A strategic approach is required across the life course to prevent predictable ill health and to address the determinants of health specific to women.
These are the RCOG's key recommendations outlined in our full report: Better for women (PDF 5.6mb)
Our primary aim: The creation of NHS-led Women’s Health Strategies
We are calling for the creation of national strategies for women's health based on a life course approach to address areas of unmet need.
Access to reliable information on women’s health
Young people should be educated from an early age about women’s health
- Government education departments must collaborate with medical colleges and disseminate accredited sources of information on women’s health to teachers.
- There should be greater investment in school nurses.
The NHS website should become the world’s best source of information for girls, women and clinicians
- The NHS UK website should link to all of the relevant support networks and tools available for girls and women.
- The NHS UK website should consolidate information on women’s health for clinicians.
To reduce health inequalities, all women should have access to and be provided with the information that they need to stay healthy
- The Government Equalities Office should work with public health bodies and women’s health charities to create a strategy to improve the dissemination of information to all girls and women especially those with protected characteristics, from disadvantaged backgrounds, marginalised communities, those with disabilities, visual impairments or language barriers or those living in institutionalised settings.
Easy access to contraception, abortion and fertility services
Access to the full range of contraception methods should be as easy as possible for all women
- Missed opportunities and barriers to women accessing contraception, in particular long-acting reversible contraception, and contraceptive advice and counselling need to be addressed.
Post-pregnancy contraception should be a key part of the maternity pathway
- NHS England, NHS Scotland, NHS Wales and Health and Social Care Northern Ireland must embed immediate post-pregnancy contraception maternity pathways and support for all women.
Make access to progestogen-only oral contraceptives and emergency hormonal contraception (EHC) as easy as possible for all women
- The Medicines and Healthcare Products Regulatory Agency (MHRA) should reclassify progestogen-only oral contraceptives from ‘prescription-only’ to ‘pharmacy product’.
- The MHRA should ensure that oral EHC is reclassified to the General Sales List to enable it to be sold straight off the shelf without consultation. It should be made free of charge
Introduce mandated co-commissioning of SRH services across the UK
- There must be a joined up approach to commissioning to ensure that women can get their sexual and reproductive health care needs met in one place.
Increase public health and sexual health budgets in real terms
- The UK Government must ensure that there is a real terms increase in public health budgets.
Women’s health one-stop clinics should be established in local community hubs and training on women’s health should be delivered to support primary and community care
- NHS England must establish one-stop women’s health clinics into Integrated Care Systems in England which should be made available at weekends and out-of-hours.
- Health Education England should ensure that education and training to support better care of women is prioritised in the delivery of primary and community training hubs for both GP training and the wider Primary Care workforce.
All women should be able to access abortion care easily and without fear of penalties or harassment
- The Department of Health and Social Care must review and expand the definition of “home” under the Abortion Act 1967.
- NHS England specialised services must continue their work to introduce regional centres where access to abortion care for women with complex co-morbidities is available.
- The devolved governments must legislate to introduce access zones around abortion care providers.
- The RCOG must continue to work with partner organisations to advocate for the decriminalisation of abortion up to 24 weeks across the UK.
End post-code lotteries in IVF treatment and offer all eligible women three full cycles of IVF
- England, Wales and Northern Ireland must offer women the same opportunities for IVF treatment as in Scotland and follow the NICE Fertility Guideline which recommends that women under 40 should be offered three full cycles of IVF.
Learning from indicators in the reproductive years to influence future health
Introduce a life course approach to preventing noncommunicable disease in women and their children supported by data collection before, during and after pregnancy
- The data collected during pregnancy should be used more effectively to help identify indicators for future health.
UK Governments should take strong action to improve the health of pregnant women and their babies
- Fortify all flour and gluten-free products with folic acid.
- Reach the Government’s smoke-free by 2030 ambition by following the recommendations of the Smoking in Pregnancy Challenge Group.
- Preconception public health should be prioritised to improve the health of women planning pregnancy.
Improve identification of women at risk from mental and physical health issues with the six week postnatal check
- The RCOG supports the NCT’s Hidden Half campaign that calls for improved guidance, tools and education for healthcare professionals in primary care on best practice around maternal mental health.
End the data gender gap
- There must be renewed effort to tackle the gender data gap by funding more studies which focus on women’s health and responses to treatment to eliminate the gender bias evident in diagnosis, treatment and medical research.
Violence against girls and women
End violence against girls and women via an improved collaborative approach, better IT systems and mandatory training with the NHS as an exemplar
- NHS Trusts and Health Boards must implement mandatory training every three years in gender based violence.
- NHS Trusts and Health Boards should adopt innovative ways to ensure that women can indicate in confidence that they are a victim or at risk.
- NHS Digital and NHS Wales Informatics Service should work with clinicians to improve IT systems used to record and submit cases of female genital mutilation (FGM).
- Mandatory reporting of FGM must extend to Northern Ireland.
- Scotland’s Female Genital Mutilation (Protection and Guidance) Bill must be revised to include mandatory reporting of FGM to the police.
Prevention of mortality from gynaecological cancers across the life course
Increase uptake in cervical screening amongst disadvantaged and marginalised women
- Public Health England, Health Protection Scotland, Public Health Wales and the Public Health Agency (Northern Ireland) must improve the uptake of cervical screening among LGBTQ+ people.
- HPV primary home-test screening should be implemented by the respective UK Government administrations without delay.
Increase uptake in cervical screening by ending fragmentation and harnessing technologies
- The UK Government should implement the recommendations of Sir Mike Richard’s report on screening programmes in England without delay. The devolved Governments must also take note of the recommendations in the report.
- The ongoing work of NHSX on developing a new IT system for the cervical screening programme must be given the highest priority.
Improve early diagnosis and treatment of gynaecological cancers
- The UK Government must fund an ongoing ovarian cancer audit.
- Public Health England, and respective devolved nation bodies, must prioritise campaigns that increase awareness of gynaecological cancer symptoms.
Keeping women in the workforce
Women’s health issues should be embedded in workplace policies
- The challenges of common debilitating women’s health issues – for example menstrual health problems and the menopause - should be recognised in workplace policy and processes.
Appointment times at GP services should increase to 15 minutes
- The RCOG supports calls for 15 minute appointments as standard in general practice, with longer for those patients with complex health needs.
Increase awareness of pelvic floor dysfunction
- Public Health England, and respective devolved nation bodies, should create a Taskforce to consider ways of raising awareness of urinary and faecal incontinence and prolapse in women.
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