Women’s health in Humber and North Yorkshire

As part of our focus on women’s health, Kathy Oxtoby looks at provision in Humber and North Yorkshire

The state of women’s healthcare is improving, says Dr Naomi Chinn, clinical lead for women’s health at Humber and North Yorkshire ICB. 

‘The biggest change is with the patients, who are now, more than ever, empowered and confident to seek diagnosis and treatment for their menstrual health. We experienced how quickly change – such as rates of HRT prescribing, and the move to prepaid menopause certificates – can happen with improved awareness and focus, a few years ago with menopause. Similar change is now happening with period health, and pathologies such as endometriosis.

‘The patient’s voice will drive change, and it’s up to the commissioners to ensure services fit to what is needed,’ she says.

Humber and North Yorkshire ICB recently reappointed Dr Chinn as clinical lead for women’s health, to continue her role in the new ICB structure. ‘In the current climate, this is a huge statement regarding the value the ICB places on this work. We will need to focus on strategic commissioning to allow improvements in specific areas, such as gynae waiting times and services closer to home,’ she says.

Championing women’s health, Dr Chinn says she is ‘now known for showing up to all sorts of meetings from frailty groups to the mayor’s sport and active fund and asking: “how does that impact women?”’ ‘I’ve got T-shirts with a uterus on them, which gets people talking!’ she says.

She says the ICB has now had a year of Local Enhanced Services for IUS (intrauterine system) fitting and removal for non contraceptive reasons, and ring pessary fitting and replacement. ‘These facilitate improved access to these services for women closer to home and without needing to wait for secondary care gynaecology,’ she says. The LES offer has included training provision so the service offer can be expanded, as well as funded appropriately for primary care. 

Gynaecology is one of the four focus areas for the ICB in relation to outpatients and waiting times. ‘But we need to be sure that we recognise the impact in proportion to the 51% of the population this affects,’ says Dr Chinn.

The ICB has also invested in training, with more trained fitters of IUS, and some trainers to embed a skilled workforce and empower clinicians across the region.

Within the Humber and North Yorkshire area there is an active network of women’s health champions, and there have been face-to-face events for learning and networking.

Dr Chinn is involved with gathering leaders and allies to support the identification of, and work on ways to address medical misogyny. Dr Chinn and two other leaders in women’s health have established the Yorkshire & Humber Women’s Health Network – a community for current and future clinical leaders working across women’s health. The network’s manifesto says its mission is to ‘bring people together to support, connect, and strengthen the workforce behind the consultations’. A key focus of the network is ‘sharing best practice and strengthening clinical pathways across the region’, the manifesto says.

‘We’ve started this Yorkshire wide group to support everyone wanting to make changes in the area of women’s health, and it’s exciting times,’ says Dr Chinn.

The ICB took a different approach to women’s health hubs. ‘A central location would never have worked with our geography and therefore we upskilled and empowered clinicians to deliver enhanced women’s health services and these were in turn supported through the LES,’ she says.

Of concern with women’s healthcare is that ‘there’s so much to do’, she says. ‘Without the continued central funding from government for women’s health hubs, it was always going to be a challenge to make meaningful changes.’ 

It is not yet clear what the future will look like for women’s health in relation to ICBs, and NHS England’s regional and national teams for women’s health, she says. ‘Humber and North Yorkshire ICB recognises the need to improve gynaecological health, and the opportunities within the 10 year plan to do this are significant.

‘There are also those within the system who recognise the wider determinants of women’s health and how these impact on the broader system, which will make a huge difference,’ says Dr Chinn.

Considering the future of women’s health more widely, she says: ‘We need clarity about what the problem is and what we are doing to address it.

‘A waiting list to see a gynaecologist is a problem, but it doesn’t define the problem with “women’s health”.

‘Many years of underinvestment and a lack of recognition have led us to this position and it’s going to take years to change that tide.

‘The focus on women’s health should not mean less attention to other health areas – it’s about equity not equality.’

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