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Women's health inquiry: anger and frustration at not enough progress being made

Baroness Julia Cumberlege has said she is angry and frustrated at the lack of progress being made after she led a critical review into how the health service treats female patients. 

During her review, she spent 2 years speaking to 700 women and their families who experienced complications linked to two drug treatments and a medical device.

The four UK governments are still considering her recommendations and say they will respond fully later this year. 

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Source: BBC News, 08 July 2021

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Women with type 2 diabetes have 60% increased chance of early death

Women in the UK with type 2 diabetes have a 60% increased risk of an early death and will live five years less than the average woman in the general population, early research suggests.

Scientists have also found that men with the disease have a 44% increased risk of dying prematurely and live 4.5 years less.

Results also suggest that smoking shortens the life expectancy of people with type 2 diabetes by 10 years, while diagnosis at a younger age cuts life expectancy by over eight years.

The findings, presented at the European Association for the Study of Diabetes in Stockholm, Sweden, are based on a cohort of nearly 12,000 patients at the Salford Royal Hospital in Salford.

“A woman with type 2 diabetes, for example, might live five years less than the average woman in the general population, while someone diagnosed at a younger age might lose eight years of life expectancy.

“It is vital that the groups at the highest risk are made aware of not just the increased risk that they face but also the size of the risk."

“Doing so may make the health advice they are given seem more relevant and so help them make changes that can improve their quality – and length – of life.”

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Source: The Independent, 21 September 2022

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Women with poor mental health ‘have 50% higher risk of preterm birth’

Women who struggle with their mental health have an almost 50% higher risk of preterm births, according to the biggest study of its kind.

The research, published on Tuesday in the Lancet Psychiatry, examined data from more than 2m pregnancies in England and found about one in 10 women who had used mental health services had a preterm birth, compared with one in 15 who did not.

The study also found a clear link between the severity of previous mental health difficulties and adverse outcomes at birth. Women who had been admitted to psychiatric hospital were almost twice as likely to have a preterm birth compared with women who had no previous contact with mental health services. And women with history of mental health difficulties faced a higher risk of giving birth to a baby that was small for its gestational age (75 per 1,000 births compared with 56 per 1,000 births).

The study recommends that when pregnant women are first assessed by doctors and midwives they should be sensitively questioned in detail about their mental health. One of the reports authors, Louise Howard, professor emerita in women’s mental health at King’s College London, said such screening would help identify “clear red flags for a possible adverse outcome”.

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Source: Guardian, 14 August 2023

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Women with chronic pain are already dismissed – new guidelines denying them painkillers are a disaster

New guidance from health officials on the treatment of chronic pain could be devastating for women already struggling to get doctors to take their pain seriously, write Sarah Graham, 

The guidelines, published last week by the National Institute for Health and Care Excellence (NICE), say that patients suffering from chronic pain that has no known underlying cause (known as chronic primary pain) should not be prescribed painkillers. Instead, it suggests, these patients should be offered exercise, antidepressants, talking therapies and acupuncture.

This has huge implications for the future treatment of anyone living with unexplained chronic pain – the majority of whom are women – and runs the risk of patients being viewed as hysterical until proven otherwise.

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Source: iNews, 7 April 2021

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Women waiting too long for abortions, health watchdog finds

Women are waiting too long for abortions, according to a major review into a leading UK provider.

The Care Quality Commission (CQC) review of the leadership at the abortion provider the British Pregnancy Advisory Service found there were “delays” in “investigating incidents”.

The remains of some pregnancies were sometimes not stored properly and there were issues were record keeping, patient monitoring and safe care, the review found.

The watchdog also noted “women did not always receive care in a timely way to meet their needs”.

The health watchdog said: “In August 2021 we found significant concerns in we found that safe care was not being provided; ineffective safeguarding processes; incomplete risk assessments were not fully completed; observations were not monitored or recorded; records were not fully completed, clear or up to date.”

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Source: The Independent, 2 June 2023

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Women wait days for induced labour in troubled maternity service

A troubled acute trust has been sent a further warning notice after inspectors found severe shortages of midwives were causing dangerous delays to labour inductions.

During one day in June, the Care Quality Commission found eight high-risk women at Blackpool Victoria Hospital had waited prolonged time periods for their labour to be induced.

