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

Attendees and apologies

• Marion Bain, Chair and Interim Deputy Chief Medical Officer
• Corinne Love, Vice Chair, Senior Medical Officer, Scottish Government
• Felicity Sung, Women’s Health Plan Team, Scottish Government
• Christine McLaughlin, Co-Director of Population Health, Scottish Government
• Lynne McNiven, Scottish Directors of Public Health
• Jill Laspa, COSLA
• Pauline Beirne, Scottish Directors of Allied Health Professionals Group
• Fiona Davis, Integration Joint Board (IJB) Chief Officers' Group
• Catherine Murphy, Executive Director, Engender
• Greig Chalmers, Chief Medical Officer Policy Division Head, Scottish Government
• Heather Currie, NHS Dumfries and Galloway
• Irene Oldfather, Health and Social Care Alliance
• Jaki Lambert, Royal College of Midwives
• Sigi Joseph, GP NHS Lothian, Guest
• Joanna Swanson, Deputising for Linda Pollock, the Interim Director for Healthcare Quality and Improvement, Scottish Government
• Josh McGinlay, Deputising for Susan Gallacher, Primary Care, Scottish Government
• Kirsty Brightwell, Scottish Association of Medical Directors
• Sarah Dillon, Women’s Health Plan Team, Scottish Government
• Shoba Galloway, Women’s Health Plan Team, Scottish Government

Items and actions

Welcome and apologies

The Chair welcomed everyone to the fourth meeting of Women’s Health Plan Implementation Board (the board). Apologies were noted as above. New Members welcomed to the board, include:

• Pauline Beirne, Scottish Directors of Allied Health Professionals Group
• Jaki Lambert, Royal College of Midwives
• Nicola Gordon, Royal College of Nursing
• Andrew Horne, Speciality Advisor for gynaecology University of Edinburgh
• Christine McLaughlin, new co-Director, along with Richard Foggo of Population Health, Scottish Government
• Fiona Davies (NHS Highland), Integration Joint Board (IJB) Chief Officers' Group

A short summary was given by the Chair on the board’s role and responsibility for new members.

Previous minutes and Chair’s update

The members agreed that the minute from the meeting of 15 June 2022 was accurate. The majority of actions from the 15 June 2022 meeting have been completed and closed. There is one ongoing action, and the Endometriosis team in Scottish Government are taking this forward by reaching out to the relevant board members to set up a meeting to discuss Endometriosis and primary care support.

The Chair provided updates on current hot topics:

• Women’s Health Champion: The Chair reaffirmed the Scottish Government’s commitment to appoint a Women’s Health Champion as set out in this year’s programme for Government, and updated the board that Ministers are considering a number of candidates to take on the role of the Women’s Health Champion and expect to make an announcement about the appointment soon

• annual update report: The update report will be published later in the year and an advance copy will be shared with the board for information in due course

• abortion: The Scottish Government has committed through the Programme for Government to support Gillian Mackay MSP with the development and drafting of her proposed member’s bill on safe access zones, subject to a forthcoming supreme court judgement. The First Minister held a technical meeting with relevant local authorities, COSLA and legal representatives to discuss the potential use of bye-laws as an interim measure whilst national legislation is being progressed

The Chair gave an update on general policy activity:

• menopause and menstrual health NHS Scotland workplace survey: A survey by the University of Glasgow for NHSScotland staff on menstrual health and menopause in the workplace is currently open until 15 November 2022. Members are invited to share this survey with their networks: Qualtrics Survey | Qualtrics Experience Management

The results of the survey will form the evidence basis to develop a workplace policy on menopause and menstrual health for NHS Scotland as an example of good practice.

• Webinars and Menopause workplace resources: We have worked with our partners at The ALLIANCE and the charity, Close the Gap, to create two new resource packs on menopause in the workplace. One is for women on menopause support in the workplace whilst Close the Gap have created a resource for employers on creating a menopause-aware workplace. These two resources launched in October for World Menopause Day and can be found on online, along with recordings of the webinars:
  • menopause and the workplace - Resource pack - Health and Social Care Alliance Scotland (alliance-scotland.org.uk) and recording: Menopause and the workplace - Webinar - YouTube
  • creating-a-menopause-aware-workplace.pdf (closethegap.org.uk) and recording: Menopause and the Workplace - What can you do as an employer? - YouTube

• Menopause, Sexual Wellbeing and Relationships webinar: The webinar took place on 24 October 2022 and was extremely well received by those who attended. The graphic illustration will shared with the meeting note

• ministerial activity for Word Menopause Month: On 25 October 2022 the First Minister attended a Menopause Café in Perth, where she had the opportunity to hear about experiences of menopause and share her own. On 1 November, the Minister for Public Health, Women’s Health and Sport closed a parliamentary member’s business debate on a motion raised by Siobhan Brown to mark World Menopause Month

• NHS Inform Videos: Three new menstrual health videos have now launched on NHS Inform Women’s Health Platform and members are invited to share them with their networks.
  • Whats Normal? - Periods (menstruation) | NHS inform
  • PMS – PMS NHS Inform
  • Irregular Periods - Irregular periods | NHS inform

A new antenatal contraceptive animation also launched last week on NHS Lothian and NHS Glasgow available on their webpages and Youtube: NHS Postnatal Contraception - YouTube.

