Agenda item

 

This item is to receive a report and presentation in relation to the formation and work of the Rotherham Women’s Health Network.

 

This item was to receive a report and presentation in relation to the formation and work of the Rotherham Women’s Health Network.

 

The Chair welcomed Nazreen Iqbal, Healthy Hospital Programme Manager at The Rotherham NHS Foundation Trust (TRFT), Linda Strettle, GP Partner at the Village Surgery and Radhika Gosakan, Consultant Obstetrician and Gynaecologist at TRFT to the meeting and invited them to introduce the presentation.

 

The Healthy Hospital Programme Manager outlined the background to the establishment, development, and early outputs of the Rotherham Women’s Health Network (RWHN),  and provided an overview of the national policy context and an analysis of local service pressures and population health need  via presentation.

 

Members were advised that the RWHN had been established in August 2025 as an organically developed, place-based partnership comprising female professionals from a wide range of sectors, including acute and primary healthcare, public health, the voluntary and community sector, and patient representation bodies such as Healthwatch.

 

It was emphasised that the Network had not been formally commissioned, nor formed part of any existing organisational structure, but had instead emerged as a result of shared professional concern that women’s health lacked both  coherent strategic focus and sufficient representation within local decision-making arrangements. The Network therefore sought to provide a collaborative forum through which partners could align priorities, share intelligence, and advocate for a more equitable and coordinated approach to women’s health.

 

The Commission was informed that the core purpose of the Network had been to address health inequalities affecting women and girls in Rotherham, with a particular emphasis on ensuring that lived experience informed service design and delivery. In its initial period of operation, the Network had achieved a number of early outcomes, including establishing cross-system relationships, improving communication between partner organisations, and increasing the visibility of women’s health issues within local forums and decision-making processes.

 

It was further reported that the Network had begun to undertake a preliminary health needs assessment, drawing on available data and stakeholder insight to develop a clearer baseline understanding of women’s health outcomes and inequalities within the borough. Although this work remained in progress, it had already begun to highlight a number of significant challenges requiring system-wide attention.

 

In setting the local context, the Healthy Hospital Programme Manager outlined the relevance of the national Women’s Health Strategy for England (initially published in 2022 and subsequently refreshed), which had, for the first time, provided a comprehensive assessment of women’s experiences across the health and care system. The Commission was advised that the Strategy had been informed by extensive national consultation and had identified consistent themes of women feeling unheard, dismissed, or inadequately supported when seeking care. Structural issues highlighted included fragmentation of services, prolonged diagnostic pathways, and insufficient inclusion of women in clinical research, all of which had contributed to inequitable outcomes. Whilst progress had been noted in certain areas, such as improved access to emergency contraception through community pharmacies, the development of digital care pathways relating to menopause and menstrual health, and a commitment from national research bodies to ensure sex-based inclusion in funded studies, it was stressed that many of the systemic barriers identified in the original Strategy persisted.

 

Particular attention was drawn to a number of clinical areas where inequalities remained pronounced. For example, the Commission noted that the average diagnostic delay for endometriosis was approximately nine years, illustrating the challenges faced by women in accessing timely investigation and treatment. Similarly, differences in the presentation and recognition of cardiovascular disease in women were reported to contribute to poorer outcomes, while persistent inequalities in maternity care, particularly affecting women from Black and South Asian backgrounds, continued to raise significant concern.

 

The Healthy Hospital Programme Manager also highlighted issues relating to menstrual health and gynaecological conditions more broadly, noting ongoing parliamentary scrutiny and national reviews in these areas. Although a refreshed national strategy had introduced a wide-ranging programme of actions, the absence of a detailed delivery plan and ring-fenced funding was identified as a significant risk to effective implementation at a local level.

 

The Commission’s attention was drawn to a series of local population health indicators which illustrated the scale of the challenge in Rotherham. It was reported that, whilst overall female life expectancy stood at approximately 81.7 years, women spent an average of 25.2 years in poor health, equating to around 31% of their lifespan.

