Women's Health Plan Implementation Programme Board minutes: April 2022

Attendees and apologies

• Marion Bain, Chair and Interim Deputy Chief Medical Officer
• Corinne Love, Senior Medical Officer, Scottish Government
• Alison Scott, Edinburgh Medical School
• Annabelle Lamont, Women’s Health Plan Project Manager
• Anne Lillico, Women’s Health Plan Team, Scottish Government
• Felicity Sung, Women’s Health Plan Team, Scottish Government
• Frances Ewan, UNITE the Union
• Grieg Chalmers, Chief Medical Officer Policy Division, Scottish Government
• Heather Currie, Associate Medical Director, Dumfries and Galloway NHS
• Irene Oldfather, Health and Social Care Alliance
• Jackie Montgomery, Scottish Directors of Allied Health Professionals Group
• Jim Miller, NHS 24, and NHS Board Chief Executive
• Justine Craig, Chief Midwifery Officer, Scottish Government
• Kirsty Brightwell, Scottish Association of Medical Directors
• Linda Pollock, Interim Director for Healthcare Quality and Improvement, Scottish Government
• Lynne McNiven, Scottish Directors of Public Health
• Maggie Simpson, Advanced Clinical Nurse Specialist
• Manira Ahmad, Public Health Scotland
• Maria Pollard, NHS Education for Scotland
• Mel McIlvar, Women’s Health Plan Programme Manager
• Michael Kellet, Director of Population Health, Scottish Government
• Patricia Moultrie, British Medical Association
• Paul Jenkins, Centre for Sustainable Delivery
• Sarah Dillon, Women’s Health Plan Team, Scottish Government
• Sarah Horan, Scottish Executive Nurse Directors
• Shoba Galloway, Women’s Health Plan Team, Scottish Government
• Tim McDonnell, Director of Primary Care, Scottish Government

Items and actions

Welcome and introduction

The Chair welcomed everyone to the second meeting of Women’s Health Plan Implementation Board (the board), including the following new members:

• Jackie Montgomery, Scottish Directors of Allied Health Professionals Group
• Sarah Horan, Scottish Executive Nurse Directors
• Fiona Davies, Integration Joint Board Chief Officers' Group
• Linda Pollock, Interim Director for Healthcare Quality and Improvement, Scottish Government

Each member in attendance introduced themselves and apologies were noted.

The Chair thanked members who had sent in their completed Declarations of Interest Forms and reminded members who were yet to do this to return their completed form to the womenshealthplan@gov.scot. It was noted that if any member who has already completed the form has anything new to declare they should inform the Women’s Health Plan team.

Minutes and actions from the previous meeting

The members agreed that the minute from the meeting of 25 January 2022 was accurate, and the outstanding actions from the previous meeting were complete.

Programme update on progress status, and risks and issues

The Chair invited Mel McIlvar, the Programme Manager of the Women’s Health Plan, to provide an update on the current programme status, and the risks and issues identified in the Highlight Report.

The Highlight Report, circulated with the meeting papers, focuses on the short terms actions which are due to be implemented by September 2022. A short summary was given on the key sections of the Highlight Report. Feedback was welcomed on the template and layout of the content.

The programme RAG status is currently ‘amber’, with progress being made across the majority of the actions. There were no risks or issues to specifically be raised with board on this occasion, however it was flagged that three of the short term actions have an amber status, mainly resourcing issues in the relevant policy areas.

Members were invited to share thoughts on how they can help progress two short term actions which currently have an amber status. The first one relates to sharing good practice examples to encourage primary care to consider different/more flexible options for the provision of women’s health services; and second one relates to the heart health actions.

Key points from the discussion on good practice examples include:

• a Strategic Primary Care Advisory Board is in the process of being set up by the Scottish Government to link with the Care and Wellbeing Programme and the women’s health agenda. This will be a useful forum to identify, gather and drill down into examples of good practice
• The ALLIANCE has a network of Community Link Workers in the Deep End Practices based in Glasgow. An approach will be made to the network to share good practice by the recently recruited Senior Development Officer for the Women’s Health Plan in the Alliance
• GP clusters could be another way of gathering examples. It was noted that GP clusters do not cover all general practice and links should also be made with wider primary care areas as there are good examples across nurse-led services and community pharmacy
• patient experience is good at identifying good practice particularly as in some cases health care professionals do not recognise when something is good practice or done in a special way
• Public Health Scotland volunteered assistance to support this work by promoting examples of good practice through their networks, and reflected on how this work on Women’s Health can be linked to the inequalities agenda
• a lot of good work was done at speed in response to COVID-19 including changes to referral pathways which in some cases have improved practice. This would be beneficial to capture and share as good practice
• The BMA has a group currently reviewing Obstetrics and Gynaecology Referral Pathways. Identifying similar review work is something Medical Directors might be able to help with at a local level across NHS boards
• The Directors of Public Health would be asked what they are doing locally to support the Women’s Health Plan
• Allied Health Professionals would be asked about the contribution they make to the life course approach through various aspects of their work

Meeting action 1: The Women’s Health Plan Team to link in all the suggestions made during the discussion for item 3.