They said one woman had waited five days, while another who was forced to wait more than two days despite her waters having broken on the ward. Delays to labour induction can lead to serious safety risks for mothers and babies.

The hospital’s maternity services, previously rated “good” for safety, have now been rated “inadequate” in this domain. The overall rating for maternity has dropped to “requires improvement”.

The problems were caused by severe shortages of midwives at the hospital, which had struggled to bring in agency staff due to a lack of availability in the area. However, inspectors also said there was a lack of any discussion or attention to the issues within the trust, despite the Healthcare Safety Investigation Branch previously highlighting concerns.

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Source: HSJ, 1 September 2022

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Women tell committee of being 'maimed' by mesh implant surgery

Women who underwent damaging surgery in Irish hospitals have accused health authorities of dragging them into a "nightmare" of "gaslighting, ignorance and disrespect".

Having had vaginal mesh implants, the women told an Oireachtas committee that they were "maimed" and then led on "a fool's errand" when they sought support from the HSE.

The Health Committee heard from members of Mesh Ireland and Mesh Survivors Ireland who represent around 750 women.

While the HSE said that it would be "extremely difficult" to provide accurate figures, it estimates that around 10,000 women had this surgery in Ireland.

More than one in ten have suffered complications, Dr Cliona Murphy, Clinical Lead for the National Women and Infants Health Programme, revealed.

Mary McLaughlin, Mesh Ireland, said that at one point, "I lay in bed 16 hours a day", because of the pain she was in.

She demanded dignity and respect for survivors in the face of this "global scandal".

The women are calling for access to a US-based expert in complete mesh removal, to mirror schemes in Scotland and the Canadian state of Quebec.

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Source: RTE, 29 March 2022

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Women take legal action over breast implant cancer link

Twenty UK women are taking legal action after developing a rare form of cancer linked to their breast implants. More than 50 women have been diagnosed with the same condition in the UK, and hundreds more worldwide. A top surgeon said there were gaps in implant information and people were almost being "used as guinea pigs".

One manufacturer has issued a worldwide recall of some textured implants, which have been linked to most cases of breast implant-associated lymphoma. The Medicines and Healthcare products Regulatory Agency (MHRA), which regulates medical devices in the UK, is currently collecting data on women affected by breast implant associated-anaplastic large cell lymphoma (BIA-ALCL).

Tens of thousands of breast implant surgeries are thought to take place each year in the UK, mostly in private clinics.

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Source: BBC News, 16 August 2019

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Women struggling to ‘sleep and work competently’ amid England’s HRT shortages

Women are being left unable to sleep or work competently because of the shortages of hormone replacement therapy (HRT) products used to treat symptoms of the menopause, the former cabinet minister, Caroline Nokes, has said.

Millions of women go through the menopause every year, with many experiencing symptoms that can be severe, such as low mood, anxiety, hot flushes and difficulty sleeping, and have a negative impact on everyday life. The number of prescriptions for HRT in England has doubled in the last five years to more than 500,000 a month.

But the rise in prescriptions has come amid several years of HRT shortages, with pharmacists often unable to fulfil prescriptions. Shortages have been blamed on manufacturing and supply issues, and have been exacerbated by the growing numbers of women seeking the products.

Speaking in the Commons on Thursday, Nokes, chair of the women and equalities committee, called for an urgent debate on the issue to ensure women “can get the supplies that we need”.

In October, the government announced that the cost of repeat prescriptions for HRT would be significantly reduced in England.

In the Commons on Thursday, Labour MP Nick Smith asked Spencer why there was “no date yet for the HRT prescription changes in England”. Spencer said it was “something the health secretary is looking at, at this moment in time”.

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Source: The Guardian, 21 April 2022

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Women report waiting longer for operations and appointments in pandemic

Women are being forced to wait longer for operations and healthcare appointments in the wake of the pandemic, according to a new report.

Research carried out by the Care Quality Commission, England’s regulator of health and social care, found 53% of women experienced longer waiting times for appointments or healthcare procedures during the Covid crisis.

The report also found 3 in 10 women experienced appointment cancellations.

More women report grappling with these issues than men – with some 44% of men saying they have experienced longer waiting times for appointments or procedures.