 

Furthermore, healthy life expectancy had declined markedly over the preceding decade, falling from 58.5 years to 51.1 years. In later life, women in Rotherham experienced fewer years free from disability compared to the national average, with those aged 65 expected to spend approximately seven years in good health, compared to around ten years across England. These figures were presented as evidence of a widening gap not only in longevity, but in the quality of life experienced by women locally.

 

Wider determinants of health were also considered, and the Commission heard that women in Rotherham were disproportionately affected by socioeconomic pressures, including housing instability, financial insecurity, and food poverty. In particular, it was highlighted that 84% of lone parent households were female, increasing their exposure to economic vulnerability. Additionally, higher rates of chronic pain were reported among women compared to men, further contributing to reduced quality of life and increased demand for health services. These factors were considered interconnected drivers of inequality, reinforcing the need for a holistic, cross-sector approach.

 

To illustrate the lived experience underpinning the data, the Commission received a case study concerning a Rotherham woman who had engaged with local services via Healthwatch. The case demonstrated a recurring theme identified through the Network’s engagement work, namely that women frequently felt their concerns were not fully heard or taken seriously within healthcare interactions. In this instance, the individual had also faced additional barriers linked to language and cultural differences, which had compounded difficulties in accessing appropriate care. The consequences were both clinical and socioeconomic, including deterioration in health, impact on mental wellbeing, and eventual loss of employment. It was noted that such experiences were not isolated, but reflective of broader systemic issues highlighted locally and nationally.

 

The GP Partner outlined a section of the presentation  which detailed findings from a local audit of gynaecology referrals, undertaken to better understand patient flow and service demand. This analysis had reviewed consecutive referrals over a one-year period. It was reported that urgent suspected cancer referrals were being managed effectively, with patients seen promptly in line with national targets and a relatively high proportion of referrals resulting in confirmed diagnoses, indicating appropriate clinical thresholds for referral. Urgent non-cancer referrals were also processed within reasonable timescales, typically within two months. However, significant delays were identified in relation to routine referrals, where waiting times were substantially longer, with some patients waiting an average of 253 days for initial consultation. These delays were attributed to system-wide pressures, including workforce challenges and high levels of demand, rather than deficiencies in individual clinical performance. The audit further demonstrated that a considerable proportion of patients referred routinely required ongoing specialist input, with only a small percentage discharged after an initial appointment.

 

Importantly, the audit identified a cohort of patients whose needs could potentially have been met outside of secondary care, particularly in relation to menopause management, menstrual disorders, and certain types of pelvic pain. It was suggested that the development of intermediate, community-based services, commonly referred to as women’s health hubs, could enable more timely access to care while reducing pressure on hospital services. Evidence from comparator areas, including Oxford and Sheffield, was presented to demonstrate the potential effectiveness and impact of such models.

 

In these areas, referral triage systems and integrated primary and secondary care services had enabled a significant proportion of patients, up to 50% in some cases, to be managed without requiring hospital-based intervention. The absence of an equivalent model within Rotherham was noted, alongside concerns regarding inconsistency of provision across the wider South Yorkshire Integrated Care System footprint.

 

The GP Partner also highlighted a number of operational challenges within existing pathways, including variability in referral quality and evidence that some patients had not undergone appropriate preliminary investigations prior to referral. This was linked, in part, to limitations in interoperability between primary and secondary care IT systems, as well as potential gaps in clinical guidance and education. Opportunities were therefore identified to improve pathway efficiency through enhanced communication, education for primary care practitioners, and the introduction of triage or advisory functions within referral processes.

 

In concluding, The Healthy Hospital Programme Manager reiterated the Network’s support for the national strategic direction of travel but emphasised that, without clear delivery mechanisms and dedicated resources, the ambition for improved women’s health outcomes risked remaining unrealised. They stressed the importance of collective leadership across the local system, involving the Council, NHS partners, and the voluntary sector, in order to translate national policy into meaningful local change. They described the  Rotherham Women’s Health Network as an emerging vehicle through which such collaboration could be facilitated but acknowledged that its longer-term role, governance arrangements, and resourcing remained to be defined. The Commission was invited to note the report, the progress made to date and the significant challenges that remained, particularly the risk that, in the absence of coordinated action, existing inequalities in women’s health would persist or widen further.