Discussion on draft job role Women’s Health Leads

The Women’s Health Plan sets out the medium term action to establish a Women’s Health Lead in every board. For this item, the Chair led a discussion on the draft role description of the Women’s Health Leads (paper 1) which was circulated to members with the meeting papers.

The Chair emphasised that partnership working is essential to the implementation of this action and Scottish Government is keen to work with the board and NHS boards to move this forward. There are currently four known boards who have Women’s Health leads in place; Ayrshire and Arran, Borders, Greater Glasgow and Clyde and Western Isles, and the draft profile has been shared with them for comment.

A key points from the discussion:

• the Women’s Health Lead of Ayrshire and Arran, Lynne McNiven, provided feedback on her role, and reflected there has been buy-in from senior leadership to staff, and a collective appetite to support the implementation of the Women’s Health Plan
• it was explained that the women’s health lead role had been made part of their core job, and as such have been able to access resources to support this work
• the funding and resource restraints at present were acknowledged and the board recognised the need to support this work at a national level to facilitate inclusion as a core part of job roles
• it was reflected that some NHS boards may identify additional staff resource required to support Women’s Health Leads with the delivery of the role objectives
• it was recognised that senior leaders and those in senior positions within NHS boards play a critical role in using their influence to promote this work
• it was suggested that the job description acknowledge the importance of Leads engaging with less heard voices and minority communities
• agreement was made for information to be shared with NHS board Chief Executives once Women’s Health Lead role finalised
• secretariat noted a correction to page 1

Meeting action 1: Jim Miller to highlight the action in the WHP to establish a Women’s Health Lead role in every health board to the Chief Executives once role finalised.

Spotlight session: menopause

The Chair welcomed Sigi Joseph and Heather Currie, along with Felicity Sung from Scottish Government Women’s Health Plan team, who had been invited along to discuss the challenges in menopause service delivery and opportunities for improvement.

Felicity gave a short overview of the menopause actions outlined in the Women’s Health Plan and gave an update on the progress of the actions to date.

Sigi Joseph focused on the challenges for primary care in supporting women with their menopause symptoms. Some of barriers highlighted included issues with women accessing GP appointments; variation in in-depth knowledge of the area amongst staff; the need for a unified approach to perimenopausal care and improving clinicians knowledge on menopause (albeit lots of guidance out there). Dr Joseph emphasised the importance of patients being informed about the menopause by having access to reliable information and understanding how to optimise appointments (for example patients keeping a log of symptoms). Consideration is needed on how to encourage and support clinicians to access the CPD available on menopause, and how opportunistic encounters like smear tests could be used to engage with women on menopause.

Heather Currie provided an overview from the perspective of secondary care and specialist services, and acknowledged the rise in referrals and waiting times; the inappropriate referrals due to a lack of basic understanding on menopause by some clinicians; and also the backlogs from the COVID-19 pandemic.

Dr Currie then took the opportunity to discuss potential improvements that could help services. These included formally establishing a Menopause Clinical Reference Group which would be a subgroup to the board; improving access to continuous training and education for healthcare professionals; continuing to raise awareness about menopause for the public; reviewing and promoting existing guidance and utilising virtual group consultation.

A copy of the presentation will be circulated with the meeting papers.

Discussion:

• members vocalised their interest in utilising virtual group consultation technology going forward and recognised the benefits this would present for patients

• an example was given of a GP recently hosting a group consultation for nearly 200 women, following this general information session around 50 women went onwards to seek a GP appointment. The board agreed this idea could potentially be explored further through a test of change
• Dr Currie shared a good practice example of delivering online training on menopause support to clinicians in the Highlands and Western Islands. Dr Currie made an offer to deliver similar online training to other interested health boards
• the ALLIANCE are developing a conversation café concept, and will produce resources for community groups and organisations so they can independently run sessions on menopause
• the board acknowledged the need to tackle barriers to access to information and support for those people with less heard voices and subject to inequalities

Programme update

The Chair invited Felicity Sung, Women’s Health Plan Team Leader, Scottish Government to provide an update on the current programme status, and the risks and issues identified in the programme report (paper 2).

The overall RAG Status is currently ‘amber’ for the Programme, with work progressing. All short term actions have now been commenced with many complete. The medium term actions are on track. It was noted that medium term actions are more complex, and will require time and support from the board. The scoping work has begun on the long term actions.

In terms of risk and issues there are no specific issues to raise with the board, however the board was invited to note the small number of issues with the ‘red’ status around resourcing.

A summary was given of recent comms activity over the past and coming months.

Members were encouraged to raise awareness about the Plan in their organisations and with their networks, and the Women’s Health Plan team offered their support and resources with this by making the offer of delivering information and awareness raising sessions on the Plan. Please contact the Women’s Health Plan Team with any requests at womenshealthplan@gov.scot.

Meeting action 2: Members invited to raise awareness about the Women’s Health Plan in their organisations and with their networks, and email the Women’s Health Plan team with any requests for support or assistance.

Any other business

 There was no other business raised at this meeting. Dates for next meetings:

• Wednesday 17 May 2023
• Wednesday 15 November 2023