Women's health plan: interim progress update 2023

Contraception, abortion, sexual health and pre-pregnancy

Abortion

The Scottish Government is continuing to focus on the commitments to improve access to abortion care as set out in the Plan.

• We are continuing to support Gillian Mackay MSP with her legislation to introduce safe access zones around premises that provide abortion services, with the consultation analysis and final Bill proposal being published on 15 June 2023. We are working to ensure the legislation can be considered by the Scottish Parliament as soon as possible.
• The evaluation into the safety and efficacy of Early Medical Abortion at Home (EMAH) was published on 22 March this year. The evaluation concluded that EMAH is highly effective, and showed no indication of any concerning changes to the low levels of complication seen compared with the arrangements pre-March 2020. Based on this, the previous Minister for Public Health, Women’s Health and Sport confirmed that the current arrangements would remain in place, allowing women to continue taking both sets of abortion pills at home when clinically appropriate. The Scottish Government is now taking forward work with NHS Boards to consider how best to take forward the recommendations made in the evaluation to improve EMAH care across Scotland.
• In January 2023, the Scottish Government formally commissioned National Services Division (NSD) (which is part of NHS National Services Scotland) to develop a specification to provide a service for abortions up to 24 weeks gestation to be provided within Scotland, to ensure that women can access all forms of abortion services as locally as possible. In the meantime, and where an NHS Board cannot offer abortion services up to 24 weeks’ gestation locally, they must work to provide an appropriate and person-centred care pathway for all patients seeking abortions up to the legal limit.

Contraception

• A Long-Acting Reversible Contraception (LARC) Short Life Working Group, chaired by Professor Anna Glasier, has been established. The group brings together experts from across Scotland to share knowledge and experience and to identify and take forward actions to address the current challenges in access to longer acting methods of contraception. The Group, which meets on a quarterly basis and reports to the Women’s Health Plan Implementation Programme Board, has already identified examples of innovative and effective practice across Scotland.

Spotlight: NHS Dumfries and Galloway Supporting ‘Seldom Heard’ Women

Sexual health practitioners have been supporting work in NHS Dumfries and Galloway to meet the health needs of their ‘seldom heard’ women. The group supports women from a range of different backgrounds including those experiencing homelessness, mental health issues or who are refugees, as well as those from minority ethnic backgrounds or who are care-experienced.

The group provides women with information on methods of contraception, menstrual health conditions and sexual health screening. Local outreach clinics are also held by a nurse practitioner, including clinics for homeless women in local housing support services, and most recently visiting Ukrainian Refugees in their temporary accommodation to better identify their health needs. To compliment this work, training sessions are delivered to support education and training of primary care colleagues and health practitioners.

Spotlight: NHS Highland Sexual Health Young Person's Service

In response to the pandemic, when many health services could not be provided face to face, the NHS Highland Sexual Health team were keen to ensure that young people in their local area could still access the service and receive the necessary support.

The concept of a ‘live chat’ was introduced as an innovative way of reaching out to young people during this challenging time and had the added benefit of improving access to sexual health services for the many young people who live in the remote and rural areas across NHS Highland.

Since the introduction of the ‘chat’ service two years ago, the number of young people using sexual health services has increased by 300%, with 80% of Live Chat users going on to make an appointment. The feedback from the people using the service has been really positive and many have found the service to be both accessible and informative.

Post-Partum Contraception

• The Scottish Postpartum Contraception Network, has been working to make post-partum contraception available to women across Scotland. In March 2023, the Network hosted their 2nd Scottish Postpartum Contraception Conference, supported by the Scottish Government. The former Minister for Women’s Health, Ms Maree Todd MSP, and Professor Glasier were key speakers at the event, and had the opportunity to hear first-hand about innovations and examples of best practice.
• A new post-partum contraception animation has been created by NHS Lothian in collaboration with service users and healthcare professionals. Providing information on getting an IUD or coil fitted after having a baby, this animation provides more information to help women make an informed decision on contraception options after giving birth and sits alongside the animation on post-partum contraception options, which is now on NHS Inform.
• Training has been developed to support NHS staff to provide information to women on postpartum contraception and its benefits, as well as practical guidance on postpartum coil insertion. As part of this work, national webinars have been held, giving NHS Scotland staff the opportunity to learn about the clinical aspects of postpartum contraception.
• Onsite visits are also being undertaken, where representatives from the network visit NHS Boards to support staff training. Empowering staff to feel confident in their knowledge and practical skills will play a key role in improving access to contraception after childbirth and supporting women to make informed choices around contraception as part of their birth plan.