In 2021 we launched Sophia Health in response to our personal and professional experiences around the gender health gap. There were news articles, podcasts, books, and personal anecdotes that all painted a picture of a huge crisis, that seemed to be ignored by the government and the wider healthcare industry. So we were extremely excited when the government’s Women’s Health Strategy was finally published on the 23rd of December. The strategy is meant to showcase the government’s ambition to close the gender health gap following the House of Lord’s Debate in July 2021 and Call for Evidence in March 2021. It is a long and detailed document with a huge amount of interesting information. In this post, I’m going to look at the main takeaways and then give my personal thoughts on some of the key areas and what I’ve seen in my own work as a GP.
A Women’s Health Strategy for England: Highlights
The Vision for Women’s Health is the result of the government's compiled information from its public survey on women’s health, an open call for written evidence, and thirdly a focus group study by the University of York with the Kings fund. There were over 100k responses, making it a very good indicator of what is happening for women across the country. Overwhelmingly, the report highlights that women are not getting the access to care they need and they are very frustrated.
Key takeaways from the report:
Stigma and Taboos in women’s health make women believe that they have to live with debilitating symptoms and they are “normal” parts of “being a woman”
Women are not being heard. 80% feel their problems were not listened to by health professionals.
Services addressing women's health have been seen as a lower priority in health
There is a lack of compulsory training in women’s health for GPs
More than 50% struggle with discomfort at discussing health issues with their workplace
Two-thirds of survey respondents expressed a lack of services available supporting women with health conditions or disabilities
There is an urgent and critical need for specialists services to address the significant health impacts caused by violence against women and girls
There is a huge need for improved information and support for mental health conditions affecting women
Deep Dive into Key Themes
The data collected demonstrates that women are disempowered and struggle to discuss female-specific health conditions, mental health, and disabilities in comparison to general health conditions. There are stigmas and taboos attached to these that mean too often women feel that these problems are something they have to put up with and do not seek help for. When they did try to get help, they often felt not listened to or that these issues were dismissed. A staggering 84 % of survey respondents noted times when they did not feel listened to by health professionals. Women frequently felt their health concerns were dismissed with conditions presenting with pain as a key feature.
Within the health service, the paper critically noted that there is a lack of women in leadership positions and that women are under-represented at all levels in health. As a female GP, this is something I’ve seen in practice first hand and I do believe it has a significant impact on how the NHS is run and its attitude to women’s health. Practices and departments where there is a more proactive female-led team, tend to have more progressive ideas on how to support women in their communities.
Healthcare policies and services
The report points out gaps in available services and geographical variations in access for example postcode lotteries for menopause clinics and fertility treatment. I have seen this firsthand in Cornwall where funding for menopause clinics has been pulled. These are now being run by the same NHS doctors as private clinics so the access is now severely limited to those in the upper socio-economic groups.
The government’s vision for women’s health strategy also raises that the covid pandemic has negatively impacted access to women’s services such as contraception clinics/ fitting of LARC (Long-acting reversible contraceptives such as the coil) but interestingly it was seen as a positive outcome that remote/online consultations have become normalised/commonplace. This is particularly beneficial to women as can be scheduled (more easily than in person appointments) around caring, family, and career commitments. The positive view of online services is great news for our team as we feel Sophia Health has a huge amount to offer as an online service.
Information and education
The report raises the need for better online access to up-to-date women’s health information and suggests that the NHS information website is not currently meeting these needs. This is backed up by other studies that suggest the use of doctor google to seek health information is widespread and often leads women to out of date, inaccurate, biased, or non-evidence-based advice. The risk of this is not only to cause distress but also adds to the lack of empowerment women face in managing their own health and could furthermore contribute to incorrect or missed diagnoses. It goes on to describe more accessible and easy-to-understand modes of delivery of health information and education such as via blog posts and social media.
There are important information gaps that we also found in our own market and user needs research. It is one of our first priorities to address this and our team aim to help fill these gaps, by creating valuable, updated content in multiple formats.
Health in the workplace
There is a need for better support for women’s health issues within the workplace, above and beyond maternity support. The report specifically addressed the issues around women dealing with the impact of menopause within the workplace. It suggests more access to flexible working to help this. It also highlights the need for employers to be equipped with a better understanding of women’s health issues and to provide policies for supporting women going through issues such as domestic abuse.
Considering the still continued challenges around maternity support, this is an area that we feel will continue to have significant challenges. However, starting to talk more publicly about things like menopause and providing helpful information to employers on how they can support their staff is a step in the right direction. Improved employment rights and proper access to medical support to help women cope with the process would also be a huge step in the right direction.
Research, evidence and data
Women’s health research has historically been neglected, causing a huge lack of knowledge around medical conditions that affect women in particular. This is especially significant in research on conditions impacting minority groups who suffer from additional systematic baises and discrimination. The plan proposes the need for better access for all women from all backgrounds to clinical research results and conclusions.
On a personal note, this is something as a doctor I was surprised and disappointed about when looking for research into prevention, diagnosis, and treatment for pre-eclampsia and placental disease in pregnancy. There has been little research or progress into this for many years despite it being one of the most common conditions causing potentially preventable maternal and baby ill health and death. When you compare this to general common health conditions such as heart disease-causing heart attacks and angina there are vast numbers of research studies into this and we are constantly seeing new updates in the guidance for prevention, detection, and management, with new medications developed frequently with an aim to reduce deaths and illness. This is just one of many examples of how our health service is androcentric - primarily focused on the male point of view of health conditions.
The evidence compiled demonstrates the systemic sexism and gaps in our current health service to such an extent that the government has a difficult task on its hands at attempting to rectify this. It comes at a time when the government is already trying to deal with the monumental weight of a struggling health service in the face of the Covid pandemic. The waiting lists for secondary / specialist care are already extremely stretched and the number of patients waiting more than a year for treatment is enormous. In addition to this, the world has moved forwards in terms of its use of technology in the digital age but some sectors of the NHS are still relatively speaking in the dark ages. There is a huge amount of work to be done to make unbiased health prevention, health education, and health care accessible and available to the women of today and tomorrow in the UK.
It is admirable that the government is hoping to make progress into this although the skeptic in me wonders if this is another aspiration that gets buried and lost under more capitalist or populist policies. While the release timeline of this paper is a bit suspicious (23rd of December?!), we hope that it’s incredibly important data is noted and picked up on by women around the country. This report continues to highlight what most women already know - MORE NEEDS TO BE DONE!
For myself and the team at Sophia Health, this policy paper has given us some useful data and confirms we are 100% on the right track. We are fully committed to our role as a progressive, innovative answer to this gender health gap and are spurred on with our ambition and drive to deliver this as a trusted, up to date and evidence-based resource for all women.
We look forward to seeing the next step in this government process when they publish the women’s health strategy in Spring 2022 and hope there is an opportunity to be a key part of the long-term solution to the issues highlighted.