agreed that a phased approach (short, medium and long term) would be helpful to signal an ongoing commitment to women’s health. Subject to discussion with policy teams and other stakeholders a three year timescale for delivery of initial proposed actions is considered reasonable, with a longer term commitment to women’s health and future iterations/stages of the plan, perhaps over a 10 year period. It will also be important to develop a governance and accountability framework and future engagement mechanisms.

It was suggested that the Women’s Health Plan could be presented as an initial overarching strategic document setting high-level priorities, followed by a separate implementation plan with individual actions and steps for implementation.

7. Engagement and Consultation

The Chair noted next steps for engagement and consultation. While policy leads and key stakeholders have been involved in the development of actions through the subject specific sub-groups and women’s health group membership, further consultation is required. The women’s health plan team intend to use the coming months to undertake significant engagement with SG policy officials and other stakeholders, to  develop an implementation plan, identify short, medium and long term actions and identify potential resourcing requirements.

The Chair highlighted the need to ensure that the plan is widely endorsed when published and asked the group to contact the women’s health plan team with any additional suggestions for external consultation.

 

8. Next steps and next meeting

The draft proposed actions will be shared with  the Cabinet Secretary for Health and the Minister for Mental Health in December for their initial input. At this point agreement from Ministers will be sought on broad direction of travel before moving on to engagement and consultation with policy leads and other key stakeholders. The women’s health plan team will also continue work on drafting the Plan and undertaking the equality impact assessment.

It is anticipated that the WHG will reconvene in late January/early February 2021.  

 

 9. AOB

Corinne Love noted that work regarding PLGF is ongoing and an update will be provided as this progresses.

Actions

	Action	Who
1.	Any further comments on proposed actions to be provided to WHP team	All
2.	Primary Care representatives to review framing of cross-cutting actions relating to primary care	SJ/LP
3.	Suggestions for additional external consultation to be provided to WHP team	All