First Women's Health Strategy for England to tackle gender health gap

Following a call for evidence which generated almost 100,000 responses from individuals across England, and building on Our Vision for Women’s Health, the strategy sets bold ambitions to tackle deep-rooted, systemic issues within the health and care system to improve the health and wellbeing of women, and reset how the health and care system listens to women.

The strategy includes key commitments around:

• new research and data gathering
• the expansion of women’s health-focused education and training for incoming doctors
• improvements to fertility services
• ensuring women have access to high-quality health information
• updating guidance for female-specific health conditions like endometriosis to ensure the latest evidence and advice is being used in treatment

Women live on average for longer than men but spend more of their life in poor health, often limiting their ability to work and participate in day-to-day activities. Closing the gender health gap and supporting women to live well will not only benefit the health and wellbeing of women, but the health of the economy.

Responses to the call for evidence highlighted a need for greater focus on women-specific health conditions, including fertility and pregnancy loss, and gynaecological conditions such as endometriosis, which affects 1 in 10 women.

To support progress already underway in these areas, the strategy aims to:

• provide a new investment of £10 million for a breast screening programme, which will provide 25 new mobile breast screening units to be targeted at areas with the greatest challenges in uptake and coverage. This will:
  • provide extra capacity for services to recover from the impact of the coronavirus (COVID-19) pandemic
  • boost uptake of screening in areas where attendance is low
  • tackle health disparities
  • contribute towards higher early diagnosis rates in line with the NHS Long Term Plan
• remove additional barriers to IVF for female same-sex couples. There will no longer be a requirement for them to pay for artificial insemination to prove their fertility status and NHS treatment for female same-sex couples will start with 6 cycles of artificial insemination, prior to accessing IVF services, if necessary
• improve transparency on provision and availability of IVF so prospective parents can see how their local area performs to tackle the ‘postcode lottery’ in access to IVF treatment
• recognise parents who have lost a child before 24 weeks through the introduction of a pregnancy loss certificate in England
• ensure specialist endometriosis services have the most up-to-date evidence and advice by updating the service specification for severe endometriosis, which defines the standards of care patients can expect. This sits alongside the National Institute for Health and Care Excellence (NICE) review of its guideline on endometriosis

Health and Social Care Secretary Steve Barclay said: "Our health and care system only works if it works for everyone. It is not right that 51% of our population are disadvantaged in accessing the care they need, simply because of their sex. The publication of this strategy is a landmark moment in addressing entrenched inequalities, and improving the health and wellbeing of women across the country."

Minister for Women’s Health Maria Caulfield said: "When we launched our call for evidence to inform the publication of this strategy, women across the country set us a clear mandate for change. Tackling the gender health gap will not be easy – there are deep-seated, systemic issues we must address to ensure women receive the same standards of care as men, universally and by default.

"This strategy is the start of that journey, but eradicating the gender health gap can’t be done through health services alone. I am calling on everyone who has the power to positively impact women’s health – from employers to doctors and teachers to industry – to join us in our journey."

Women’s Health Ambassador Dame Lesley Regan said: "Having spent my career looking after women, I am deeply aware of the need for a women’s health strategy that empowers both women and clinicians to tackle the gender health gap.

"We need to make it as easy as possible for women to access the services they need, to keep girls in school and women in the workplace, ensuring every woman has the opportunity to live her life to her fullest potential. This strategy is a major step in the right direction, listening to the concerns of women, professionals and other organisations to tackle some of the deep-rooted issues that we know exist."

Feedback from thousands of women across the country also revealed that they feel their voices were not always listened to, and there was a lack of understanding or awareness among some medical professionals about health conditions which affect women. To address this, the strategy commits to:

• commissioning urgent research by the National Institute for Health and Care Research (NIHR) into healthcare professionals’ experiences of listening to women in primary care, with a focus on menstrual and gynaecological symptoms to inform policy to ensure women’s voices are heard
• introducing specific teaching and assessments on women’s health in undergraduate curricula for all graduating medical students from 2024 to 2025 and for all incoming doctors
• major investment via the NIHR into research on women’s health issues, including a new policy research unit on reproductive health, and plans to:
  • address data gaps
  • identify barriers to women participating in research
  • improve the quality of data collected by the NHS – this will include running a new reproductive health experience survey every 2 years to continue to listen to women and gather insight on their experiences of services, including for contraception and menopause

By tackling the gender data gap through increased research, building understanding through training and tackling the root causes of why women’s voices are not always listened to, both women and clinicians should feel empowered to have more informed discussions over their care.

The publication of the strategy is the latest action taken by the Government to address the issues and disparities many women face. This includes appointing the first ever Women’s Health Ambassador for England earlier this year, the creation of a network of family hubs in 75 upper-tier local authorities across England, and providing protections to the millions of people who experience domestic abuse through the Domestic Abuse Act 2021.