Helena Mckeown, a GP who previously specialised in women’s health at the British Medical Association (BMA), told The Independent she is not surprised by the findings.

"Our world is full of sexism and we know of other examples of sexism and biases in healthcare. Some of them are racial biases. To stop unconscious biases, they need to be recognised and addressed.

Ms Mckeown, one of the directors of the Menopause Expert Group, a non-profit which provides education about menopause, said female patients are treated differently to men.

She added: “We need to make sure we are not taking women saying they are in pain differently to men saying they are in pain. It is really important that we address this problem of women waiting longer for operations and appointments.”

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Source: The Independent, 22 January 2022

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Women needlessly having their appendix out in almost one in three cases

Women are having their appendixes removed wrongly in nearly a third of cases, British research suggests.

Researchers said too many female patients were being put under the knife when they should have undergone investigations for period pain, ovarian cysts or urinary tract infections. They said the study, which compared practices in 154 UK hospitals with those of 120 in Europe, suggests that Britain may have the highest rate of needless appendectomies in the world. 

Surgeons said they were particularly concerned by the high rates among women, with 28% of operations found to be unnecessary. 

They said the NHS was too quick to book patients in for surgery, when further scans and investigations should have been ordered. 

Researchers warned that such operations put patients at risk of complications, as well as fuelling NHS costs.

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Source: The Telegraph, 4 December 2019

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Women left in extreme pain from invasive hysteroscopy procedures hit out

Women have been left in extreme pain from an invasive procedure that’s been described as the “next big medical scandal”.

The Campaign Against Painful Hysteroscopy (CAPH) has collated more than 3000 accounts of “pain, fainting and trauma during outpatient hysteroscopy” throughout the UK – including more than 40 so far from Scotland.

CAPH said female patients are being subjected to barbaric levels of pain and claim hospitals prioritise efficiency and cost-cutting over their needs and welfare.

The group believes the issue could become as bad as the vaginal mesh scandal, which saw women left in severe pain and with life-changing side effects after being treated with polypropylene mesh implants for stress urinary incontinence and pelvic organ prolapse.

Katharine Tylko, of CAPH, said: “Severely painful outpatient hysteroscopy is the next medical scandal after vaginal mesh. Cheap, quick and easy-ish NHS outpatient hysteroscopy without anaesthesia/sedation causes severe pain/distress/trauma to approximately 25 per cent of patients.”

Margaret Cannon, from Rutherglen in Lanarkshire, told how she had an “excruciatingly painful” hysteroscopy at Stobhill Hospital in April 2020 without anaesthetic or analgesia.

She said: “I am a qualified nurse and midwife, so have good insight into how all the medical and nursing professionals failed me. I had been told to expect mild cramp and I kept thinking, ‘What’s wrong with me that I can’t tolerate the pain?’ I felt violated and assaulted.”

She felt so strongly about her experience that she complained. When she finally received a response, she said it “was dismissive and none of my points were addressed”.

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Source: Daily Record, 19 March 2023

See also our 'Painful hysteroscopy' thread in the hub Community.

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Women in UK waiting almost nine years for endometriosis diagnosis, study finds

Women are waiting nearly nine years for an endometriosis diagnosis in the UK, according to research that found health professionals often minimise or dismiss symptoms.

The study by the charity Endometriosis UK suggests waiting times for a diagnosis have significantly deteriorated in the past three years, increasing to an average of eight years and 10 months, up 10 months since 2020. In Scotland, the average diagnosis time has increased by four months.

The report, based on a survey of 4,371 people who have received a diagnosis, shows that 47% of respondents had visited their GP 10 or more times with symptoms before being diagnosed, and 70% had visited five times or more.

The chief executive of Endometriosis UK, Emma Cox, said: “Taking almost nine years to get a diagnosis of endometriosis is unacceptable. Our finding that it now takes even longer to get a diagnosis of endometriosis must be a wake-up call to decision-makers to stop minimising or ignoring the significant impact endometriosis can have on both physical and mental health.”

The report includes examples of patients’ experiences, with many being told that their pain was “normal”.

One said: “I was constantly dismissed, ignored and belittled by medical professionals telling me that my symptoms were simply due to stress and tiredness. I persevered for over 10 years desperate for help.” Another said she had been told she was “being dramatic” after going to her GP as a teenager with painful periods. Another said: “A&E nurses told me that everyone has period pain so take paracetamol and go home.”

