If a women’s health strategy was to be included in the long-term plan, the next challenge would be faithfully translating this from a national plan into action at a local level.
There is a crisis of variation in the provision of sexual and reproductive health (SRH) services across the country. Where a woman lives, how old she is, and her socio-economic status all influence her ability to access both preventative and protective aspects of SRH care. To illustrate:
In Blackpool, 41 in every 1,000 women under 16 years old accessed emergency contraception in 2017/18. This compares to less than 1 in 1,000 in Wiltshire and West Berkshire[i]
In Shropshire, the proportion of individuals aged 15-24 screened for chlamydia is nearly three and a half times lower than in Lambeth[ii]
In Whitby, a woman would need to travel 52 miles in order to see their nearest menopause specialist on the NHS. The City of London, in contrast, has three NHS menopause specialists within a two-mile radius[iii]
This postcode lottery is completely unacceptable, and local authority outturn figures reveal that this variation extends to spending at the population level. Whilst Hackney and Lambeth local authorities respectively spent £67.10 and £75.45 on SRH services per woman, Cumbria and Shropshire respectively spent only £10.44 and £9.63 per woman.[iv]
These shocking inequalities must be addressed. Earlier this year, an Advisory Group on Contraception (AGC) Freedom of Information audit found that, in the face of widespread cuts to services, when local authorities do invest in SRH, the returns are worthwhile. 9 out of the 14 councils in the most deprived areas of England that did increase investment in SRH services between 2016/17 and 2017/18 saw a reduction in the number of abortions.[v]
Local authorities will be responding to the priorities set out in the long-term plan. Our call would be for the importance of SRH services to be reflected both in the national vision and local implementation. Women’s health relies on it.
[i]NHS Digital, Statistics on Sexual and Reproductive Health Services England: 2017/18 – Data Tables. Last accessed 6 December 2018: Sexual and Reproductive Health Services, England – 2017-18: Data Tables.
[ii]Public Health England, Sexual and Reproductive Health Profiles (Chlamydia proportion aged 15-24 screened) 2017. Last accessed 6 December 2018: https://fingertips.phe.org.uk/profile/sexualhealth/data#page/3/gid/8000057/pat/6/par/E12000007/ati/102/are/E09000002/iid/90777/age/156/sex/4and https://fingertips.phe.org.uk/profile/sexualhealth/data#page/3/gid/8000057/pat/6/par/E12000005/ati/102/are/E08000025/iid/90777/age/156/sex/4.
[iii]British Menopause Society, Click. Search. Connect. Find your nearest BMS-recognised menopause specialist. Last accessed 6 November 2018: https://thebms.org.uk/find-a-menopause-specialist/.
[iv]Spend per woman calculated using Department for Communities and Local Government’s General Fund Revenue Account Outturn RO3 – SOCIAL CARE AND PUBLIC HEALTH SERVICES 2016-17 and Office for National Statistics Population Estimates for UK, England and Wales, Scotland and Northern Ireland: Mid-2016.
[v]Advisory Group on Contraception (AGC), Cuts to contraceptive care deepen as new data reveal half of councils closed sites providing contraception since 2015,2018. Last accessed 6 December 2018: http://theagc.org.uk/wp-content/uploads/2018/09/2018-FOI-audit-press-release-1.pdf.