 

The Chair thanked the Rotherham Women’s Health Network for their insightful report and presentation, and invited questions and comments from members.

 

Councillor Harrison wanted to understand whether any funding had been secured locally in the absence of ring-fenced national funding, and what risks existed to both the Network’s priorities and sustainability given its reliance on voluntary participation.

 

The Healthy Hospital Programme Manager advised that, although no dedicated funding had been secured, there had been encouraging strong engagement from system partners, including the Rotherham Place Board, which had shown interest in the RWHN’s work and had committed to incorporating women’s health within its planning. They further reported that the Council’s Public Health team had offered administrative support. However, it was acknowledged that much of the work continued to rely on individuals contributing beyond their core roles, and cautioned that, without additional resource, the momentum and impact of the Network could not be sustained at scale. The GP Partner reinforced this concern, noting competing clinical and organisational responsibilities within primary care, and emphasised the need to access emerging funding opportunities to support future delivery.

 

Councillor Harrison also queried, given that one of the recommendations of the report provided was the establishment of a women’s health hub, what the business case, funding model, and timeline were for establishing such a facility, and how equitable access would be ensured, particularly for those in rural locations or with transport barriers.

 

The GP partner confirmed that no formal business case or secured funding model currently existed and that financial constraints across the NHS presented a significant challenge to developing such a facility. They referenced examples from other areas, particularly Oxford, where hub services were distributed across communities to maximise accessibility. The  Consultant Obstetrician and Gynaecologist added that the development of a business case and identification of funding sources would be essential next steps if the model were to progress and achieve sustainability in the long term.

 

Councillor Fisher wanted to understand how commitments made at Place Board level would be translated into tangible system-wide improvements rather than isolated actions.

 

The Healthy Hospital Programme Manager explained that, whilst the Network remained at an early stage, it had already succeeded in convening key partners across the system. The GP Partner emphasised that the intended system-wide improvement lay in placing women at the centre of care, enabling earlier intervention and reducing lengthy waits. They also highlighted frustration amongst primary care clinicians where patients could not be progressed through the system efficiently, suggesting that improved integration, potentially through a hub model, would strengthen communication and service delivery across organisational boundaries.

 

Councillor Fisher also queried how variation in referral quality and pre-referral testing in primary care would be addressed, and what underlying drivers of inconsistency had been identified. Councillor Fisher noted that a postcode lottery had been observed in relation to access to Long Acting Reversible Contraception (LARC) options within the Access to Contraception Review, and wanted to understand whether there was the potential to engineer this out through collaborative service design at local level.

 

The GP Partner outlined plans to improve education and standardisation through regular training sessions for general practitioners. They also described proposals for structured referral templates to ensure that appropriate investigations were undertaken prior to referral. Additional initiatives, including a potential local women’s health conference and broader stakeholder engagement, were identified as opportunities to improve shared understanding and reduce variation in care, thereby promoting greater equity.

 

Councillor Harper asked whether there was sufficient intelligence at this early stage to identify gaps in outcomes relating to ethnicity, deprivation, or other inequalities, particularly given the anticipated abolition of Healthwatch.

 

The Healthwatch Rotherham Manager, Kym Gleeson, responded that analysis of relevant data was ongoing and that findings would be reported to the Rotherham Women’s Health Network in due course.

 

Councillor Harper asked how the Network was addressing wider determinants of health, and whether it had established links with other Council Services that were able to provide support and assistance around the wider determinants of health.

 

The Healthy Hospital Programme Manager confirmed that the Network recognised that women’s health outcomes were intrinsically linked to broader socioeconomic factors, including housing, employment, and childcare, and that discussions were already taking place with Public Health colleagues and other partners to ensure a coordinated, system-wide response.

