Health and Social Care

Women’s Health Champion – Spring update

May 13, 2024 by Professor Anna Glasier No Comments | Category Women's Health Champion

I have now been in post for 15 months and I am delighted to be able to take this opportunity to update you on some of the work that I have been undertaking.

Abortion

I am very pleased to have been asked to chair an expert group which will start meeting this summer to review the abortion law in Scotland.

Most members of the public, and a surprising number of health professionals, are not aware that abortion is illegal in Great Britain except under the conditions of the 1967 Abortion Act.

A lot has changed since 1967 – including the procedures used to induce abortion.

In Scotland in 2022, 98.8% of abortions were done using medical methods, and more than 55% were early medical abortions undertaken at home, where both medications were taken in the home.

In 1967, medical abortion did not exist and all abortions were done in hospital using surgical techniques.  A recent increase in the number of women being investigated or brought before the courts in England suspected of inducing abortion at or beyond the legal limit of gestation has led to increased calls for abortion to be decriminalised. Simply decriminalising abortion does not necessarily result in modernising the abortion law and we can learn from the experience of Australia, New Zealand, Canada and Northern Ireland in how decriminalisation can have unanticipated consequences.

With this in mind, the SG is setting up an expert group to consider abortion law reform in Scotland with the emphasis on reframing abortion as a healthcare issue not different from other medical conditions.

Contraception

The short-life working group – Challenges and Opportunities in the provision of Long-Acting Reversible Contraception (LARC) in Scotland – finished its work at the end of last year. The group wrote a report emphasising the value of LARC in preventing unintended pregnancy but highlighting that provision has not returned to anywhere near the levels seen before the Covid pandemic, which even then fell short of meeting the demand.

In February, a paper entitled ‘Optimising Prevention of Unintended Pregnancy’ was presented to the NHS Board Chief Executives asking Boards to consider how to increase women’s access to LARC methods of contraception. I look forward to working with the Boards in the coming months as we think about how best to provide this support to women across Scotland.

Finally, on the subject of both contraception and abortion, Dr Rosie McNee – a Public Health Registrar from NHS Forth Valley – has recently finished her secondment to the Women’s Health Team. She has been exploring the possible reasons for the significant rise in abortion rates in Scotland – including changing attitudes to both abortion and contraception and difficulties with access to contraception.

Dr McNee has presented her findings to a number of audiences including a lunchtime Women’s Health Champion seminar, the first in what we hope will become a series of presentations on interesting topics relevant to the Women’s Health Plan.

Menopause

The menopause continues to be a priority for the Women’s Health Plan.

Our National Menopause Clinical Reference Group has been working on pathways for managing women with post-menopausal bleeding (PMB) distinguishing PMB occurring in women who are not taking hormonal replacement therapy (HRT) from that in women who are taking HRT since the latter group (provided the HRT regimen is appropriate) are at much lower risk of cancer. A pathway for the management of women who might benefit from testosterone therapy has also been developed.

The Minister for Women’s Health, Jenni Minto MSP, recently visited the Maggie’s Centre in Edinburgh to meet women who have experienced treatment induced menopause.  I know that both she and I would like to do more to improve the information, care and support available to women who experience treatment induced menopause and we will be considering this in the coming months. We are so grateful to those who felt able to tell their stories.

Menstrual Health

Our new National Menstrual Health Specialist Network has now met three times and enthusiasm for the group is growing. At the most recent meeting, we were delighted to have a spotlight session on adenomyosis with Dr Varsha Jain a Clinical Research Fellow from the Centre for Reproductive Health at the University of Edinburgh and discussed ways of improving communication with patients in secondary care.

We would be delighted to welcome new members to the Network. If you are a healthcare professional working in menstrual health and would like to join the network please contact womenshealthplan@gov.scot.

Heart Health

I have been working with the Heart Health team and others to produce a series of guidelines on the management of contraception, menopause and menstrual dysfunction for women with pre-existing heart disease since estrogen therapy is the mainstay of management of all of these conditions. At the same time, we have been working with the Tommy’s Campaign team and also with NHS inform colleagues, to update and triangulate information on pregnancy planning advice for women with heart disease.

I recently visited Chest Heart and Stroke Scotland’s (CHSS) Health Defence Hub at Maryhill. The service offers free health checks with lifestyle advice and opportunities to participate in exercise classes and walks. The enthusiasm of both the staff and the participants was impressive. I was surprised that the service is not yet used by the local general practices when it would seem to me to be a great way of improving the health of people living with, or at risk of, heart disease. CHSS are soon to start a similar project in Douglas in Dundee, and I have put the NHS Tayside Women’s Health Leads in touch with CHSS in the hopes that they can promote the service to the Board and particularly to the local GP services.

In February, I attended an interesting meeting at the Digital Health & Care Innovation Centre in Glasgow to explore concepts around access to data for innovation with a particular focus on women’s cardiovascular health. Inspired by that meeting, I met with the new Director of the University of Edinburgh Centre for Reproductive Health, Professor Andrew Horne, to discuss other initiatives linking heart disease to reproductive health. We are discussing holding a half day workshop in the summer in order to develop some research ideas. More information to come in due course!

Cervical Cancer Elimination

I have been asked to Chair a group of experts to consider what is needed to eliminate cervical cancer in Scotland – and by when. Coinciding with the start of World Immunisation Week 2024, the first meeting of this expert group took place on Thursday 25 April. The passion and expertise within the room was clear to see, and I look forward to working with the group to ensure progress towards cervical cancer elimination in Scotland. With a combination of HPV vaccination and cervical screening, elimination of this condition – which still results in over 800 deaths a year in the UK – should be possible. From my experience of offering cervical smears, one of the biggest challenges will be in finding ways to help women overcome the barriers and anxiety that prevent someone accessing cervical screening.  Tackling inequalities must be at the heart of our approach if we are to understand how we can best support women and girls to access the care and services that they need.

I continue to hold regular meetings with Ms Minto and she and I have had a second meeting with MSPs from all parties interested in Women’s Health. These discussions are much less formal and are a really fruitful forum for discussion.

Health and Social Care Alliance Scotland (the ALLIANCE)

In December I was interviewed by Irene Oldfather to celebrate the end of my first year as the Women’s Health Champion. It was nice to meet people from the Alliance in person, the first chance I have had to do so although I continue to participate in their various webinars. The webinars can be found on the ALLIANCE website along with numerous other excellent resources.

The ALLIANCE have also recently published new resources on women’s heart health.

Young Women’s Movement

Finally, I was delighted to attend the reception to mark 100 Years of the Young Women’s Movement. It is fantastic to see the voices of Scotland’s young women being supported and amplified and I hope that we can do the same as we continue to work toward our ambition, that we live in a Scotland where all women and girls experience the best possible health – throughout their lives. Girls and young women have much to tell us –  and I am here to listen.

NHS Inform Women’s Health Platform : Women’s health | NHS inform

Contact: Womenshealthchampion@gov.scot

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