Our Vision for the

1 Let s take actionOur Vision for the women s health Strategy for EnglandPublished December 2021 Our Vision for the women s health Strategy for EnglandContentsMinisterial Foreword 11. The Call for Evidence and the case for change 22. The ambition for women s health 43. women s voices 84. Healthcare policies and services 105. Information and education 126. health in the workplace 147. Research, evidence and data 168. Priority areas 18 Menstrual health and gynaecological conditions 18 Fertility, pregnancy, pregnancy loss and post-natal support 20 The menopause 22 Healthy ageing and long-term conditions 23 Mental health 24 The health impacts of violence against women and girls (VAWG) 259. Next steps for developing the women s health Strategy 26 Our Vision for the women s health Strategy for England1 Ministerial Foreword In March 2021, the Secretary of State for health and Social care and the Minister of State for Patient Safety, Suicide Prevention and Mental health published a Call for Evidence seeking views on the first-ever government-led women s health Strategy for the time the Call for Evidence closed 14 weeks later, we had received nearly 100,000 responses from women across the country, and over 400 written responses from organisations and experts working in the health sector and beyond.

2 As set out in the analytical report accompanying this publication, their stories make sobering reading. And we are determined to make sure that these women s perspectives count. The system must be reformed along with its core values so that the voices of this 51% of the population are is possible. In October 2021, in a debate on a Private Member s Bill aiming to remove prescription charges on Hormone Replacement Therapy (HRT), we heard frank personal testimonies from MPs, not only regarding menopause specifically but regarding their experiences of healthcare more was with great pride and heartfelt thanks to all those who stood up to speak that day that I (Maria Caulfield MP) was able to announce the government s intention to slash HRT charges, along with the establishment of a UK Menopause Taskforce co-chaired by Carolyn Harris MP, who proposed the Private Member s Bill, and myself.

3 This action has shown us all what can be achieved when people and organisations work together to do the right is time to re-set the dial on women s health . This publication sets the government s Vision for a new healthcare system, which offers equal access to effective care and support, prioritising care on the basis of clinical need and not of gender. Our Vision is underpinned by the analysis of what you have told us through the Call for Evidence. When we publish the full Strategy next year, we will set out our ambitions in more detail, and will follow up with full delivery plans where and healthcare professionals across England have made clear their voices and have told us what they need us to change. In some areas this change will come more quickly than in others; there are no silver bullets when it comes to decades of bias, and if change is to be meaningful then it must sometimes take time.

4 But I know that there is real willingness across all parts of the health sector and beyond to make this moment will not let you RT HON SAJID JAVID MPMARIA CAULFIELD MP21 The Call for Evidence and the case for changeOn 8 March 2021, the government launched a Call for Evidence to inform the development of England s first women s health Strategy. Our rationale was twofold. First, to improve the way in which the health and care system listens to women , and to reset our approach to women s health by placing women s voices at the centre of this work. Independent reports and inquiries not least the report of the Independent Medicines and Medical Devices Safety Review and the report of the independent inquiry into the issues raised by Ian Paterson have found that it is often women whom the healthcare system fails to keep safe and to whom the system fails to listen.

5 We are determined that the women s health Strategy will be a catalyst for change. Second, to improve women s health outcomes. Whilst women in the UK on average live longer than men, women spend a greater proportion of their lives in ill health and disability when compared with men, and there are growing geographic differences in women s life expectancy. We also know that there are disparities between different groups of women in terms of access to services, experiences of healthcare, and health outcomes. We want to investigate the ways in which the healthcare system s structure adversely affects women s Call for Evidence The Call for Evidence ran for 14 weeks from 8 March to 13 June 2021. There were three parts to this Call for Evidence: Qa women s health Let s talk about it public survey, which was open to all individuals aged 16 and over in England Qan open invitation for individuals and organisations with expertise in women s health to submit written evidence Qa focus group study with women across England, undertaken by the University of York in collaboration with the King s Fund.

