Women's health plan: progress report

Cross-cutting actions: progress against the short-term actions

The Women's Health Plan contains 11 'cross-cutting' actions which span the Plan's priority areas and underpin many of the other actions in the Plan.

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

Women's Health Platform

The Women's Health Platform was launched in May 2022.

Bringing together women's health information from across NHS Inform into one place, the Platform responds to women's ask for a 'trustworthy, comprehensive health website for women and girls and healthcare professionals'.

Resources have been renewed and refreshed, including, menopause, menstrual health and heart health. More information on these can be found in the menopause, menstrual health and heart health sections of the report.

The development of the Platform continues beyond the short-term timescales of the action and will be an ongoing piece of work throughout the lifetime of the Plan.

Women will be provided with consistent, reliable and accessible information empowering them to make informed decisions about their health and healthcare.

Spotlight on: lived experience

The voices of women played a very significant role in shaping the development of the Women's Health Plan, and it is essential these voices continue to influence and drive its implementation. The ongoing input of lived experience is being taken forward by the Health and Social Care Alliance Scotland (the ALLIANCE) who have developed a full programme of work to support women's health, including the Lived Experience Stakeholder Group.

Action 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.

• Women's Health Plan Lived Experience Stakeholder Group has been established and first met in August 2022.
• Senior Development Officer recruited in March 2022.
• Operational Plan finalised in May 2022.

Members of the stakeholder group have been recruited across a variety of geographical locations and experiences, to reflect women's real-life experiences of their health, and the healthcare they need. Group membership continues to be considered with new members to be invited whilst the Group formalises its objectives and way of working.

The voices of women and girls are vital to achieving the Plan's ambitions and this work will continue throughout the lifetime of the Plan.

Irene Oldfather, ALLIANCE Director of Strategic Partnerships and Engagement, reflects on the journey so far;

'Through both the development and implementation phases of the Women's Health Plan, it has been important to have women's voices at the heart. As the Women's Health Plan was being developed, a lived experience sub-group was established to oversee engagement with women across Scotland on their experiences of health care and access to services and information. Now, as we reflect on the achievements of the Plan so far, it is critical that we consider how women's experiences continue to be heard and fed into our work to reduce health inequalities.

'We have made a good start, and the ALLIANCE is pleased to have convened a Lived Experience Stakeholder Group which will follow the implementation of the Plan, and permeate through the various actions. I am very grateful to all of the women who gave of their time so far to help us inform the Plan, and note the commitment that our Stakeholder Group brings. This commitment is led by their own experiences of accessing health information and services. As we go forward we hope the Group will influence policy and shape good practice.

'The Lived Experience Stakeholder Group and the ALLIANCE's wider engagement work to support the Plan, reminds us that each of us can contribute to this important piece of work by acknowledging, respecting and promoting women's health in Scotland.

'Sitting alongside the work of the Implementation Group, is the challenge of bringing women's health issues out of the shadows. Encouraging open conversations and destigmatising the language around women's health is not just the responsibility of government but is everyone's business.'

To stay up to date with the ALLIANCE's work to support the Women's Health Plan, including future events and further resources, you can sign up to the mailing list via whp@alliance-scotland.org.uk

Sharing good practice

Action 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.

• A Women's Health Knowledge Hub ('KHub') has been created for stakeholders involved in the delivery and implementation of the Women's Health Plan to share examples of best practice and facilitate discussions on improvements in women's health, across all sectors.

Work is ongoing to facilitate the sharing of good practice across networks, including the National Menopause Specialist Network where examples of innovative practice across primary and secondary care are regularly shared.

Work on delivering this action will continue beyond the short term and sharing good practice will be an ongoing piece of work throughout the lifetime of the Plan.

Video and telephone consultation

In March 2020, a rapid programme of expansion of the Near Me service was established in support of the COVID pandemic. The number of video consultations rose steeply from around 1,000 per month, pre-pandemic, to a peak of 92,000 per month in March 2021. Since COVID restrictions have lifted, call volumes have stabilised and vary between 40 and 50 thousand calls per month.

Women and girls need access to services that are flexible to their life circumstances, such as work, education and caring commitments. The greater availability of video and telephone consultations means that women and girls have more choice around the types of consultations that fit flexibly into day to day commitments. Data from the Near Me end of call survey showed that 63% of respondents were women.

Action 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.

• Social media campaigns to promote Near Me have taken place since February 2022, including around International Women's Day and Endometriosis Awareness Month.
• To promote the use of video consultation, the views of four women's health specialities (abortion service, sexual trauma counselling, gynaecology and sexual health) have been sought, to explore how they are using Near Me.

Case studies are being developed and will be shared across Scotland on the Women's Health Plan Knowledge Hub to illustrate how Near Me can positively support women and girls who use these services. Early engagement with Endometriosis UK highlighted that women with endometriosis see value in using Near Me for appointments.

Near Me and Endometriosis: An Engagement Exercise

* Key points from women with lived experience of stage IV Endometriosis and Clinicians from Specialist Endometriosis Centres (BSGE*)

Graphic text below:

• Joint consultations with the local consultant
• Supports blended working
• 80% of Nurse Specialist appointments at Glasgow BSGE are by Near Me
• Pain and flares have a huge impact on travel to appointments
• Reduces time off work and removes the need and cost of travel and parking
• Patients are more likely to attend appointments because it is convenient

An engagment exercise was completed by NHS Near Me to understand the value of video consultations in the diagnosis, treatment and management of endometriosis.

The engagement involved:

• Endometriosis UK survey to members;
• detailed interviews with women diagnosed with endometriosis; and
• detailed interviews with clinicians involved in treating women with endometriosis.

Findings from the engagement highlighted a range of benefits of video consultations for endometriosis, including for:

• patients experiencing pain given that they do not need to leave their home;
• patients living in rural and remote areas;
• patients who work, reducing the time they need to take off work;
• post-op and follow-up appointments, where physical examinations are not required;
• pre-op appointments, where physical examinations are not required;
• helping to make a holistic assessment of the patient, which cannot be done as easily over telephone;
• seeing a patient with their local clinician; and
• enabling women to avoid triggers which could exacerbate their symptoms, for example, sharing waiting areas with those accessing ante-natal care when they may be experiencing fertility challenges.

Findings from the engagement activities have informed the direction of the Near Me programme, including how services are supported to implement Near Me for their patients.