Women's health plan: progress report

Contraception, abortion, sexual health and pre-pregnancy: progress against the short-term actions

Improving women's access to abortion

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

• A Chief Medical Officer letter was issued to NHS Boards in December 2021 which required Boards to make telephone or video consultation universally available Abortion – Women's health plan actions on telemedicine and contraception (scot.nhs.uk)

NHS Boards have confirmed that telephone consultations are now routinely offered.

Action 13: For post-abortion contraception, provide all women with 6 or 12 months, progestogen-only pills with their abortion medications. Fast track to long-active reversible contraception if desired.

• A Chief Medical Officer letter was issued to NHS Boards in December 2021 requiring them to offer the progestogen-only pill to patients during their abortion consultation Abortion – Women's health plan actions on telemedicine and contraception (scot.nhs.uk)

Clinicians have provided feedback that this is now routinely offered.

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

• Public Health Scotland (PHS) has amended the existing abortion database to provide an updated digital platform, which enables NHS Boards to directly input data about abortions.
• Directions were issued by the Scottish Government on 27 April 2022, signed by the Minister for Public Health, Women's Health and Sport. These directions contained information on the updated data that NHS Boards are required to provide to Public Health Scotland and the timescales for its provision.

Beyond the short term

Action 15: NHS, Local Authorities, Justice agencies and the Scottish Government to work together to find ways of preventing women feeling harassed when accessing abortion care due to protests or vigils.

The Scottish Government is committed to safeguarding women's rights to access abortion care, free from stigma or harassment.

• To achieve this the Scottish Government is committed to supporting legislative change to protect safe access to health care facilities that provide abortion services through national legislation by supporting Gillian Mackay MSP with the development and drafting of her proposed Safe Access Zones Member's Bill.

Action 16: Increase options for women around where they can take abortion medication (mifepristone).

• The approval for early medical abortion at home (EMAH), which allows for the abortion medication (mifepristone) to be taken at home, has been extended, and a clinical evaluation of early medical abortion at home is due to be completed shortly.

Arrangements will be reviewed once the evaluation is complete.

Action 17: Provide mid-trimester abortion care locally or regionally for all indications.

Work is being prioritised with NHS Boards to ensure that abortion services for all women up to 24 weeks' gestation can be provided as locally as possible.

• In June 2022, the Scottish Government wrote to NHS Board Chief Executives to clarify the expectation for NHS Boards to meet the Health Improvement Scotland standard of delivering abortions up to at least 20 weeks gestation.
• All mainland NHS Boards have confirmed that they now offer this service up to at least 20 weeks’ gestation.

Improving access to contraception services

Action 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.

Awareness raising of Near Me for women in prisons will take place through a two-pronged approach.

1. Engaging with prison health centre staff to raise awareness of Near Me.

2. The development of an engagement approach to raise awareness with prisons of the potential for Near Me consultations with NHS Board clinicians.

• Engagement with Prison Health Centres on how Near Me is used has taken place, including a presentation to the Prison Healthcare Network in September 2022.

Engagement communications targeted at secondary care services, informing them that Near Me is available in prisons, are under development.

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

• Short-life working group on pre-pregnancy care has been established.
• Scoping exercise undertaken by the short-life working group to identify priority areas for the provision of information.

Beyond the short term

Action 25: Ensure that discussions on contraception take place during pregnancy. Women should be given adequate and appropriate information on their options, as well as rapid access to their preferred method where applicable.

• Scottish Government funding of £44,337 was provided to the NHS Lothian Post-Partum Contraception Project in February 2022 to improve the availability of post-partum contraception.

NHS Lothian Post-Partum Contraception Service.

The NHS Lothian Post-Partum Contraception Service was designed to improve access to contraception after childbirth. It is working to allow women the opportunity to discuss contraception options antenatally and be empowered to make an informed choice as part of their birth plan, with a full range of contraceptive methods made available to women to access immediately following childbirth.

This service can remove the difficulties women can experience in trying to access contraception after they leave the maternity hospital and can reduce their chance of experiencing an unintended pregnancy.

In October 2022, the project launched a new animation aimed at providing women with information about postnatal contraception.