{"id":50253,"date":"2021-05-13T12:52:11","date_gmt":"2021-05-13T11:52:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50253"},"modified":"2021-05-13T12:52:24","modified_gmt":"2021-05-13T11:52:24","slug":"placing-womens-voices-at-the-centre-of-their-care","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/13\/placing-womens-voices-at-the-centre-of-their-care\/","title":{"rendered":"Placing women\u2019s voices at the centre of their care"},"content":{"rendered":"

It is very encouraging to see the UK government <\/span>announcing its intention to develop a Women’s Health Strategy<\/span><\/a>. Anyone who doubts the need for this just has to look back over the last year in the life of the NHS.<\/span><\/p>\n

2020 is thought of as the year of covid-19. But it was also a year that saw a succession of large scale avoidable harm scandals\u2014all affecting women.<\/span><\/p>\n

In February 2020, the Paterson Inquiry<\/a> reported on the criminal activities of Ian Paterson, who performed unnecessary breast surgery on thousands of women. In the same month, Bill Kirkup, who led the investigation into deaths in maternity services at <\/span>Morecambe Bay<\/span><\/a>, was appointed to carry out an <\/span>independent review<\/span><\/a> into avoidable harm in East Kent Hospitals’ maternity services.<\/span><\/p>\n

In July 2020, the <\/span>Cumberlege review<\/span><\/a> of medicines and medical devices described the “anguish, suffering and ruined lives” of thousands of women affected by treatments including pelvic mesh.\u00a0 And in December 2020, Donna Ockenden’s <\/a><\/span>Emerging Findings<\/span> report began to lift the lid on 1,862 reported cases of avoidable harm and death in maternity services at Shrewsbury and Telford.\u00a0\u00a0<\/span><\/p>\n

These harms were avoidable because the providers knew about them. Patients and bereaved relatives had been speaking up\u2014sometimes for years. But no one had wanted to hear them.<\/span><\/p>\n

Men have been affected too\u2014for example as fathers and birth partners in the case of the maternity deaths. And in the aftermath of the harms inflicted by Paterson, and those described by Cumberlege, many husbands and partners have had to become carers.<\/span><\/p>\n

The fact remains, though, that the brunt of the harm has been borne by women.\u00a0\u00a0<\/span><\/p>\n

Women’s voices at the centre<\/b><\/p>\n

A consultation is now open via a <\/span>call for evidence<\/span><\/a> which lists six core themes, the first of which is “Placing women\u2019s voices at the centre of their health and care.” This is undoubtedly the most important, given the disasters listed above. But how do we place women’s voices at the centre of their care?<\/span><\/p>\n

Baroness Cumberlege described the women who contributed to her <\/span>First Do No Harm<\/span><\/a> report as “\u2026well informed, knowledgeable, and research based. They never failed to ensure we learnt from them and were up to date with emerging developments. They are outstanding communicators and expert in the subject matter.”<\/span><\/p>\n

Evidently, the problem is not with women not speaking up, but with the healthcare system not being willing or able to listen.<\/span><\/p>\n

Opening the ears of our healthcare system<\/b><\/p>\n

The NHS\u2014from the Long Term Plan downwards\u2014describes itself as “person-centred” and “evidence-based.”\u00a0\u00a0<\/span><\/p>\n

A healthcare system that wants to be both person-centred and evidence-based has to have a really good evidence base for patient experience. Alongside that, it needs a professional learning infrastructure to help translate the evidence into practice.\u00a0 In these areas, the NHS is sadly lacking.<\/span><\/p>\n