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Source: The Guardian, 4 March 2024

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Women in UK ‘seldom’ told drug used in surgery can impede contraception

Women undergoing NHS operations are not being routinely informed that a drug commonly used in anaesthesia may make their contraception less effective, putting them at risk of an unplanned pregnancy, doctors have warned.

Administered at the end of surgery before patients wake up, sugammadex reverses the action of drugs that are given earlier in the procedure to relax the patient’s muscles. The drug is known to interact with the hormone progesterone and may reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill, combined pill, vaginal rings, implants and intra-uterine devices.

However, new research suggests that robust methods for identifying at-risk patients and informing them of the associated risk of contraceptive failures is not common practice across anaesthetic departments in the UK.

Current guidance says doctors must inform women of child-bearing age about the drug. Women taking oral hormonal contraceptives should be advised to follow the missed pill advice in the leaflet that comes with their contraceptives, and those using other types of hormonal contraceptive should be advised to use an additional non-hormonal means of contraception for seven days.

But doctors at a major London hospital trust found no record within the medical notes of relevant patients that they had been given advice on the risks of contraceptive failure due to sugammadex.

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Source: The Guardian, 2 June 2022

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Women in Scotland who require surgical mesh removal can receive free treatment in US or England

Spire Health Care in Bristol and the Mercy Hospital in Missouri have been awarded contacts by the Scottish government to perform surgical mesh removal for Scottish women, with costs for travel and surgery covered by the hospitals, the BBC reports.

Each procedure has been estimated to cost between £16,000 and £23,000, with contracts to remove the mesh outside of Scotland expected to start later in the summer. 

Marian Kenny, 62, from Glasgow has said, "It has given me and lots of other women hope - and that's not something I've had in my life for quite some time."

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Source: BBC News, 12 July 2021

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Women in psychiatric unit ‘feared for sexual safety’

Women in a newly opened psychiatric intensive care unit (PICU) had concerns for their sexual safety, a Care Quality Commission (CQC) report has revealed.

Inspectors found women in the PICU at Cygnet Health Care’s Godden Green Hospital, in Kent, were afraid to shower because male staff did not always knock before entering bedrooms and staff entered bathrooms without permission. Patients were often looked after by male staff despite having asked for a female staff member and, in some cases, had an all-male care team.

Most patients the inspectors spoke to had concerns about their sexual safety.

The CQC carried out an unannounced inspection of the PICU in October, following concerns raised by members of the public and to check concerns identified in an earlier inspection of the hospital’s child and adolescent mental health services were not organisational. 

The PICU opened in November 2019. Since the summer, Kent and Medway NHS and Social Care Partnership Trust has commissioned some of the beds, but HSJ understands it stopped admissions for a time to review the care being provided. 

Inspectors found records referred to PICU patients as “difficult” and “troublemakers” and warned a ”culture of negativity towards patients had developed among some staff”.

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Source: HSJ, 4 December 2020

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Women in low-income households are less likely to receive the health care they need

A study of 10,650 females in the UK found those with a combined household income of up to £25,000 per annum are less health literate and are less likely to attend health screenings or vaccination invitations.

In fact, 1 in 10 have never had health issues such as blood pressure or cervical cancer checked, compared to just 5% of those in a household earning more than £40,000 per annum.

15% of lower earners said they didn’t take up offers of preventative healthcare because they felt it was not needed.

They are also the least able to talk to and understand healthcare professionals (72% compared to 81% of high-income households) and least likely to know where to access health information (79% compared to 89% of high-income households).

Although 75% feel informed about what is needed to be healthy, this rises to 88% of those in high-income households.

It also emerged 30% of low earners who experience daily pain, such as joint pain, backaches or headaches, have stopped work completely as a result, compared to just 10% of high-income households.

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Source: The Independent, 24 January 2023

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Women in labour being refused epidurals, official inquiry finds

Women in labour are being refused epidurals in breach of official guidelines, a government inquiry has found.