 

Councillor Thorp sought clarity regarding the described model operating in Sheffield.  They questioned whether reduced referrals might result in patients receiving less care in practice.

 

The GP Partner explained that the Sheffield model involved triaging referrals and providing advice back to General Practitioners where appropriate, ensuring that patients were seen by the most suitable clinician without unnecessary delay. They stated that evidence suggested this approach had reduced unnecessary referrals without negatively impacting patient outcomes, but acknowledged that ongoing evaluation would be required.

 

Councillor Thorp probed referral and discharge data, and asked whether the intention of proposed changes was to reduce the number of patients reaching consultant appointments unnecessarily.

 

In response, the GP Partner explained that some discharges were unavoidable due to national referral requirements, particularly for suspected cancer pathways. However, they noted that delays and inefficiencies could arise where patients attended specialist appointments without having undergone appropriate initial investigations. The  Consultant Obstetrician and Gynaecologist added that work was ongoing within the Trust to improve referral pathways and outpatient performance, whilst also highlighting the importance of encouraging earlier patient presentation through public health interventions.

 

Councillor Thorp also raised concerns about the potential loss of Healthwatch and the implications for patient insight. The Healthy Hospital Programme Manager acknowledged the value of Healthwatch in capturing lived experiences and confirmed that the Network would continue to advocate for its role, while also exploring alternative data sources across NHS services and research functions. The Managing Director of TRFT (The Rotherham NHS Foundation Trust) reinforced this point, emphasising that Healthwatch provided a unique and valuable perspective that complemented formal service data.

 

Councillor Thorp asked which single recommendation of the four referred to in the RWHN’s report would be most critical if only one could be progressed.

 

The GP Partner stated that the establishment of a women’s health hub would have the greatest impact, citing strong support from General Practitioners and evidence from other areas that such models improved access, patient empowerment, and system efficiency.

 

Councillor Yasseen provided a reflective contribution rather than a direct question, highlighting the scale of women’s health inequalities and the historical underrepresentation of such issues. They welcomed the report as a compelling case for action and emphasised the importance of political advocacy, partnership working, and practical support, including the potential development of a conference to bring together stakeholders and expertise.

 

The presenters collectively expressed appreciation for this support and reiterated the importance of collective action to progress the agenda.

 

A question submitted by Councillor Clarke relating to food insecurity was then raised in their absence by the Chair.  They queried how the issue manifested locally and what actions were being taken in response.

 

The Healthy Hospital Programme Manager explained that food insecurity was a recognised public health issue addressed through existing partnership arrangements but emphasised that women, particularly single parents, were disproportionately affected. They reflected that this reinforced its relevance within the wider women’s health agenda. Public Health representatives added that coordinated work was underway through local food networks to address these challenges.

 

Councillor Harper questioned why declining healthy life expectancy among women had not been more prominently addressed previously.

 

The Healthy Hospital Programme Manager responded that these issues were longstanding but had often been overlooked, with women living longer but spending more years in poor health. The GP Partner and other contributors added that whilst there had been notable improvements in areas such as screening and maternity care, significant challenges remained, including mental health needs and systemic biases in healthcare delivery.

 

The Chair thanked the representatives of the RWHN for the report, presentation and insightful answers to members’ queries.

 

Resolved:-

 

That the Health Select Commission:

 

1. Noted the contents of the report, recommendations and presentation received.

 

2. Agreed to prepare a formal report recommending that the Rotherham Women’s Health Network be invited to sit as a Co-optee on the Health Select Commission, to be formally considered by the Commission at its next meeting and referred to OSMB to confirm the appointment in line with the Council’s Constitution.

 

3. Agreed to ensure that the desire for a Women’s Heath Hub and the provision of relevant associated women’s health services be included in considerations in relation to the Town Centre Health Hub Phase 2 as part of the consultation process and the Commission’s formal pre-decision scrutiny scheduled to take place later in the municipal year.