The BIG Conversation: Women's Health Report for North East & North Cumbria

Summary

In July 2024, the ‘Women’s Health ‘The Big Conversation’ was launched in partnership with the North East and North Cumbria Healthwatch network. 

‘The Big Conversation’ included an online survey from July - September 2024 which was shared across the North East and North Cumbria. Alongside the survey, six focus groups took place, targeting specific groups of women who were identified as ‘seldom heard’ e.g. who have additional health inequalities or barriers to accessing health care such as those with learning disabilities, unpaid carers, and women with maternal mental health challenges.

The information gathered has been analysed with key themes and recommendations included in this report. 

This report will be shared with the North East and North Cumbria Integrated Care Board (NENC ICB) and used to further inform the key priorities including future ‘Big Conversations’, what improvements are needed, and what other topics are of most importance to women. 

Survey Questions: 

We had 4,497 responses to the BIG Conversation Women's Health Survey, which asked women across the region five questions:

• Where would you go for women's health-related information?
• How confident do you feel about telling healthcare professionals about your women's health concerns?
• What is important to you when using women's healthcare services?
• What matters to you in terms of your health and well-being?
• What are your top five health priorities?

Focus Groups:

6 focus groups were held across the North East and North Cumbria to understand in more depth the issues and priorities of communities we often don’t hear from. 

We spoke with 35 individuals from the following groups: 

• Women who have experienced sexual abuse in Darlington* 
• Women with learning disabilities in Cumberland Women who are refugees and asylum seekers in Stockton 
• Women who are unpaid carers in Northumberland 
• Women from ethnic minorities in South Tyneside 
• Women with lived experience of maternal mental health issues in Westmorland and Furness 

We asked all our focus groups:

• What ‘general health’ meant to them. 
• Where would you go to find general information about keeping healthy.
• Where would you go to find information about specific women’s health issues.
• Their top 3 priorities 

Headline Findings

• 61% of women said they feel confident to speak with a healthcare professional about their women’s health issues. However, many went on to say they aren’t confident they will be heard or get the help they need. 
• Women said they aren’t listened to, they are dismissed and not taken seriously when seeking support from healthcare professionals. 
• GPs have a critical role as the ‘gatekeepers to support’ for most women. We heard that many women are concerned that their GP does not listen to them, act on what they are told or doesn’t have up to date knowledge about many women’s health issues. Improving experiences in primary care will significantly improve confidence in women’s health care. 
• Women want the choice to have a female healthcare professional; this is a strong message from our general engagement but particularly important in our targeted work with underrepresented groups. 
• The GP (75%) and NHS website (75%) were selected as the most common place to find information on women’s health. Our session with underrepresented groups highlighted the need for targeted accessible communications and the importance of peers in their communities and community support organisations. 
• It is important to women that their health records are easily accessible by healthcare professionals and kept up to date. 
• Women would like more research into women’s health concerns. 
• Additional insight was provided which was specific to the cohort e.g. it was felt by the focus group of women with learning disabilities that there was a lack of knowledge around the impact of neurodivergence on women’s health. Confidentiality was a concern for the focus group which included women who had experienced sexual assault.

Overall, women told us their top 5 priorities in relation to women’s health are: 

• Mental health and wellbeing: Including depression, anxiety and eating disorders. 
• Healthy ageing and long-term conditions: Including falls, heart disease, stroke, diabetes, dementia, bone, joint and muscle health, and bladder/urinary. 
• Menopause, perimenopause and hormone replacement therapy (HRT). 
• Screening services: Including cancer screenings for cervical, breast and bowel. 
• Menstrual and gynaecological health.

Key Recommendations

The findings of our report are based on the feedback we received from the online survey and focus groups and developed in line with NENC ICB’s Women’s Health 7 key workstreams and the top 5 priorities from the survey. 

1. Ensure the NHS constitution is at the forefront of all patient care, irrelevant of gender. Specifically putting the patient at the heart of everything the NHS does and it’s values of respect, dignity and compassion.
2. Co-produce a ‘Women’s Promise’ which details the level of care and support women can expect in the North East and North Cumbria, specifying that healthcare professionals will be conscious of the need to show women that they are being listened to and their concerns taken seriously.
3. Create a directory of women’s specific health services across the North East and North Cumbria, including Women’s Hubs, and promote locally to raise awareness and encourage use.

4. Ensure women are aware of their rights, including to request: 

   - To see a female healthcare professional if preferred 

   - A second opinion 

   - To have a chaperone 

   - To escalate their concerns

5. Develop a Women’s Health Training matrix which includes the desired levels of training for all healthcare roles. Training must be continuous to ensure knowledge and understanding among all health professionals reflects the latest research.
6. Ensure the Women’s Health Training matrix is included in contracts and future contract monitoring, particularly in primary care (GP practices). 
7. Introduce women’s health ‘MOTs’ across the lifespan to provide regular health-checks, screening and a space for women to raise concerns. 
8. Increase the capacity to offer women’s healthcare services particularly in remote and rural areas to ensure more equitable and local access.
9. Offer flexible appointment times at evenings and weekends to maximise accessibility recognising the additional access requirements women may need e.g. due to caring responsibilities.
10. Ensure published (physical and digital) information on women’s health is easily accessible, and available in a range of formats including easy read, British Sign Language, and relevant non-English languages.
11. Prioritise medical research on women’s health to close the national ‘health gap’ and create a more equitable healthcare system for all. 
12. Conduct further research and engagement on women’s health, including the priority areas identified by The BIG Conversation – particularly those areas not currently selected as an ICB work stream (Healthy ageing and long-term conditions and Bones, joints and muscle health).