The first Women’s Health Plan for Wales was launched in December and illustrates a 10-year vision to improve healthcare services for women.
By NHS Wales
NHS Wales Women's Health Plan 2025-35
Priority 8 : Ageing Well and Long term Conditions Across the Life Course
This section presents key areas of clinical focus that have come from the National Strategic Clinical Networks and programmes within the NHS Wales Executive. They are in no means an exhaustive representation of the areas that need our attention.
They are a snapshot to outline where work is currently being delivered, where priorities for women’s health already exist, or where further attention is required. It is the intention that any unconscious bias that exists to the needs of women within health and across networks, will move to conscious questioning, purposeful collecting of data, and pro-active delivery of services.
As described in earlier sections, the Plan needs to be delivered in collaboration with the other eleven National Strategic Clinical Networks, so increasing potential opportunities for reaching as many women as possible in Wales.
To facilitate a life course approach to women’s health, Networks need to commit to:
- Disaggregation of data by deprivation, sex and gender.
- All Networks to consider their work-plans annually through a ‘women’s lens’ and ask, “what does this mean for women with … e.g. asthma/ rheumatoid arthritis etc”.
- Collaboration across networks to support training and education on women’s health.
7.8.6 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) disproportionately affects women, with recent studies indicating that approximately 75-85% of individuals are female. The impact of ME/CFS on women’s health can be profound, leading to significant physical, emotional, and social challenges.
Women with ME/CFS experience a range of symptoms that hinder their ability to participate in daily activities, maintain employment, and act as carers. People with ME/CFS are more likely to have co-morbid conditions such as Irritable Bowel Syndrome and Fibromyalgia, which also affect more women than men, and can lead to additional challenges for diagnosis and healthcare support.
The ‘Women’s Health Wales Coalition Quality Statement’ emphasises the need for equitable access to diagnosis and treatment for women experiencing ME/CFS, recognising the unique challenges they face.
By integrating this understanding into the Plan, there is an urgent need for tailored healthcare services, increased awareness, and dedicated research funding aimed at improving diagnosis, treatment, and support for women affected by ME/CFS.
MEA Comment
The fact that ME/CFS has affected more women than men, with estimates rising from 67% to the 75-85% reported here, remains a significant factor in medical prejudices against recognising the true nature of ME/CFS. The spectre of historically paternalist concepts such as neurasthenia still promote assumption for behavioural causality in the absence of defined diagnostic test results.
Getting past this obsolete orthodoxy is an important factor in realising the scope for timely and effective diagnosis, and for applying available treatment by prescribing to reduce symptoms and guiding good management, including accessing practical support.
We know that, overall, these achievable improvements should reduce the scale, and (for some or possibly many) the duration of illness. But there remains the fact that many ME/CFS patients experience a severe onset of their illness, which clashes with NHS strictures on practice, particularly in Primary Care. Suitable resourcing, from initial contact with the GP practice, needs to be applied, contrary to normal approaches to practice triage and time-limited appointments.
Ewan Dale, Trustee, ME Association
We have now met with 4 of the service development leads in Wales who are working on plans to introduce integrated services for ME/CFS and Long Covid. Each of the 7 Health Boards in Wales received additional government funding to provide an integrated specialist service in their region.
We have also met with the service lead from Pontypridd which was the first service in Wales to integrate. We will be contacting the remaining 2 regions in the New Year and hope to bring all 7 leads together – potentially with leads from England and Scotland – to share best practice and prioritise domiciliary care for the worst affected.
We have offered help to 5 ICBs in England, that have initiated service reviews and approved service integrations, and aim to work with more next year.
With Scotland announcing last week that it is also funding integrated specialist services the trend is established, and will hopefully lead to more people in the UK having access to specialist services that have adopted the NICE Guideline's clinical recommendations.
Russell Fleming, Health and Social Care Project
Further Information
- The RCGP Chair, Kamila Hawthorne, has responded to the latest report from the Women and Equalities Committee on the RCGP blog:
- HSC Bulletin: Welsh Service developments | September 17, 2024