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

Attendees and apologies

• Marion Bain, Chair and Interim Deputy Chief Medical Officer
• Alison Scott, Edinburgh Medical School
• Annabelle Lamont, Women’s Health Plan Project Manager
• Anne Lillico, Women’s Health Plan Team, Scottish Government
• Corinne Love, Senior Medical Officer, 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 

The Chair welcomed everyone to the third meeting of Women’s Health Plan Implementation Board (the board). Apologies were noted as above. Members welcomed Catherine Murphy, Executive Director of Engender, to the board.

Previous minutes and Chair’s update

The members agreed that the minute from the meeting of 6 April 2022 was accurate. The majority of actions from the 6 April meeting have been actioned, with some remaining ongoing.

The majority were for the Women’s Health Plan team who have taken on board comments on the draft Implementation plan (this will picked up in the next item), and have arranged meetings with Centre for Sustainable Delivery and Public Health Scotland in the near future.

The Chair provided some general policy updates on current hot topics including menopause, access to hormonal replacement therapy and abortion.

Meeting action 1: The Women’s Health Plan Team will engage directly with the board’s staff side representatives on the development of a Menopause Workplace Policy.

Implementation plan

The Chair invited Anne Lillico, Women’s Health Plan Team Leader, to give an update on the Implementation Plan. After further consideration the Implementation Plan has been revised to be a working document for the Women’s Health Plan Implementation Board. It will be published as a board paper on the Women’s Health Plan Scottish Government web pages.

Members were content with this approach, and the updated Implementation Plan will be published online as a paper for the board shortly.

Lived experience work: update – ALLIANCE

The Chair acknowledged that the ALLIANCE work plan is now underway and invited Irene Oldfather, Health and Social Care ALLIANCE, to give a brief update on recent stakeholder events, and the ALLIANCE annual conference Women’s Health Plan session.

The first stakeholder event took place on 31 May 2022 with ALLIANCE member organisations, and another stakeholder event took place this morning (15 June 2022) with women who had previously been involved in the development of the Plan. Women’s Health Plan Team members presented at both events. Alongside these events, there was the ALLIANCE Annual Conference which took place on Friday 10 June and with a session on ‘Why we need a Women’s Health Plan?’. The Chair, alongside a panel of experts including Dr Sigi Joseph, took part in the Annual Conference. At all of these events there was a good balance of perspectives, and lots of support for the Women’s Health Plan. The ALLIANCE will compile a written summary of each event.

As an action point from the first meeting the ALLIANCE have also met with community link workers to identify areas of good practice, and the intention is to continue to meet on a regular basis.

The ALLIANCE are planning to start a monthly newsletter, and Irene invited members to share any opinion pieces or other contributions they wish to include in the newsletter.

Meeting action 2: Members invited to consider providing contributions for the ALLIANCE’s monthly newsletter.

A question was asked on how the ALLIANCE targets different groups of women. Since the ALLIANCE is a network organisation they have members across a variety of areas. The chair commented on how helpful it was to see the ALLIANCE programme of engagement underway, and asked board members to consider how they might engage with different groups across NHSScotland to bring in that variety of perspectives from across the service.

Spotlight session: progress on endometriosis actions

The Chair invited Moira Nelson and Claire Mellor from the Scottish Government Endometriosis policy team to give a presentation on the progress of the medium term WHP actions on Endometriosis.

An update was given on the new Patient Pathway on Endometriosis developed by the Centre for Sustainable Delivery and plans for it to be implemented soon; as well as the recent Wellbeing of Women funding call on Endometriosis research that is currently open. A lived experience group and advisory group has been set up to support delivery of the endometriosis actions. The team have been focusing on raising awareness on Endometriosis and have updated content on NHS Inform and developed a lived experience video. To help improve awareness in early education the team is working with Young Scot, Parent Club and Education Scotland. An overview was also given on the challenges related to diagnosis times of endometriosis along with access to specialist centres.

