BNSSG Healthier Together

Women’s health

Note: although we use the term women we recognise that trans, non-binary, intersex and gender-expansive people require women’s health services and we are working to ensure services are accessible and inclusive for all.

How we are improving women’s health services

The Women’s Health Strategy for England was published in 2022. The strategy set out a ten-year plan for improving women’s and girls’ health and wellbeing, including developing Women’s Health Hubs across England.

Women’s Health Hubs will build on what is already provided by general practices to improve access to services, quality of care and to reduce health inequalities. The national guidance on Women’s Health Hubs outlines eight core service areas:

  • menstrual problems assessment and treatment, including but not limited to care for heavy, painful or irregular menstrual bleeding, and care for conditions such as endometriosis and polycystic ovary syndrome
  • menopause assessment and treatment
  • contraceptive counselling and provision of the full range of contraceptive methods including Long-Acting Reversible Contraception for both contraceptive and gynaecological purposes and emergency hormonal contraception
  • preconception care
  • breast pain assessment and care
  • pessary fitting and removal
  • cervical screening
  • screening and treatment for sexually transmitted infections (STIs), and HIV screening

Our approach

1. Understand

We gathered local and national data on women’s health needs, current outcomes and existing service provision. We talked with a lot of people who work in women’s health. This included GPs, nurses, gynaecologists, sexual and reproductive health clinicians, people working in the voluntary, community and social enterprise sector, academics and commissioners. We set up our Women’s Health Steering Group and Working Group.

2. Plan

We talked with our stakeholders to develop and agree on priority areas and outcomes we want to achieve for women in Bristol, North Somerset and South Gloucestershire. Our Women’s Health Working Group is busy developing plans to improve our services that will achieve these outcomes.

3. Do

From September 2024, we will be making improvements to women’s health services in Bristol, North Somerset and South Gloucestershire. We will monitor and evaluate these changes and, if needed, adapt our plans to meet our key outcomes.

Our plans

These are being developed and delivered with a focus on reducing health inequalities and following a trauma-informed approach, which acknowledges the prevalence of trauma in society, recognises the signs and symptoms of trauma and resists re-traumatising people.

Women’s Health Primary Care Networks

General practices already provide a lot of women’s health services. However, provision varies between practices. For example, overall, general practices in Bristol, North Somerset and South Gloucestershire fit more long-acting reversible contraception (coils and implants) than the England average. However, some practices only have one member of staff who is qualified to fit contraception, which can lead to long waiting times.

We also know that knowledge and experience in providing menopause care varies between general practices. A recent Bristol, North Somerset and South Gloucestershire Healthwatch report on menopause care experiences highlights where there are gaps in care.

We will deliver

  • Improved access to and quality of coil and implant fitting and menopause care in general practice.
  • A more trauma-informed approach to women’s health services.
  • Better signposting to local women’s health services and useful and reliable information to support decision-making and self-management.

How we will do this

We are working with groups of practices called Primary Care Networks (PCNs) to improve women’s health services.

PCNs will make and implement plans for how they can best provide women’s health care across their practices. For example, setting up a coil and implants clinic that all patients from across the PCN can be booked into.

We will provide training for PCN staff on trauma-informed care with a specific focus on women’s health.

We are collating information on local women’s health services, including voluntary, community and social enterprise services, so general practice staff are better able to signpost people to what is available. We are also collating useful and reliable information on women’s health to help women in decision-making and self-management. Here are a few sites:

NHS England videos on endometriosis

Bristol Menopause Toolkits – information in Arabic, Somali, Punjabi and Urdu

We will work with PCNs to identify and help to address health inequalities in their local population.

 

Inclusion health groups

Inclusion health is an umbrella term used to describe people who are socially excluded, who typically experience multiple overlapping risk factors for poor health, such as poverty, violence and complex trauma. People in inclusion health groups tend to face significant barriers to accessing and navigating mainstream health services.

We want to improve access to and quality of women’s health services for the following broad groups of people:

  1. Migrants in vulnerable circumstances. This includes asylum seekers and refugees.
  2. People facing multiple disadvantages. These are people experiencing a combination of problems including homelessness, substance misuse, involvement with the criminal justice system, mental ill-health, and victims of interpersonal violence and abuse.
  3. Gypsy, Roma, and Traveller communities.

We will deliver

We will deliver local, small-scale interventions to improve health outcomes and reduce health inequalities for these groups through:

  • improved access to women’s health information or services
  • improved patient experience or quality of women’s health services

How we will do this

We will provide small grants to local organisations or community groups working in Bristol, North Somerset, or South Gloucestershire who have trusted relationships with people in these groups.

We will award one-off grants from £5,000 to £20,000, with a first phase of grants being advertised in Summer 2024, focusing on reaching migrants in vulnerable circumstances and people facing multiple disadvantages.

We are open to different ways of addressing women’s health needs, including medical and non-medical interventions. We encourage partnership applications, such as a joint application from a larger charity or specialist health service, collaborating with a community group.

Note: we will be exploring women’s health work with Gypsy, Roma, and Traveller communities later in 2024.

Find out more in our grant guidelines and application form

 

Training and information for professionals working in women’s health

Confident and competent professionals are essential for high quality healthcare. Training and education sessions are an effective way of staying up to date with clinical guidance and best practice. It can also be helpful for professionals to talk and work together across different organisations and specialisms. For example, it helps to broaden understanding of women’s needs and to align and connect different services.

We will deliver

We will deliver a more confident, expert workforce with better connection and awareness among those working in women’s health services.

How we will do this

We will promote existing free and low-cost training resources and opportunities with our local professionals.

We are funding a Menopause Training Clinic in the menopause service at St. Michael’s Hospital, Bristol (part of University Hospital Bristol and Western NHS Foundation Trust). This clinic will enable six GPs to upskill in complex menopause care so they can bring this into their general practices.

We are providing a training and education package for healthcare professionals. This will include clinical sessions, such as pelvic health and contraceptive counselling. It will also include sessions on making services more inclusive, such as trauma-informed care and how to support people who are trans, non-binary or intersex to access the services they need.

 

Who we are working with

Our Steering Group

Senior staff from key Integrated Care System (ICS) organisations meet quarterly to steer a system-wide, joined-up approach to improving women’s health and reducing inequalities. The organisations represented include:

  • local councils
  • the local health system and provider organisations
  • the voluntary and community sector
  • Healthwatch

Our Working Group

The Women’s Health Working Group meets monthly to plan improvements and support their implementation. Membership includes:

  • general practice clinicians
  • secondary care clinicians
  • VCSE representatives
  • public contributors
  • local authority colleagues
  • Integrated Care Board (ICB) programme managers
  • Bristol, North Somerset and South Gloucestershire Training Hub staff

Our local community

It is key that the Bristol, North Somerset and South Gloucestershire Women’s Health programme is driven by input from local women.

We have two public contributors on our Working Group, and support them to contribute to the Group’s plan to improve services in Bristol, North Somerset and South Gloucestershire.

Our work to improve outcomes for women from inclusion health groups will be informed by engagement and co-design of services with people from these groups.

Primary Care Networks (PCNs) will engage with their local communities to help ensure that the changes they make to women’s health services in their area meet the needs of local people.

Contact us

For more information, contact the team via the Bristol, North Somerset and South Gloucestershire Women’s Health email bnssg.womenshealth@nhs.net