Women's Health Plan: implementation plan - year one

Women's Health Plan: Implementation Plan

The Women's Health Plan^[1] sets out 66 short, medium and long term actions which will drive forward change and improvement in women's health to ensure that we achieve a Scotland where all women and girls enjoy the best possible health, throughout their lives.

The Women's Health Plan Implementation Programme Board ^[2](the Board) has been established to oversee and drive the delivery of the Plan. The Board brings together a range of organisations to ensure that the actions within the Plan are implemented effectively and in partnership, with continued input and influence from women themselves. The Board is supported by a Delivery Group made up of those who have responsibility for leading the work to deliver the actions in the Plan.

This Implementation Plan has been developed as a tool to assist the Board in its monitoring of progress with a particular focus on deliverables for Year One, which are due to be achieved by September 2022.

The Year One deliverables are the outputs which will enable the successful implementation of the short term actions and set the foundation for the Women's Health Plan.

The first Women's Health Plan Annual Progress Report will be published in Autumn 2022 and will set out progress against these, and other, outputs and actions within the Plan.

A further Implementation Plan will be published setting out the outputs for the medium and long term actions during year two of the Women's Health Plan.

Year One outputs

The table below outlines the Women's Health Plan short term actions along with outputs which are the key deliverables for the first year of the implementation of the Women's Health Plan. These outputs will set the foundation for the Plan and create the building blocks to further progress.

Reporting on the outputs will be in the first annual update and progress report which will be published in Autumn 2022.

Priority: Cross cutting actions.

Aim: Actions which cut across all of the Plan's priority areas, and underpin some of the others.

Actions

1. Establish a central platform for information on women's health on NHS Inform.

Outputs

• Refreshed information is published on menopause and menstrual health, including endometriosis.
• The Women's Health Platform is live on NHS Inform.

2. Seek women's lived experience, through the continuation of a lived experience group, to inform health policy and improve healthcare services and to ensure women are meaningfully involved in decision making and priority setting going forward.

Outputs

• Recruitment of a Senior Development Officer (The ALLIANCE).
• Establishment of a Stakeholder Lived Experience group.
• Development of an Operational Plan including a programme of events.

3. Share examples of good practice to encourage primary care to consider different and more flexible options for provision of women's health services to best meet the needs of their communities.

Outputs

• Undertake an exercise to gather good practice examples.
• Share examples with Health Board Primary Care Leads and General Practice.
• Development of a Women's Health Plan Knowledge Hub.

4. Promote the use of video or telephone consultation where appropriate to support access to services for women, particularly those who may otherwise be required to travel long distances or who may have difficulty travelling to appointments.

Outputs

• Current use of Near Me video consultation mapped in respect of women's health priority areas.
• Development of an engagement plan to promote use of Near Me.

Priority: Improves access to abortion services.

Aims:

• All women will be able to access timely abortion care without judgment.
• All women will have choice about how and where they access abortion services.

12. Make telephone or video consultation universally available as an option for abortion services.

Outputs

• Issue a Chief Medical Officer letter to Health Boards.
• Engagement with Members of Scottish Abortion Care Providers network on whether the Chief Medical Officers letter had been received and the service is being offered.

13. For post abortion contraception, provide all women with 6 or 12 months progestogen only pill with their abortion medications. Fast track to long acting reversible contraception if desired.

Outputs

• Issue a Chief Medical Officer letter to Health Boards.
• Engagement with Members of Scottish Abortion Care Providers network on whether the Chief Medical Officers letter had been received and the service is being offered.

14. Review data collected on abortions to ensure it is relevant, whilst protecting anonymity.

Outputs

• Provide an updated digital platform for Health Boards to input data relating to abortion.
• Update the data collected to ensure it is both necessary and relevant.

Priority: Improve access to contraception services, including rapid and easily accessible postnatal contraception.

Aims:

• All women will be able to access a full range of contraception easily, quickly and confidentially.
• All women will be able to access sexual health services easily, quickly and confidentially.
• All women will have easy access to the information and advice they need to best prepare themselves for pregnancy.

19. Promote use of video or telephone, in addition to face-to-face, consultation for women, including those in prisons to provide greater privacy, dignity, choice and flexibility.

Outputs

• Current use of Near Me video consultation mapped in respect of women's health priority areas.
• Current use of Near Me in prisons mapped to identify where further action is needed.
• Development of an engagement plan to promote use of Near Me.

20. Provide accessible information and advice on pre-pregnancy care.

Outputs

• Short life working group established to develop evidence based content.
• Content published on NHS Inform Women's Health platform.

Priority: Improve access to information for girls and women on menstrual health and management options.

Improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis.

Aims:

• All young people will be aware of normal menstrual health.
• Average diagnosis time for endometriosis will be reduced.
• All women will be able to access the right support and effective treatment for endometriosis.
• When required, all women will have access to a specialist endometriosis centre.

27. Promote the use of positive language around menstrual health.

Outputs

• Menstrual health, content including endometriosis and polycystic ovary syndrome on NHS Inform reviewed, refreshed and published.
• Refreshed Relationships, Sexual Health and Parenthood guidance for young people includes positive language around menstrual health, including endometriosis.
• Scottish Government Endometriosis research grant awarded.

