Closing the gap: transforming healthcare interactions for women in the UK

By Charly Rochford, Nicole Samuels & Toni Beckton 

Over the last five years it has been impossible to escape negative reporting about our health system – whether it’s long waits for elective care, difficulties accessing GP appointments, or hospital corridors full of sick patients. You would be forgiven for thinking that our health system has begun to fail in recent times. In reality, our health system has been failing more than half our population for much longer.

By our government’s own admission, “51% of our population faces obstacles when it comes to getting the care they need”.1 The UK has the largest female health gap in the G20 and the 12th largest globally2. This is both in terms of quality of care and outcomes, and in how women access and experience care.

Research shows that a positive experience of healthcare has a positive impact on patient safety and clinical effectiveness amongst other outcomes measures3. From this we might then assume that a poor experience of healthcare leads to worse outcomes. For women specifically, these experiences include: feeling they aren’t listened to (84% of women reported not being listened to by health professionals according to the Department of Health and Social Care Survey 20214), having symptoms dismissed, not being given adequate choice in their care4,and all too often receiving default responses like “are you pregnant?” and/or “you should lose weight”.

So, what does this mean for women in the UK? It means that women are receiving care that isn’t tailored to their needs, with an implication for their overall health, their families and relationships, their independence and ability to lead full lives.

And what are the wider implications for the UK if we continue to neglect women’s healthcare?

• Ongoing economic inactivity: women make up 49% of the workforce but represent a disproportionate number of those out of formal work, linked to increased rates of long-term sickness5. 60,000 women are estimated to be not in work due to menopause, with an economic impact of £1.5bn5.
• Cost to businesses and economy: the NHS Confederation estimates an economic cost of up to £10.6bn associated with women missing work due to period related symptoms – not even considering the wider range of women’s health challenges.
• Impact on homes, families and future generations: women are known to undertake most of the unpaid labour in the home. Yet, of those with a long-term condition, 73% said it impacted their ability to look after their family or home5.

Sidelining women’s health services and allowing poor-quality care interactions not only has a direct cost for our health and care systems, has knock-on effects for the economy: “if an additional £1 per woman in England were invested in these services, the economy could benefit from an additional £319 million in total gross value added”5. With return on investment ratio of almost 10:16, improving women’s access, experience and outcomes should be a priority.

This International Women’s Day, IMPOWER is focusing on how we can drive change by improving the everyday interactions women have with healthcare providers. We work across health and social care with frontline professionals applying our well evidenced theory that changing individual’s behaviours builds the confidence needed to make change happen at scale.

IMPOWER already uses Applied Behavioural Science (ABS) to reframe the conversations held between frontline care staff and the people they support underpinned by our digital tools such as VCARE and VSEND. These ‘better conversations’ lead to improved outcomes, and both staff and service users have a better experience with each interaction. For example, instead of asking “What do you need?” we would ask “What is important to you?”, which tends to lead to a more positive conversation highlighting the person’s existing support network and encouraging a more creative and strengths-based support package to be developed.

So, how can we use IMPOWER’s experience and methodology to reframe women’s interactions with the health system and health professionals? Using ABS, we can design a strengths-based approach to a conversation a woman might want to have with a health professional that might lead to a different outcome.

For example, if the health professional assumed that the woman had already spoken to other women in her life, researched available options, and had desired outcomes in mind, the conversation might include questions such as:

“What outcomes are important to you? What do you want the treatment to help you to be able to do? Where do you want to get to?”

“What do you think is going on in your body? What treatments or remedies have you already tried, and are there any options you would like to explore?”

This doesn’t undermine the clinician’s expertise and experience but instead opens a dialogue that empowers women to make informed choices.

If more women had positive experiences of healthcare, outcomes could improve, and this could have a material effect on the UK economy with fewer women missing work for health-related problems, fewer women leaving the workforce, and more women able to do the work they want to do – whether that’s in the workplace or at home providing for families.

1. Women’s health strategy: https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england
2. Women’s Health Outcomes: Is There a Gender Gap, House of Commons Library: https://lordslibrary.parliament.uk/womens-health-outcomes-is-there-a-gender-gap/
3. Doyle C, Lennox L, Bell DA systematic review of evidence on the links between patient experience and clinical safety and effectiveness BMJ Open 2013;3:e001570. doi: 10.1136/bmjopen-2012-001570
4. Results of the ‘Women’s Health – Let’s talk about it’ survey – GOV.UK
5. Women’s health economics: investing in the 51 per cent, NHS Confederation report, 2024 https://www.nhsconfed.org/publications/womens-health-economics
6. UK population by gender 2023 | Statista