Women’s health

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 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.

We will deliver

• Improved access to coil and implant fitting.
• Better 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 are doing this

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

PCNs are making and implementing plans to improve women’s health care across their practices. PCNs are engaging with their patients where their work involves a change in how they provide services.  Here are some examples of what PCNs are doing:

• Training staff to fit contraceptive coils and implants
• Working together across practices to run more coil and implant clinics
• Training staff to fit pessaries. Pessaries are used to treat pelvic organ prolapse, which can feel like a bulge or lamp in your vagina. You can find out more about pessaries on the NHS UK website.
• Setting up group education sessions on the menopause led by GPs and other health care professionals with expertise in menopause care.
• Running community outreach and engagement events.
• Supporting people who can find it more difficult to have a cervical screening appointment, for example people with Learning Disabilities.
• Making Hormone Replacement Therapy (HRT) medication reviews as efficient and effective as possible. HRT is used to help manage the menopause. You can read more about HRT on the NHS UK website.

We will also be providing training for PCN staff on trauma-informed practice with a specific focus on women’s health. Healthwatch Essex’s video on trauma and cervical screening illustrates why this is so important.

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 some examples of useful websites:

NHS England videos on endometriosis

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

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 are improving access to and quality of women’s health services for people in the below groups who fall under the ‘inclusion health’ umbrella:

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 people.

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 are we doing this

We sought applications from local organisations and community groups to bid for a small grant (£5,000 – £20,000) to improve access to or experience of women’s health services for people in the three groups listed above.

We worked with two public contributors and two representatives from local charitable organisations Womankind and Missing Link, Next Link and Safe Link to review the bids and award the grants.

We have awarded 11 small grants to local organisations and community groups who have trusted relationships with people we want to better support. Read about what each grant involves on our inclusion health grant page.