6 Our Vision for the women s health Strategy for England3We received 110,123 responses to the public survey, of which 97,307 were from individuals who told us that they lived in England and wanted to share their own experiences, the experiences of a female family member, friend or partner, or their reflections as a health or care professional. We also received over 400 written responses. A separate report on the written evidence submitted by organisations and individuals with expertise in this field will be published in early 2022. The findings of the focus group study can be found on the PREPARE website. The Call for Evidence findings are summarised throughout this document and can be found in full in the Call for Evidence consultation response. We are extremely grateful to all the individuals and organisations who responded to our Call for Evidence. The public survey provides a rich source of data on women s experiences of healthcare over the life course and on the interventions that would make the most difference to them.

7 In turn, this provides a strong mandate for change, and the starting point for our future policy development. The Strategy s aim is to improve the health of all women and girls, irrespective of whether they have undergone gender reassignment or are transgender. While in this document we refer to women , we recognise that some transgender men, non-binary people and people with variations in sex characteristics (VSC) or who are intersex may also experience some of the same issues covered. We also recognise that people who are trans, non-binary or have VSC will have specific needs and experiences, and work is ongoing across government to address these. The Call for Evidence told us that women do not feel heard within the healthcare system. We are clear that this must stop. We commit to making change The ambition for women s healthA new approach Central to the women s health Strategy will be a focus on women s health across the life course.

8 Unlike a disease-orientated approach, which focuses on interventions for a single condition often at a single life stage, a life course approach focuses on understanding the changing health and care needs of women and girls across their lives. It aims to identify the critical stages, transitions, and settings where there are opportunities to promote good health , to prevent negative health outcomes, or to restore health and wellbeing. Key considerations include the ways in which specific life events or stages of life can influence future health . For example, we know that women who have high blood pressure or pre-eclampsia during pregnancy are at greater risk of heart attack and stroke in the approach has already been adopted by the World health Organisation (WHO) and the Royal College of Obstetricians and Gynaecologists (RCOG) in their report Better for women . The main benefit of this approach is that it allows us to intervene earlier in order to prevent negative outcomes and to improve intergenerational health outcomes, as well as to improve overall quality of life course approach also enables action on wider determinants of health , for example social, economic and environmental factors.

9 It is important to consider such factors in the round alongside opportunities for preventative action to support women and girls in improving their health outcomes, or to reduce the risk of ill health later in know that there are disparities between different groups of women in terms of access to services, experiences of healthcare, and health outcomes. A key priority of the women s health Strategy will be to better understand and tackle disparities in experience and outcomes throughout women s Vision for the women s health Strategy for England5 Early menopause and perimenopausePerimenopause and menopauseContraception, pregnancy, fertility, pregnancy loss, abortion care , and postnatal supportAdolescents and young adultsPuberty-24 Middle and reproductive years25-50 Later years51+Reproductive health needsGeneral health needsThematic priorities across the life course women s voicesHealthcare policies and servicesInformation and educationHealth in the workplaceResearch, evidence and dataHPV vaccinationBreast cancer screeningDementia and AlzheimersOsteoporosis and bone healthMenstrual healthGynaecological conditionsSexual health and wellbeingWellbeing and lifestyle healthy weight.

10 Exercise and smokingMental healthLong-term conditionsHealth impacts of violence against women and girlsPelvic floor healthCervical screeningGynaecological cancers6 This Vision document This document, Our Vision for the women s health Strategy for England, sets out what we were told in the Call for Evidence, and the key themes and areas of focus that make up our ambition. The thematic chapters set out in both the Call for Evidence, and now outlined in this Vision , were chosen because they are relevant to women s health across the life course. These themes are: Qwomen s voices (section 3) Qhealthcare policies and services (section 4) Qinformation and education (section 5) Qhealth in the workplace (section 6) Qresearch, evidence and data (section 7).Collectively, these themes set out the government s Vision for the health of women and girls going forwards. Against each theme, we have set out a summary of what we have heard in the Call for Evidence, followed by an outline of our ambition and next steps.