28. Where appropriate offer women who are eligible for combined hormonal contraception, the option of a continuous or extended regimen and raise awareness of the option of no bleeding, even if contraception is not required.

Outputs

• Contraception content on NHS Inform raises awareness of no bleeding option.
• Faculty of Sexual and Reproductive Health guidelines promoted among healthcare practitioners through NHS Inform.

Priority: Ensure all women who need it have access to specialist menopause services for advice and support on the diagnosis and management of menopause.

Aims:

• When required, all women will have timely access to menopause support and services.
• Healthcare professionals will be aware of the impact medical or surgical treatments to induce menopause have on subsequent health.
• All women will have access to a Healthcare Professional with an interest in menopause through primary care.

34. Develop, maintain and promote a support network for Menopause Specialists throughout Scotland. Each healthcare professional (HCP) with special interest in menopause should have access to at least one Menopause Specialist for advice, support, onward referral and leadership of multidisciplinary education.

Outputs

• Development of a Menopause Specialist Network.
• Quarterly meetings of the Menopause Specialists Network.
• Network membership representative across NHS Scotland.

35. Provide a holistic approach to care by promoting greater joint working between healthcare professionals on menopause diagnosis and treatment across primary and secondary care and specialist clinics, including through joint education sessions starting with pre and post qualification training on gynaecology.

Outputs

• Training sessions provided on menopause for pre and post gynaecology qualification.
• National Specialist Menopause Network supports joint working across primary and specialist care.
• Examples of joint menopause support across primary and secondary care collated and shared on a Women's Health Plan Knowledge hub.

36. Establish a dedicated menopause policy post within Scottish Government.

Output

• Establishment of a menopause health policy post in DG Health and Social Care.

Priority: Reduce inequalities in health outcomes related to cardiac disease.

Aims:

• Opportunities for optimisation of cardiovascular health and risk reduction will be taken across a woman's life course.
• Healthcare professionals will be aware of gender specific differences in presentation and management of heart disease in women and act to reduce inequality of care and improve outcomes.
• All women will have access to information on the risk factors for and symptoms of heart disease enabling them to quickly and confidently describe their own symptoms when speaking to healthcare professionals.
• All women with heart disease will receive appropriate support in managing their risk factors, recovery and living with a long-term cardiac condition through appropriate follow up and access to cardiac rehabilitation and psychological support.
• All women with heart disease will be provided with individualised advice and co-ordinated care to access safe contraception, termination, assisted conception, pregnancy and gynaecological care.

44. In all heart health consultations, opportunities should be taken to provide individualised advice and care to women, and in all pregnancy and pre-pregnancy discussions and interactions opportunities should be taken to optimise women's heart health to optimise women's holistic health as part of the life course approach.

Outputs

• Invite the Scottish Obstetrics Cardiology Network to contribute to the development of the pre-pregnancy care framework.
• Identification of cardiac risk factors embedded within Scottish Government Pre-pregnancy Framework.
• NHS Inform content on pre-pregnancy care includes information on cardiac risk factors.
• Inclusion of Women & Heart Disease in the Heart Failure Hub's 'Ensuring Success in Heart Failure' conference (Autumn 2022).
• Promotion of life course approach through Scottish Obstetric Cardiology Network, National Heart Disease Task Force.
• Launch of Pre-preconception toolkit by Scottish Obstetric Cardiology Network.

45. Where research shows there are sex-related differences in prevention, diagnosis, investigation or treatment of Cardiovascular disease (CVD) these should be detailed in guidelines and pathways.

Outputs

• Inclusion of content highlighting sex-related differences in Heart Failure pathways developed as part of the implementation of the Heart Disease Action Plan.
• Inclusion of content highlighting sex-related differences in Chest Pain pathways developed as part of the implementation of the Heart Disease Action Plan.
• Engagement with SIGN on review of Cardiac Rehabilitation guidelines.

46. Improve information and public awareness of heart disease symptoms and risks for women.

Outputs

• Women's Heart Health campaign on NHS Inform.
• "Wear it Red Day" 2021 promoted on Scottish Government social media.

Priority: Reduce inequalities in outcomes for women's general health.

Aims:

• Gender and cultural competence will be built into health policy and healthcare services.
• Undervaluation of caring professions will be addressed.
• Accountability, transparency and participation should be the basis for budget decisions and public expenditure will be reflective of the needs and rights of women and girls.

• Clinical training and CPD will include education, training and long term coaching, in equality, diversity and human rights.

55. Establish a Health Equality team within Scottish Government, to pursue intersectional healthcare policy with a particular focus on sex, race, disability and sexual orientation.

Output

• Health Inequalities policy team established in DG Health and Social Care.

56. Encourage NHS boards to engage with the Equally Safe at Work employer accreditation programme.

Outputs

• Establishment of an Advisory Group to inform work around NHS Boards engagement with the Equally Safe at Work accreditation programme.
• Establishment of a pilot project with a geographic mix of health boards.
• Good practice guides on achieving Equally Safe at Work accreditation developed.
• Evaluation report of pilot project.

57. Ensure National Performance Indicators are disaggregated where appropriate.

Outputs

• Initial exercise carried out to review current National Performance Indicators and those in development to ensure they are disaggregated by gender.
• Gender breakdowns provided as part of the regular process of updating the National Performance Framework.