Better for Women: report

“It is important we provide a comprehensive health service for girls and women throughout their lives.”

A survey, commissioned by The Royal College of Obstetricians and Gynaecologists, of over 3,000 women, has found that women are struggling to access healthcare services locally.

This, the ensuing report concludes, is due to under-funding and to the fragmentation of sexual and reproductive healthcare services.

As part of its ‘Better for Women‘ report, the Royal College of Obstetricians and Gynaecologists (RCOG) is calling for better joined up services, and for one-stop women’s health clinics to provide healthcare needs for women in one location and at one time.

The report also emphasises the need for national strategies to meet the needs of girls and women over their life course – from adolescence, to the middle years and later life.

There should, the report says, be a greater focus on moving the UK away from providing a disease intervention service towards a preventative health service.

The report recommends setting up one-stop women’s health clinics provide reproductive and sexual healthcare services – such as contraception, STI testing, cervical screening, and treatment and advice about the menopause – in one location and at one time to improve services for women and make savings for the NHS.

And these clinics should be open in the evenings and at the weekends to improve accessibility for girls and women.

This, says the RCOG, will also help to address social and economic inequalities.

The survey found that:

Nearly 4 in 10 women (37 per cent) are unable to access contraception services and 60 per cent of women in the UK cannot access unplanned pregnancy services, including abortion care, locally;

Latest statistics show that abortions are at an all-time high and highlight the unmet contraceptive needs of women. In 2018, there were 200,608 abortions in England and Wales – an increase of 4 per cent on the previous year;

Over a third (34 per cent) of women did not attend their last smear test, the survey shows. This is despite the cervical screening programme being able to prevent up to 70 per cent of deaths from cervical cancer;

Only half (50 per cent) of women are able to access sexually transmitted infections (STI) services and 56 per cent of women are unable to seek help for menstrual health issues, such as for heavy/painful periods, locally;

Over half of women (58 per cent) cannot access menopause services, despite almost every woman going through the menopause at some point in life;

Almost half (48 per cent) of women think that a one-stop-shop women’s health clinic for all routine women’s health services could improve their access to these services;

Almost half (45 per cent) of women think that drop-ins for specific services, for example, cervical screening, could improve access, and over 2 in 5 (42 per cent) women think that more convenient appointment times would help;

And nearly half (43 per cent) of women with an income of less than £15,000 did not attend their last smear test, compared to 24 per cent of women on higher incomes – highlighting social and economic inequalities.

Poor access to basic women’s health services leads to a rise in unplanned pregnancies, abortions, poor patient experiences and outcomes, and increases damaging postcode lotteries throughout the country.

Healthcare services must make it as easy as possible for women to attend smear testing and reduce any barriers that may prevent access, the report stresses.

The report calls for:

Easy access to contraception, abortion and fertility services;

NHS-led women’s health strategies to focus on a preventative model of healthcare, rather than the current disease intervention service;

The NHS UK website to become the best source of information for girls, women and clinicians;

All young people to be educated from an early age about women’s health;

Women’s health issues, such as the menopause, to be embedded in workplace policies; and

The prevention of deaths from gynaecological cancers across women’s life-course.

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), explaining the issue, said: “I see a patient in my contraception clinic who requires a difficult fitting of the coil. She is also due her cervical smear test. This is the perfect opportunity to provide both services.

“However, my clinic is not commissioned to provide smears, so I am unable to do so. Instead of having all of her needs met in one go, this woman now has to book two appointments for two different vaginal examinations.

“It is expensive, frustrating for me as a doctor, and unfair for the woman. Something has to change.

“This is why this report is calling for a joined-up approach to the commissioning of sexual and reproductive healthcare services.

“Cuts to public health budgets and a fragmented commissioning system have created barriers for women to access holistic care.

“Collaborative commissioning can improve the quality and availability of sexual and reproductive healthcare services, increase access and reduce inequalities.

“Collaborative commissioning must become the norm, with enhanced accountability across the system.

“This would be cost-effective for the NHS in the long-term whilst providing women and girls with high-quality, integrated sexual and reproductive healthcare.”

And Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said: “It is time for a new and bold approach to transform women’s health services and we look forward to working with many key partners to bring about much needed changes across the NHS and particularly in the community.

“Many of the barriers to access to women’s healthcare services can be improved by ensuring services are joined up and more responsive to the needs of girls and women.

“It is important we provide a comprehensive health service for girls and women throughout their lives. We want to empower 51 per cent of the population to be as healthy as possible and ensure no one is left behind.

“This doesn’t need to come at a great financial cost to the NHS. In fact, we believe we can do better for less.”

To read the full report, click here.

To see the RCOG/FSRH’s manifesto for the general election on 12 December, click here.