A discussion took place on this work, and how the board can support the delivery of the actions related to endometriosis. Key discussion points included:

• the challenges around having a clear definition of “waiting time”
• the role out of the Modernising Patient Pathway and ensuring it is implemented effectively with relevant healthcare services as well as ensuring women are aware of it whilst they undergo diagnosis.
• the challenge around engaging with primary care to ensure they are engaged and informed about endometriosis and menstrual health in general.
• work happening on improving care for other diseases, such as cancer, in primary care as part of the diagnosis/patient journey that could provide some learning.
• work required to improve the consistency of care across Scotland for endometriosis.
• referrals to Specialist centres in tertiary care, and the role of secondary and primary care in support and diagnosis of women with endometriosis.

Meeting action 3: The Endometriosis team to convene a meeting with relevant members (including Susan Gallacher, Deputy Director for Primary Care, Kirsty Brightwell, Scottish Association of Medical Directors and Michelle Watts, Scottish Government Clinical Advisor), to discuss Endometriosis and primary care support.

Programme update on progress status and risks and issues

Progress status and risks and issues

The Chair invited Annabelle Lamont, WHP Project Manager, to provide an update on the current programme status, and the risks and issues identified in the Highlight Report.

Annabelle provided an overview of the Programme Report for the reporting period 2, April to May 2022 which focused on short and medium term actions.

The programme RAG status is currently ‘amber’, with progress being made across the majority of the short and medium term actions. No specific action was raised with the board as a cause for concern on this occasion, however it was flagged that three of the short term actions have an amber status, mainly due to resourcing issues in the relevant policy areas.

The board noted that there are still a number of risks on the Risk Register that are unscored. These are long-term and as such, the decision has been taken by the WHP Team to delay scoring until further into the programme of work. This is as a result of these actions requiring further scoping before delivery and before accurate mitigations can be mapped. Annabelle raised that of those risks and issues escalated, all will continue to be monitored and the board updated accordingly.

Maggie Simpson, Chair of Women’s Heart Health Subgroup during development of the Plan, commented that the heart health RAG status could be reviewed and  lowered as work is underway. The Heart Health subgroup had a variety of clinicians who contributed to the Plan and who would welcome a meeting with policy leads to discuss how they can be involved in progressing this work. 

Meeting action 4: A meeting to be set up with Maggie Simpson and the Scottish Government Policy lead for Heart Health on engagement with clinicians from the Women’s Heart Health Subgroup.

Communications and engagement

Annabelle shared the comms and engagement plan and talked through the key areas and timelines.

Delivery Group: update – Greig Chalmers

An update was provided on the last meeting of the Delivery Group by Chair Greig Chalmers, who advised that work continues on the delivery of the WHP actions however there are currently difficult financial pressures from the recently published spending review which are being navigated. Work will begin in the summer to draft the first annual progress report for the Plan which will be published in Autumn 2022.

He also noted that policy leads are interested in engaging with SIGN to review the inclusion of sex-differences in guidance more generally. Lynne Nicol advised that this is being discussed with Health Improvement Scotland and will provide an update shortly.

A question was raised on whether there were plans for further action on the completed actions within the Plan to ensure they are embedded. In response it was reflected that there are plans to monitor and evaluate how the completed actions have been implemented.

Women’s Health Champion

The Chair invited Denise McLister, Women’s Health Plan Team Leader, to give an update on the Women’s Health Champion, a medium-term action in the Women’s Health Plan. The draft role description was circulated with the papers. Members shared comments on the draft role, which included:

• the role description should include more of a community focus to encourage a variety of candidates that are not necessarily from a medical background.
• the criteria should also bring out more of the intersectional dimension, requiring candidates to have a good understanding of the intersectional issues involved.

It was noted that there are numerous requests in NHS boards for health leads/champions in general and this will need to be considered when Women’s Health leads in boards are sought.

The Women’s Health Plan Team will take these comments on board, and welcomed any further comments by email (womenshealthplan@gov.scot).

Any other business

An issue was raised around funding barriers to local areas taking forward local initiatives to support the Women’s Health Plan actions. The Chair agreed to reflect on that point with Jim Miller and board Chief Executive colleagues.

The Chair noted that Denise McLister and Anne Lillico, joint Women’s Health Plan Team Lead, will be retiring from SG before the next meeting, and extended thanks to both of them for their work on the Women’s Health Plan.