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A life-course approach to women’s healthcare should be adopted using every interaction a woman has with the health service, irrespective of age, to promote health and lifestyle rather than the constant firefight against disease and ill health, according to a new report from the Royal College of Obstetricians and Gynaecologists (RCOG).
The report, High Quality Women’s Health Care: A proposal for change, published today, calls for a series of changes in the way women’s healthcare is structured, including a more midwifery-led maternity service.
It concludes that the combined force of the NHS reforms, workforce and financial pressures against a backdrop of rising demand, increasing complexity and changes in demographics means that the delivery of women’s health care in the current configuration “cannot be sustained”.
It wants to see services for women managed in clinical networks which link primary, community, secondary and tertiary services and an end to postcode variation in healthcare provision. It also recommends a reduction in the number of medically staffed units so that women are not going to places which are understaffed.
The report recommends the appointment of a national clinical director in women’s health to champion women’s healthcare and says hospitals should be configured “so that safe and timely care can be provided by multiprofessional teams”. It says too much care is currently provided by hospitals.
For maternity services, it wants to see 24/7 medical obstetric services provided for women on fewer sites than at present and for gynaecological services, it wants more care closer to home, in the community or in a primary care settings.
With an ageing female population, more specialist attention is also needed for women in later life, it says. The RCOG’s Expert Advisory Group, which undertook the review, says that focus should be on health promotion and preventive medicine rather than disease intervention.
Chair of the Expert Advisory Group, Dame Joan Higgins, said: “Women’s health services need to be planned in a way that enables integration across different levels of care, delivered in partnership between local health and social care services and the voluntary sector. This network of providers should ensure that women experience co-ordinated and appropriate care which meets their needs.
“Women will still have ready access to hospital-based care but this will be when clinical need dictates or the woman chooses to have her care delivered in this setting.”
Dr Tony Falconer, President of the RCOG added: “There is much to celebrate about the current quality and delivery of women’s health care services in the UK. The UK has declining infant, neonatal and maternal mortality rates. However, there is scope for significant improvement and an urgent need to elevate the standards of care in all parts of the UK.
“The life-course approach will ensure that at every opportunity, the health service can be there to give advice and improve a woman’s health irrespective of her situation or her social background. Adopting such an approach to delivering health care will provide women with consistent information from a young age, enabling them to make better decisions about their own health. This is an empowering document – both for women and the NHS.”