Organisations call for the Government to accelerate action on women’s health

Today, the RCOG along with 48 other organisations representing women’s health and mental health are calling for concrete action if women are to receive the quality healthcare they need across their lifetime.

The UK government election manifesto promised “never again will women’s health be neglected” yet recent polling commissioned by the RCOG shows that only 5% of women think the government is treating women’s health as a priority.

Our organisations can attest to the devastating impact on women and their families of underinvestment in women’s healthcare. Every day, we hear from women living with life-shattering gynaecological conditions and in need of reproductive healthcare, often waiting months and years for appointments and care. We hear safety and quality reports of maternity services highlighting the impact of poor maternity staffing on women’s care, and we hear about stark health inequalities affecting the most vulnerable women in our society.

We understand that the government is operating in a challenging fiscal context and this is why we want to work with you to offer solutions to drive NHS savings and economic growth. Investment in women’s health makes economic sense. The NHS Confederation found that every additional £1 of public investment in obstetrics and gynaecology services per woman in England is estimated to deliver a return on investment of £11[1]. As it stands, unintended pregnancies cost an estimated £193 million to the NHS in England each year.^[2] Contraception is one of the most cost-effective preventative interventions, with the government’s own analysis demonstrating that every £1 spent on publicly funded contraception saves £9 in averted direct public sector healthcare and non-healthcare costs.^[3] Looking specifically at the provision of long-acting reversible contraception (LARC) in primary care, every £1 invested creates £48 in savings for both the NHS and the wider system over 10 years.^[4] As such, we urge the UK government to prioritise women’s health needs in upcoming Spending Review, and the 10-Year Health Plan to follow.

46% of women surveyed by the RCOG found accessing women’s health services difficult or very difficult. We believe that the Women’s health hub model provides an opportunity to tackle this. Early evidence shows that hubs reduce the number of appointments women need and move care into communities. The hub model also helps to prevent poor health outcomes with priorities based on local need, this is vital to reducing health inequalities. The progress made on establishing women’s health hubs across England is now at risk. Financial challenges facing Integrated Care Systems[5]may force them to discontinue or scale back their hubs, now that the central mandate and ring-fenced funding has been removed.

Women face some of the longest NHS waits. There are currently over 600,000 women waiting to see a gynaecologist in England, many are waiting for months and years with serious conditions preventing them from living full, healthy lives, reaching their potential, and participating in the economy. Women make up a significant portion of the UK workforce in key sectors but many have to work less, or stop work altogether[6], because their health needs are not being met. Long-term, sustained funding to address the complex systemic issues driving gynaecology waiting list growth will be critical to achieving the government’s goal of ensuring people wait no longer than 18 weeks, and will ultimately save money.

Despite the dedication and hard work of maternity teams, there simply aren’t enough staff to provide the safe, personalised and compassionate care that every woman deserves. The tragic impact for women will continue until the government invests in improved staffing levels and training time, including for perinatal mental health services. Lord Darzi’s report adds to the clear evidence that key factors in maternity staffing such as burnout, unstable working patterns, loss of trained staff and challenges with training are holding maternity services back. It was encouraging to see the recent NHS guidance reference the importance of focusing on challenged services, including maternity and neonatal care.  However, we are concerned that valuable initiatives, such as Maternal Medicine Networks, are at risk of deprioritisation as ring-fencing is removed, in the face of difficult fiscal trade-offs between services.

Finally, to move towards a health service that not only tackles poor health in the short term, but prevents it in the long term, the government must end staggering inequalities in health outcomes for women across the UK. Austerity and insufficient investment in the NHS has disproportionately affected women and girls. This is cutting lives short, with women in the most deprived areas of the UK dying many years earlier than their least deprived counterparts. In England, Black, Asian and minority ethnic women have worse outcomes and experiences than white women across multiple outcomes including decades-long disparities in the risk of dying during or shortly after pregnancy, stillbirth and premature birth, and diagnosis and treatment of gynaecological cancers. Vulnerable women with severe mental illness are also experiencing inequalities in service access, as their needs are not met by non-trauma informed and flexible services. Ending inequalities in women’s health will require strong investment in public health to support women to live in good health for longer. The 10-Year Health Plan must make visible and coordinate connections with UK government Departments to achieve sustainable and long-term improvements to the wider factors shaping women’s health.

This week, as we mark International Women’s Day, we collectively urge the government to ‘accelerate action’ and put women and girls at the heart of health policy. Through investment in the women’s health hub model, support for safe and personalised maternity care and the obstetrics and gynaecology workforce, and tackling health inequalities, the government can achieve its essential missions and deliver better health for women and girls across the country.

Yours sincerely,