In findings reported by the Guardian, an investigation by the Department of Health and Social Care also found that women may not be being kept fully informed that if they choose to give birth at home or in a midwife-led unit they may have to be transferred if they want an epidural. Failing to make women aware of that possibility would also be in breach of National Institute for Health and Care Excellence (NICE) guidelines.

As a result of the inquiry, the Health Minister Nadine Dorries will write to all heads and directors of midwifery and medical directors at NHS trusts this week to remind them of the NICE guidance regarding pain relief during childbirth and to ensure it is being followed.

Clare Murphy, Director of external affairs at the British Pregnancy Advisory Service, said the “results of the government’s inquiry are sadly not surprising”. She added: “We have spoken with many women who have been so traumatised by their experience of childbirth that they are considering ending what would otherwise be wanted pregnancies. Pain relief is sometimes treated as a ‘nice extra’ rather than an integral part of maternity care, and women and their families can suffer profoundly as a result."

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Source: Guardian, 3 March 2020

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Women in healthcare sector earn 24% less than men, international report finds

Women working in healthcare earn on average 24% less than their male peers and face a larger gender pay gap than in other economic sectors, a joint report by the International Labour Organization and the World Health Organization has found.

The analysis, which looked at data from 54 countries across all geographic and income regions, found a raw gender pay gap of around 20%, which jumped to 24% when factors such as age, education, and working time were considered. Gender pay gaps also tended to be wider in higher pay categories, where men were over-represented, while women were over-represented in the lower pay categories.

The authors said the findings highlighted that women, who accounted for 67% of the global health and care workforce in 2020, were underpaid and undervalued.

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Source: BMJ, 13 July 2022

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Women have struggled to get help with the menopause for decades but it’s about to change

HRT used to be a dirty word. Now it’s a battle cry. Women will begathering in Parliament Square in London later this month to support the menopause bill to demand free prescriptions for hormone replacement therapy in England. The bill could help thousands more women to access this life-changing treatment and will put the menopause under the microscope.

For years, a combination of medical sexism, hysterical reporting and outdated science has held women back from asking for the health care they need. HRT replenishes the oestrogen, progesterone (and sometimes testosterone) that women lose when having the menopause. As a result of previous misleading reports linking the treatment to a risk of breast cancer and dementia, HRT has long been considered controversial.

Last week, however, a BMJ paper studying more than 100,000 HRT users over two decades in the UK found that there was no overall association between hormone replacement and an increased risk of developing dementia. Meanwhile, the science lumping the many different types of HRT together in one “causes-breast-cancer” basket is being questioned by menopause experts.

A sexist, ageist culture has kept the menopause – and the stigma associated with it – hidden for decades. In a TUC survey of 4,000 women, 85% said the menopause affected their working life. Many women have lost their health, jobs, relationships and even their lives at the time of their menopause, when rates of suicide peak.

But now, Labour MP Carolyn Harris is pushing the second reading of her menopause bill through parliament later this month. Aside from making HRT free in England (it’s already free in Scotland and Wales), the bill will also cover broader issues around menopause rights and education, particularly in the workplace.

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Source: The Guardian, 6 October 2021

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Women giving birth at under fire maternity unit left alone with unsupervised workers, NHS watchdog finds

Women in labour at a London maternity unit deemed “inadequate” were left alone with unsupervised support workers who were not given any guidance, an NHS safety watchdog has found.

In a scathing report of North Middlesex Hospital’s maternity services, the Care Quality Commission also found examples of delays to induction of birth for women, and one case of a woman with a still-born baby who was left waiting for the unit to call her in for an induction.

Inspectors have downgraded the maternity unit from “good” to the lowest possible rating “inadequate” following an inspection earlier this year.

Staff reportedly told inspectors they felt they were “criticised” or “bullied” when reporting safety incidents within the unit.

“We heard that the criticism or bullying was worse if the incident reported was relative to other staff and their perceived behaviours,” the report said.

There was also evidence the hospital was not recording the severity of safety incidents correctly for example two “never events”, which are among the highest category incidents, were categorised as “low harm”.

Other findings included women and babies came to harm as the hospitals did not follow standards to language interpretation despite covering a higher than average minority ethnic population.

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Source: The Independent, 11 December 2023

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Women forced to wait more than five times ‘longer than men for heart failure diagnosis’

Women are forced to wait more than five times longer than men for a heart failure diagnosis, a new study has found.

