#EmbraceEquity: Why we need a policy vision for women’s reproductive healthcare
This International Women’s Day, Bayer UK’s Romika Purwaha sets out how the Government can improve access to women’s reproductive healthcare services and contraception.
Implementing a strategy is one of the toughest actions to take in business. When I started my career in pharmaceuticals, I was told that “strategy is simply resource allocation” and it is no different for a government. It has now been six months since the Women’s Health Strategy was published1, which set out an ambitious vision for women’s health.
Despite significant political disruption, it is welcome to see the Government maintaining momentum on the strategy, including policy to enable greater access to hormone replacement therapy (HRT)2.
That being said, reproductive health, and having the right to choose, is a key foundation of women’s health, so it is disappointing that this gap has not yet been filled. The increasing vagueness around the promised Sexual and Reproductive Health Action Plan is concerning and suggests that resources for this part of the strategy are not being allocated appropriately to support women across their entire life course.
One area most at risk is contraceptive provision, which was subject to significant challenges and funding cuts long before COVID-193 and has been further exacerbated by the pandemic. NHS data highlights that since 2015, there has been a 48% decline in contraception-related contacts with sexual and reproductive health services4, with the number of clinics offering a service falling from more than 850 in 2015 to fewer than 400 in 2021-225.
More broadly, women are being made to wait to access services they need. One in three women with a women’s health condition, for example heavy menstrual bleeding or menopause, say they have been made to wait three years or more for a diagnosis6. Experts say the delay in diagnosis can lead to a significant negative impact on women’s physical and mental health7, and highlights the need to improve awareness and access to women’s healthcare services.
We are therefore urging the Government to reconsider its apparent decision to row back on the publication of the Sexual and Reproductive Health Action Plan, originally promised as a standalone strategy to build on the Women’s Health Strategy8. Clear, accountable plans are needed to increase access to contraception and support menstrual wellbeing. This should sit in harmony with the ambitions to improve menopause care and the holistic ‘life course’ approach set out in the strategy last summer. We cannot risk any part of women’s healthcare falling through the cracks.
One of the biggest issues facing women and girls is that of siloed commissioning of women’s reproductive healthcare services. This is currently split, with contraception services funded by local authorities and menstrual services by Integrated Care Systems.
A woman who needs the same procedure, but for different reasons, can be bounced around different clinics, adding cost to the system along with further burden on providers. For long-acting reversible contraception (LARC) alone, fragmented commissioning frameworks have contributed to a historic reduction in provision, despite it being the most effective form of contraception9.
While fragmented commissioning and funding cuts are damaging for all women, it is most detrimental to more vulnerable groups. In line with this year’s theme for International Women’s Day #EmbraceEquity, any sexual and reproductive health policy plan must consider how improved commissioning can help all women access the support they need.
Bayer recognises that, at both national and regional levels, systems are strained and facing a range of competing priorities. Collaborative action is therefore required to balance the pressures of today with the long-term gains that can be made from tomorrow.
This is backed up by the Government’s own assessment – Public Health England data shows that for every additional £1 spent on long-acting reversible contraception (LARC) in primary care, there is a £48 return on investment over 10 years10.
That’s why we support providers of women’s health services, offering training and education to support the fitting of LARC, aligned to the Faculty of Sexual and Reproductive Health’s (FSRH) letter of competence11.
This year, Bayer will be setting out its own vision for women’s reproductive healthcare across the life course, from the education received in school, to improved access to contraception and menstrual health services, to managing the challenges that come with menopause. My team and I are looking forward to working with stakeholders from across the system to enhance and refine our vision. In doing so, we can make a tangible difference to the lives of women of all ages, from all postcodes, and in all communities.
Romika is the Head of Women’s Health & Established Products, Bayer UK. She is a dedicated advocate for women’s health and is passionate about ensuring quality healthcare services and education are available to women everywhere. Bayer is a recognised leader in women’s healthcare, offering a wide range of effective short and long-acting contraception methods, as well as therapies for menopause management and gynaecological conditions.
Job Bag Number: PP-PF-WHC-GB-1242
Date of article: March 2023
1. https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england. Access February 2023.
2. https://www.gov.uk/government/news/hundreds-of-thousands-of-women-experiencing-menopause-symptoms-to-get-cheaper-hormone-replacement-therapy. Access February 2023.
3. https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/1419/1419.pdf. Accessed February 2023.
4. NHS Digital SRHAD data. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2021-22. Accessed January 2023.
5. NHS Sexual and Reproductive Health Services Data tables 2015/16 and 2021/22. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services. Accessed January 2023.
6. https://www.independent.co.uk/news/health/women-health-diagnosis-delay-treatment-b2280080.html. Accessed February 2023.
7. https://www.independent.co.uk/news/health/women-health-diagnosis-delay-treatment-b2280080.html. Accessed February 2023.
8. https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england. Accessed February 2023.
9. https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/1419/1419.pdf. Accessed February 2023.
10. PHE, Extending contraception ROI tool, Contraception return on investment tool - maternity and primary care settings. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1001464/ROI_LARC_maternity.pdf. Accessed January 2023.
11. https://www.fsrh.org/education-and-training/letter-of-competence-intrauterine-techniques-loc-iut/. Accessed February 2023.
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