More reproductive health training is needed for nurses and doctors working in primary care, a new report has suggested.
The ‘Women’s reproductive health conditions’ report, published today by the House of Commons Women and Equalities Committee, says primary care funding for training nurses and doctors currently prioritises long-term conditions like diabetes, above reproductive health.
In its first report of the new parliament the committee call for an ‘equal focus’ on early intervention and prevention for reproductive ill health.
And it recommends the urgent implementation of a training programme ‘to improve the experience of treatment and diagnosis in primary care’.
Informing the report, Dr Anne Connolly, co-chair of the Menstrual Health Coalition and co-editor of Women’s Health in Primary care, said women’s health training needs to be improved for nurses and other practice staff, including pharmacists and physicians’ associates.
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During evidence sessions for the report, Dr Connolly had said more support was needed to encourage nurses to talk about reproductive health with patients.
‘I do a lot of nurse education. The nurses will say, “I don’t know the answer, so I don’t ask the questions”. When they are doing smears, they do not feel able to talk about, “What are your periods like?”,’ she explained.
Dr Connolly, who is a GP, described how practice nurses are funded to go on long-term conditions courses on diabetes, or cardiovascular clinic courses, because practices will receive the quality and outcomes framework (QOF) moneys to fund the practice, whereas women’s health is no longer funded.
‘Nurses will fight hard to go on nurse training courses and the training priorities will not be on women’s health,’ Dr Connolly added.
The report also calls for improved National Institute for Cate Excellence (NICE) guidelines on reproductive care and for any new guidelines to be better communicated to primary care patients and staff.
It also recommends that all primary care practitioners should be trained to deliver appointments including cervical screening, and ante- and post-natal checks, which it says are an opportunity to detect often-overlooked reproductive health issues, such as endometriosis.
The report warns of a ‘lack of empathy’ in primary care around the adverse effects that some treatment options can have on patients, for example by focusing on ‘managing’ symptoms rather than offering a diagnosis.
Ruth Bailey, practice nurse and chair of the Royal College of Nursing (RCN) Women’s Health Forum, warned that current diagnosis delays for menstrual conditions are ‘simply unacceptable and unjust’, adding that high-quality nurse education and ongoing supervision are key to improving women’s health.
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‘Primary care faces an unprecedented workforce crisis, and we have seen training budgets cut so access to education needs sustained investment to enable nurses to improve outcomes for women,’ she said.
Jo Campion, public affairs advisor at Endometriosis UK, said the charity ‘welcomed’ the reports recommendations for reducing the average endometriosis diagnosis time to two years.
The average waiting time for endometriosis diagnosis is currently eight years 10 months, according to Endometriosis UK.
‘To make that happen, we need an ongoing cultural shift to ensure that the symptoms of menstrual health conditions are not normalised or dismissed in primary care or elsewhere,’ Ms Campion told Nursing in Practice.
Ms Campion called upon NHS organisations, royal colleges, professional bodies and universities to deliver better education to ensure primary care nurses can accurately refer patients to secondary care.
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‘We welcome the select committee’s recommendation for a new training programme on reproductive ill health in primary care, and the recognition that this should prepare primary care practitioners to support those from all backgrounds,’ she said.
Last month, NICE published new guidance on the diagnosis and management of endometriosis to help health professionals detect the condition sooner.
Also in November, NICE updated its guidance on treating and identifying menopause.