Researchers discovered women are 96 per cent more likely to get an incorrect diagnosis of heart failure than men – attributing sharp disparities to such problems being wrongly viewed as “a man’s disease”.

The study, conducted by leading heart failure charity the Pumping Marvellous Foundation, found men said they waited an average of just over three and a half weeks to get a formal diagnosis after their first GP visit, but women waited just over 20 weeks instead.

Researchers warned such delays were linked to “poorer quality of life, financial losses, mental health issues and avoidable deaths” – adding that health professionals do not give heart failure the same attention and gravity as cancer and other diseases.

"One of them [GP] actually said, your symptoms are probably not to do with your heart because you’re young and you’re female. Even though my father had a heart condition," says Sarah, who was diagnosed at the age of 42.

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Source: The Independent, 27 August 2020

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Women feel ‘violated and traumatised’ by painful hysteroscopies – and say the NHS misinformed them

Caroline remembers screaming. It was like an electric shock which went from her neck to her toes. It was like being tasered in her most intimate area. She could not move because she was scared. She called out to the doctor to stop.

“I can’t believe what happened to me was done in an NHS hospital,” Caroline, 56, says. “I feel that if they were wearing black balaclavas it would have suited what I experienced more. I felt like I was subjected to a very violent assault. That is the trauma that I’m dealing with now.”

Caroline is one of thousands of women who have faced excruciating pain when undergoing a hysteroscopy, a medical procedure used to examine inside the womb, where biopsies may be taken. It is used to detect cancer, pre-cancer and other benign abnormalities.

One in three women face severe pain during a hysteroscopy – rating it at least seven out of 10 – according to the Royal College of Obstetricians and Gynaecologists. That means thousands of women in the UK could be left traumatised by this medical procedure each year.

Campaigners believe the NHS is failing to properly inform patients of the pain they may endure. The NHS website describes it as a “simple” and “relatively quick” procedure which is “not usually carried out under anaesthetic”.

But women who have spoken to The Big Issue describe feeling “violated” during a hysteroscopy. They believe they were unable to give “informed consent” and some have been left with long-term physical and psychological trauma.

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Source: The Big Issue, 18 January 2024

Related reading on the hub:

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Women died after ‘gross failings’ by scandal hit mental health trust

A young woman died following “gross failings” and “neglect” by a mental health hospital in Essex which is also facing a major independent inquiry into patient deaths.

Bethany Lilley, 28, died on 16 January whilst she was an inpatient at Basildon Mental Health unit, run by Essex Partnership University Hospitals.

The inquest examined the circumstances of her death this week and concluded that her death was contributed by neglect due to a “plethora of failings by Essex University Partnership Trust”.

Following the three week inquest, heard before coroner Sean Horstead, a jury found “neglect” contributed to Ms Lilley’s death and identified “gross failures” on behalf of the trust.

The jury identified a number of failings in her care including evidence that cocaine had made its way onto a ward where she was an inpatient.

There was evidence of “very considerable problems in the record-keeping at EPUT psychiatric units.”

It was also concluded staff failed to carry out a risk assessment of Ms Lilley in the days leading up to her death, and failed to carry out observations.

Ms Lilley’s death is one of a series of patients who have died under the care of mental health services in Essex, which have been brought into the light following the campaigning of bereaved families.

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Source: The Independent, 19 March 2022

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Women bear brunt of Covid-related work stress, UK study finds

Women are being disproportionately affected by a rise in mental health problems caused by increasing workloads as people do their jobs from home amid the pandemic.

The length of the working day has increased steadily, resulting in a 49% rise in mental distress reported by employees when compared with 2017-19. Women are bearing the brunt of problems as they juggle work and childcare, according to a report by the 4 Day Week campaign and thinktanks Compass and Autonomy.

The report, Burnout Britain, cshows that women are 43% more likely to have increased their hours beyond a standard working week than men, and for those with children, this was even more clearly associated with mental health problems: 86% of women who are carrying out a standard working week alongside childcare, which is more than or equivalent to the UK average, experienced problems in April this year.

The report warns that “as well as an impending recession and mass unemployment, we are heading into an unprecedented mental health crisis”.

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Source: The Guardian, 9 October 2020

 

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