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.

The national guidance on Women’s Health Hubs outlines eight core service areas:

  • menstrual problems, including care for heavy or painful periods, and endometriosis and polycystic ovary syndrome
  • menopause
  • contraceptive counselling and the full range of contraceptive methods
  • preconception care (when a person is thinking about having a baby)
  • breast pain
  • pessaries – a treatment option for pelvic organ prolapse, which is when one or more organs in the pelvis slip down and bulge into the vagina)
  • cervical screening – to help protect against cervical cancer
  • screening and treatment for sexually transmitted infections (STIs), and HIV screening.

Women’s health services

We used the one‑off Women’s Health Hub funding to improve our existing women’s health services. These investments will help make our care more effective, supportive and easier to access.

Women’s health in GP surgeries

GP surgeries 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 contraceptive devices, which can lead to long waiting times. Coils and implants are not only used for contraception. They can also help manage heavy periods.

We also know that knowledge and experience in providing menopause care varies between clinicians. The Healthwatch report on menopause care experiences highlights gaps in care.

How we have improved women’s health in GP surgeries

We have worked with groups of general practices called Primary Care Networks (PCNs) to improve women’s health services. PCNs reviewed their current services to understand their strengths and areas for improvement, then implemented changes to provide better care.

Training and clinics

  • Trained more GPs and nurses to fit contraceptive coils and implants.
  • Worked together across practices to run more coil and implant clinics.
  • Provided additional training on the menopause for healthcare professionals.
  • Trained more nurses and GPs to fit pessaries, which treat pelvic organ prolapse. You can find out more about pessaries on the NHS UK website.

Education and group sessions

  • Ran group education sessions on the menopause led by GPs and other menopause experts. Over 1,000 people have attended online sessions, many reporting increased confidence in managing the menopause. Example feedback includes:

“So very helpful, I really appreciate your time and effort tonight’ and ‘This has been so informative, thank you ladies!”

  • Some PCNs ran group education sessions on cervical screening and periods.
  • Held small group consultations on the menopause, allowing women to hear about treatments other women are using, share advice, and receive individual care in a group setting.
  • Created a podcast explaining the women’s health services available at the surgery.

Community engagement and access

  • Ran community outreach and engagement events.
  • Supported people who find cervical screening more difficult, including those with a learning disability, people who have experienced trauma, and people who have a cervix but do not identify as female.

Medication reviews

Made Hormone Replacement Therapy (HRT) reviews as effective as possible by training clinical pharmacists to undertake reviews and using text messages to communicate about the review. Read more about HRT on NHS UK.

Improving services for those who need it most

We aimed to improve access to and the quality of women’s health services for those who need them most. This includes people who are considered part of 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.

How we have improved services for people in inclusion health groups

We awarded 11 small grants to local organisations and community groups who have trusted relationships with people in the following inclusion health groups:

  1. Migrants in vulnerable circumstances, including 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 people.

Read about what each grant involved on our inclusion health grant page.

Information on women’s health and local services

Women’s health resource directory

Working with the Bristol and South Gloucestershire signposting website WellAware, we have created a Women’s Health resource directory.

The directory brings together a range of trusted information and local support services on topics including menstrual health, contraception, menopause, and cervical screening. It’s been developed with input from local clinicians, VCSE partners, and public contributors to ensure it reflects the needs of local communities.

Visit the women's health directory on WellAware

Real Women Talk Health podcasts

Working with community radio station BCfm, we have created a six-part podcast series designed to give women and those who support them clear, jargon-free guidance on key health topics.

Each short episode tackles a different subject – menopause, periods, cervical screening, contraception, pelvic health and sexual health – featuring local expert guests, sharing honest experiences, and signposting to local support.

You can listen now on Spotify, Apple Podcasts, Amazon Music and YouTube.

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.

Training we provided

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

We funded 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 enabled six GPs working in deprived areas to increase their skills in menopause care.

We provided online and in-person training and education sessions for healthcare professionals. Topics included:

  • Contraceptive counselling, pain relief options and how to support discussions around hormones.
  • How to fit pessaries as treatment for pelvic organ prolapse.
  • Supporting people with a Learning Disability to access women’s health services.
  • Supporting trans and non-binary people to access women’s health services, with a focus on contraception and the menopause.
  • Menopause and mental health.
  • Period problems, including Pre-Menstrual Dysphoric Disorder.
  • Cardiovascular disease in women.
  • Racial health inequalities for women, with a focus on maternity care.

Trauma-informed practice

Experiences of trauma and adversity can have a profound and wide-reaching impact on the lives of individuals, families and communities. These experiences can influence people’s interactions and how they interpret the world and their surroundings.

A trauma-informed approach acknowledges the prevalence of trauma in society, recognises the signs and symptoms of trauma and resists re-traumatising people. You can read more about trauma-informed practice on our Trauma-Informed Practice page.

We know that experiences of trauma can make accessing healthcare difficult for some women, especially when it comes to invasive procedures such as having a cervical screening or a contraceptive device fitted. Healthwatch Essex’s video on trauma and cervical screening illustrates the importance of a trauma-informed approach.

We ran a nine-month programme providing trauma-informed practice learning sessions for staff in GP surgeries, Sexual Health (Yuno) and Gynaecology.

Many staff reported that the training made them confident in understanding trauma in their healthcare service and how they can support people who may have experienced trauma. Here are some of the things that healthcare professionals will do better as a result of the training:

  • Give their patients a safe space to ask questions.
  • Give their patients a non-verbal option to indicate that they would like a procedure to stop, such as raising a card in their hand.
  • Provide choices to their patients where possible.

Who we worked with to decide where to invest our Women’s Health Hub funding

Our Working Group

We set up an expert Women’s Health Working Group to develop the above plans and support implementation. The group met monthly for one year. Membership included:

  • General practice GPs and an Advanced Nurse Practitioner
  • One Care (GP Federation) representative
  • Gynaecology and Sexual and Reproductive Health consultants
  • Voluntary, Community and Social Enterprise (VCSE) Alliance representatives. Read more about the VCSE Alliance.
  • Public contributors
  • Bristol, North Somerset and South Gloucestershire Local Authority colleagues
  • Integrated Care Board (ICB) programme managers
  • Bristol, North Somerset and South Gloucestershire General Practice Training Hub representative
  • A local academic with an interest in women’s health.

 

Photo: some of the Women’s Health Working Group members.

Our local community

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

We have used local reports and insights from local people to shape our plans. For example:

  • The Bristol Healthwatch report on the menopause
  • A report from local academics on their engagement with a group of Somali women about women’s health
  • The Bristol, North Somerset and South Gloucestershire Sexual Health Needs assessment, which included input from local people.

We appointed two public contributors to our Working Group and supported 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 was informed by engagement and co-design of services with people from these groups.

Some of the Primary Care Network (PCN) plans involved engagement 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