Meeting action 2: The Alliance to approach Community Link Workers in Glasgow to source examples of good practice.

Key points from the discussion on supporting the delivering of the heart health actions include:

• work has previously been paused to review the SIGN cardio guidelines due to the pandemic but this will restart shortly. During the development of the WHP there were volunteers to support the review of the sex specific sections, and hopefully there input will be included going forward. The Heart Disease Action Plan has a specific recommendation for all referral pathways to reflect women’s heart health issues so another stream of work to support these actions
• two heart health pathways to be published later this year contain content highlighting sex-related differences
• women’s heart health has been included in the agenda for the Ensuring Success in Heart Failure Conference in June 2022 to help raise awareness
• the Scottish Obstetric Cardiology Network will roll out its pre-conception Toolkit in Summer 2022. It will include general information on women’s health for health care professionals not aware of obstetrics cardiology
• board-level managed care networks could be an excellent links to highlighting sex-related related difference in pathways

Draft implementation plan

A copy of the draft Implementation Plan was circulated with the meeting papers. Anne Lillico, Women’s Health Plan Team, was invited by the Chair to talk about the draft Implementation Plan.

The Implementation Plan focuses on the outputs for short term actions related to year-one of the Plan, and an overview was given on the plans content. Following the board's approval, the draft Implementation Plan will be sent for ministerial clearance to publish in late May.

The Women’s Health Plan Team will review some of the outputs in light of the discussions from this meeting. The Chair positively commented on the balance of detail included in the plan, and the clear layout. Anne then invited members to share wider comments on the draft Plan. Key reflections were noted:

• the recent RCOG publication focused on waiting times, in particular highlighted the long wait times for gynaecology as well as other health services related to women’s health. It was suggested that this report could be referenced in the Implementation Plan as a way of emphasising the importance of the Women’s Health Plan and delivering on the actions
• it was recommended that each of the actions included in the Implementation Plan are numbered
• the Implementation Plan should reference how COVID-19 has shaped things in relation to the Women’s Health Plan
• it was suggested that in the introduction to the Plan some wider context should be included to show how this work links and connects to the wider work taking place in terms of NHS recovery and the Care and Wellbeing Programme
• consideration should be given on how the impact of the Women’s Health Plan is captured in the Implementation Plan
• the tone of the introduction to the Implementation Plan should reflect that the work to implement the actions will be coproduced, rather than just governed by senior leaders

Meeting action 3: The Women’s Health Plan Team will take on board comments and reflections made by members on the Implementation Plan.

The Women’s Health Plan Team agreed to link in with Centre for Sustainable Delivery on the work they are taking forward through Gynaecology Speciality Delivery Group and more broadly how the Centre can assist with the implementation of the Women’s Health Plan.

Meeting action 4: The Women’s Health Plan Team to arrange a meeting with the representatives from Centre for Sustainable Delivery.

NHS Inform platform

The Chair invited Felicity Sung and Sarah Dillon from the Women’s Health Plan Team to present on the work being taken forward on the NHS Inform Women’s Health Platform. A copy of the presentation will be circulated to members with the meeting note.

The presentation summarised the progress to date on the NHS Inform Platform with the launch of the menopause webpages and myth busting films in October 2021, and the development of menstrual health webpages which are due to launch later this month. The next topics for development include Pelvic Health, Pre-Pregnancy care and Women’s Mental health. It was highlighted that the content on Menopause on NHS Inform has been translated to 5 languages including BSL, alongside an easy read version. Work will also take place to provide information to those who are digitally excluded or who don’t wish to access information online.

Members were asked how awareness could be raised about the Women’s Health platform. Reflections include:

• the platform is useful resource to use as a signpost for patients to get informed and have access to verified information. GP receptionists may also find it helpful resource
• this could be an opportunity to explore how children engage with these topics through Education Scotland, and digitally through an ipad or social media platforms (tiktok). This could also be explored through Young Scot or National Advisory Group on Women and Girls
• Scottish Government exploring how to promote the Platform, for example including web links to the NHS Inform Platform in screening letters to women
• members agreed they can share the NHS Platform with their networks once launched

Delivery Group update

Grieg Chalmers, the Chair of Women’s Health Plan Delivery Group, gave a short update on the Delivery Group. The Group, made up of Scottish Government policy leads who hold responsibility for specific actions in the Plan, held its second meeting of last week with short term policy leads. A useful discussion was had on each of the short term actions, and the ongoing work to delivery these actions. The next meeting will take place in May 2022.

Public Health Scotland offered their assistance to support the delivery of this work.

Meeting action 5: The Women’s Health Plan Team to arrange a meeting with the representatives from Public Health Scotland to discuss what support they can provide in the delivery of the WHP actions.

Any other business

As it was Mel Mcllver’s last meeting before she moves on to a new job, the Chair took the opportunity to thank her for the work she has undertaken on developing the programme structure and reporting process.

The next meeting of the board is scheduled for Wednesday 15 June, 13:00 to 15:00.