International Women’s Day: Accelerating progress in improving women’s health in England

Author:

Márcia Costa

In 2022, the then Conservative government published the first Women’s Health Strategy for England acknowledging that women have been underdiagnosed, undertreated, and underserved in healthcare, with systems designed ‘for men by men’. This 10-year Strategy, was aimed at tackling the gender health gap, and set out ‘bold ambitions to tackle deep-rooted, systemic issues within the health and care system, improve the health and wellbeing of women, and reset how the health and care system listens to women’.ⁱ In commemoration of this year’s International Women’s Day (IWD) on 8^th March 2025 and its campaign #AccelerateActionⁱⁱ, our blog explores progress in reducing gender health inequalities and current position on prioritising women’s health.

International Women's Day 2025 is a time to reflect on women's healthcare in England

IWD provides an opportunity for collective global activism and celebration. While IWD highlights both progress and setbacks, at the current rate of progress, according to the World Economic Forum it will take until 2158, some five generations from now, to reach full gender parity. Hence the campaign to Accelerate Action calls for increased momentum and urgency in addressing the systemic barriers and biases that women face, both in personal and professional spheres.ⁱⁱⁱ

When it comes to women’s health, gender inequalities in some areas appear to be growing. Here in the UK, on the eve of IWD, the Royal College of Obstetricians and Gynaecologists (RCOG) and 48 other women’s health charities and organisations, published the results of a survey that revealed that just five per cent of women believe the UK is treating women's health as a priority and only 36 per cent found it easy or very easy to access women’s health services.^iv The RCOG called for a commitment to implement crucial actions needed to tackle underinvestment in women’s healthcare. It also recognised that the government is operating in a challenging fiscal context but highlighted various sources of evidence that investment in women’s health makes economic sense. In particular:

while there is a complex landscape of commissioning women’s health services, a national study of the benefit-cost ratio found that on average every £1 spent on women's health hubs, there are estimated to be £5 worth of benefits to both patients and the NHS (the worst- and best-case scenarios were £2 and £13 respectively)^v,vi
the NHS Confederation analysis of return-on-investment in October 2024, estimates that every additional £1 of public investment in obstetrics and gynaecology services per woman in England could deliver a return on investment of £11 (generating an estimated £319 million in total gross value added to the economy). It emphasises that the excessive costs to the economy of women being unable to work due to a range of women’s health conditions and that although addressing existing inequalities will require an initial investment, this expense is relatively modest compared to the growing costs incurred by both the NHS and wider society as direct consequence of continuing to neglect the health outcomes of women.^vii

The NHS and progress on the Women’s Health Strategy

The NHS workforce is predominantly female (75.7 per cent of NHS staff are female) meaning the NHS has a crucial role in improving the health of its own workforce and in improving women’s health in an equitable and sustainable way. In July 2022, the NHS welcomed the seminal Women's Health Strategy. The ambition was to improve the health of its own staff but also improve access to equitable healthcare for women seeking help and support from the NHS. While there has been no formal evaluation of progress, various milestones include:

appointing a first ever Women’s Health Ambassador to drive system-level changes to close the gender health gap and in 2024, the first ever national clinical director for women’s health was appointed to support with the implementation of the strategy^viii,ix
providing access to information to help women navigate a fragmented health service has been improved including the creation of dedicated area on the NHS website bringing together more than 100 topics on women’s health, a new tool to access information about NHS-funded IVF treatment in each region, and a new hormone replacement therapy (HRT) hub^x
enabling improved access to cheaper HRT, with a new prescription prepayment certificate introduced in 2023, which reduced prescription costs to £19.30 per year and for eligible HRT items^xi
introducing the NHS Pharmacy Contraception Service offering more choices and removing some of the barriers to access contraception^xii
implementing a new AI-enabled breast cancer diagnosis trial of some 700,000 women in England, backed by £11 million of government support^xiii
providing £25 million government funding for each Integrated Care Board (ICB) to invest in dedicated women's health hubs to improve access to services and reduce gynaecology waiting times^xiv.

The role of women’s health hubs in prioritising improvements in women’s health

This latter initiative on women’s health hubs brings together healthcare professionals and existing services to provide integrated women’s health services in the community, meeting women’s needs across the life course. These hubs don’t have be in a building or a specific place, but can deploy digital resources to provide virtual consultations, or alternatively make use of existing facilities like GP surgeries or community centres. The intention being to improve access to and experiences of care, improve health outcomes, and reduce health inequalities.^xv

In addition to the economic analysis mentioned above, a government cost-benefit analysis, published in March 2024, found that if one hub was created in each primary care network, the net central value would be of £7.3 billion over the 10-year period of the strategy.^xvi On 22 April 2024, NHS England wrote to Integrated Care Boards (ICBs) chief executives and chairs outlining guidance on women’s health hubs and an expectation that at least 75 per cent of ICBs should have a hub in place by July 2024 and by December 2024 every ICB should have at least one hub meeting all core services.^xvii By the end of 2024, 36 ICBs (of 42) had at least one hub.^xviii

In many ways the creation of women’s health hubs is a prime way of achieving the governments three shifts (moving care from hospitals to the community, embracing digital transformation, and shifting from treatment to prevention).^xix However, in the January 2025 NHS Planning Guidance for 2025–26 there was no mention of women’s health hubs, raising concerns from numerous stakeholders that the priority given to reducing gender inequalities in health would be undermined. In March 2025, in its response to the Women and Equalities Committee’s first report of session 2024 to 2025 on women’s reproductive health, the government stated that it ‘remains committed to improving women’s health and are working with NHS England on how to take forward the Women’s Health Strategy for England by aligning it to the missions and forthcoming 10 Year Health’. It also responded that it was committed to moving towards a neighbourhood health service, with more care delivered in local communities, and that ‘women’s health hubs are an example of this approach and can play a key role in delivering the government’s manifesto commitments on tackling long NHS waiting lists, as well as shifting care into the community’.^xx

Conclusion

IWD is a time to reflect on the progress made and actions needed to improve equality in life outcomes for women. Our personal view is that unless women’s health challenges are understood, prioritised, and tackled equitably, then other aspects of women’s lives will always be playing catch up. As noted in our previous blogs on IWD and England’s first Women’s Health strategy, the gender health gap has had profound and wide-ranging impacts for generations of women. While the seminal Women’s Health Strategy was a pivotal moment in raising awareness and identifying the priorities needed to improve women’s health. However, like all strategies changes will take time to implement effectively. While there have been improvements at the micro level, at the macros level health inequalities persist or have even worsened. To ‘Accelerate action’, it is crucial that progress is monitored and evaluated, and that political commitment is sustained to ensure women have equitable access to evidence-based interventions and don’t fall through the cracks.