Women's health plan: progress report

Heart health: progress against the short-term actions

Whilst the following actions on Heart Health are set out in the short term, they are also longer-term ambitions that must necessarily continue throughout the life of the Plan, and beyond. This will ensure women's continued access to high-quality information and services that take into account their particular needs in relation to heart health.

Action 44: In all heart health consultations, opportunities should be taken to provide individualised advice and care to women, and in all pregnancy and pre-pregnancy discussions and interactions, opportunities should be taken to optimise women's heart health to optimise women's holistic health as part of the life-course approach.

• The Scottish Obstetrics Cardiology Network are developing resources for the delivery of pre-pregnancy care, for both professionals and for patients.
• Resources for women on pregnancy with a heart condition can be accessed at Pregnancy with a heart condition (scot.nhs.uk)
• Resources for professionals will be available in early 2023.

Scottish Obstetric Cardiology Network resources to support the delivery of preconception care.

Heart disease is the leading cause of maternal death in the UK. Some women who have a heart condition before pregnancy do not receive appropriate preconception care or counselling to inform them of, and give opportunities to reduce, their risk.

Pyramid of responsibility

We all have a role to play:

• Life choices: individual

Following advice from HCP or other sources, women and men have autonomy to make individualised decisions related to lifestyle and care. The role of the HCP is to ensure that these are informed decisions with opportunities to access and to continue to provide non-judgemental care once these decisions have been made

• Preconception counselling: recognising red flags

Women with increased risk in pregnancy due to cardiovascular disease or other red flags receive preconception counselling with a HCP with expertise in this area.

• Preconception care: all healthcare professionals

Reinforce the core components of preconception care

Support people to access information and promote behaviour change

Recognise and assess for 'red flags' and deliver or refer for more specialist preconception counselling

• Preconception health: Public Health

National initiatives that promote health and wellbeing and reduce health, social and economic inequalities for women and men recognising the impact these have on pregnancy and child outcomes. In Scotland these include improving diet and healthy weight, increasing physical activity, a reduction in smoking and effects of drugs and alcohol misuse as well as a Women's Health Plan and Health Literacy Action Plan

The Scottish Obstetric Cardiology Network (SOCN) have worked with healthcare professionals, including cardiologists, cardiac nurses, pharmacists, sexual health consultants, psychologists and primary care professionals, and women with lived experience of heart disease, to develop resources to support the delivery of pre-conception care.

For healthcare professionals the resources provide information on their role in pre-conception care and counselling, including how to make an assessment of a person's cardiac risk in pregnancy and access additional advice if required.

For patients SOCN have developed information leaflets and a video. This includes a list of questions for people to ask their healthcare professionals about the impact of their heart disease in pregnancy. The aim is to support patients to make an informed choice about contraception, pursuing pregnancy or assisted reproductive therapies and ensure they have access to healthcare professionals with expertise in heart disease in pregnancy when they need it.

Pregnancy with a heart condition (scot.nhs.uk)

Action 45: Where research shows there are sex-related differences in prevention, diagnosis, investigation or treatment of CVD these should be detailed in guidelines and pathways.

The Heart Disease Action Plan makes a commitment to establish nationally agreed pathways of care for heart disease. This will support a 'Once For Scotland' vision of what good quality care would look like across a whole pathway.

• Work is underway on the development of a number of pathways through the delivery of Heart Disease Action Plan.

Action 46: Improve information and public awareness of heart disease symptoms and risks for women.

• Women's Heart Health pages created on NHS Inform.
• Social media and awareness raising carried out for 'Wear it Red' Day 2021.