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UK’s obstetric clinical negligence claims on the rise ―how worried should women be?

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Despite medicine’s continuous improvement, medical negligence still occurs. Whether it happens due to misdiagnosis, surgical errors or medical product liability, the patient is the only one to suffer the consequences, as many are too afraid to file a lawsuit. 

Although Britain’s medical system was once considered one of the best in Europe, it has now fallen into disgrace, especially since numerous healthcare providers have been on strikes in the past year, leading to staff shortages and delays. It seems like the people whose jobs are most important struggle with low pay, which, especially during surging living costs, is decreasing the number of available staff. Moreover, the working conditions aren’t great. 

But what’s more worrying is that these factors lead to numerous negligence claims, and obstetrics is on top of the list, along with emergencies and orthopaedic surgeries. Should women be worried?

Clinical negligence claims are booming in the UK 

According to Statista, the number of clinical negligence claims almost doubled since 2010 until now, while non-clinical have decreased. Unfortunately, this medical field is one of the most important as it focuses on pregnancy and childbirth, as well as the postpartum period, meaning an increasing number of mothers suffer various cases of malpractice. This might also be the case as to why the number of births has decreased incredibly in the past decades, as 2020 was noted as a historical low for the country, with the fertility rate going in the same direction. 

However, these aspects are not an excuse for the high number of malpractice cases since they can also become the cause of low birth rates. Misdiagnosis, prescription errors and even childbirth injuries make the case of medical negligence, so taking action as soon as possible is best. 

Unfortunately, many complications arise in obstetrics 

Getting a degree in gynaecology means going through medical school, passing difficult tests, and finishing the residency program. After that, students must gain experience by being guided by staff midwives or nurses, which some consider sufficient to grasp all the knowledge. 

However, obstetrics isn’t that easy because there’s always something new to learn since abnormal cases are frequent. Women can experience bleeding in the first and second trimesters due to many instances, from intrauterine death or certain diseases, for which students must know how to identify the signs and symptoms and define treatment. Failure has often led to maternal death, which, in the UK, has also increased considerably in the past years. Among some of the causes, depression has been found to contribute to the likeliness of premature death. That’s why early treatment and detection are vital. 

Despite that, many British women choose not to have babies

Besides the increased risks of developing an additional health issue, some women simply choose not to give birth, especially 30-year-old women. Indeed, the trend of women wanting to have babies when they’re older compared to the previous generations is normal. After all, having kids very young is considerably more complex compared to the past, and many women take into consideration the chance of raising their kids alone in case of divorce or the passing of their significant other. 

And that’s because the housing costs have boomed, and people can barely rent a flat, especially with increasing mortgage rates. At the same time, childcare fees are not easy to handle as women’s salaries might stagnate, and the burden of one partner to face them can be challenging. 

Moreover, insecure employment after giving birth can hinder a woman’s capability to work again in a field she studied for, which, if it’s accompanied by repaying student loans, can be a thorn in one’s side. 

What’s the final solution? 

Guilt-tripping women about having kids to save the planet might not be the best idea, which is what happens currently. Many are considering a woman’s duty to have children, but things have changed in the past decades, and women have the right to a successful career or choose to have kids later in life when they’re prepared and have found the right partner. 

Some women still have to argue for their child-free rights, as society’s concepts have still not changed entirely, unfortunately. But what’s more worrying is that many mothers in the UK are single-handled raising their kids, having to experience food insecurity, especially during the pandemic.  

But besides the social barriers, the truth is that women’s health hasn’t been that interesting for researchers for decades, which is why there are many conditions women have that are not fully understood by medical providers. 

On endometriosis and autoimmune diseases 

Lately, many women received the diagnosis of endometriosis, which has been found to affect around 10% of women globally. The chronic disease has no cure for the moment, and treatment is scarce due to limited research. However, the symptoms are impairing women’s health, as they trigger severe pain during periods and sexual intercourse, as well as developing infertility in some cases. But what’s more worrying is that the prevalence of developing endometriosis is on the rise while the causes are not known. 

On the other hand, autoimmune diseases like rheumatoid arthritis are another condition that hasn’t been studied enough from the female perspective as there aren’t as many women in clinical trials compared to men. The disease is two to three times more common in women as they’re more affected by exposure to chemicals and lifestyle risk factors, but there isn’t much more than that known for the moment. 

Hence, more research is needed to understand how women are affected by genetics, environmental changes and other causes by completing representation with pregnant women, Black and Indigenous women. 

How healthy are you? 

Women’s health is at risk, especially since many are the victims of clinical negligence during pregnancy in the UK. Considering that the medical system is flawed and staff problems are leading to fewer patients being consulted, we’re worrying that outside factors will influence women’s health negatively. At the same time, women’s health isn’t the researchers’ focus at the moment since conditions like endometriosis are still unknown to doctors, even if they’re one of the most aggressive health problems. 

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Opinion

‘Women are left in limbo’: how telemedicine can cut down NHS gynaecology waiting times

By Kat James, director of new projects at Consultant Connect

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Almost 600,000 people in England are waiting for gynaecology treatment. It is clear the current system is not fit for purpose.

The NHS, across the board, is struggling to reduce waiting lists, but gynaecology health, in particular, has been sent to the back of the queue.

Referral numbers are about 60 per cent higher than pre-pandemic, which represents one of the three highest specialties in terms of volume increase since pre-COVID.

Not only are women left feeling neglected, but longer wait times also result in them needing more complex treatment or even emergency admissions to hospital.

Then, there is also the impact on family life, work, and women’s mental health. A survey of the Royal College of Obstetricians and Gynaecologists found that four-fifths (80 per cent) of women said their mental health has worsened due to the wait and that one in four of those whose mental health had deteriorated, pain was given as a reason.

More than three-quarters (77 per cent) of women said their ability to work or participate in social activities had been negatively impacted.

One of the main stumbling blocks impacting patient waiting times is the disconnect between primary and secondary care. Often, patients who have faced long waits for their appointment are discharged after their first hospital appointment and told that their care is best taken care of by their GPs.

The good news is that new ways of working better connect primary and secondary care and ensure patients receive the right treatment first time. If applied at scale, these solutions considerably reduce waiting lists.

For example, giving GPs immediate access to speak to a consultant on the phone for specialist advice and guidance for their patient. In ordinary circumstances, a GP would have to call the hospital switchboard or send a written advice request which might take days to be answered.

Often, these queries would go unanswered or aren’t transferred to the correct department, resulting in patients being referred sometimes unnecessarily or presenting at a busy A&E department.

Technology like Consultant Connect allows GPs to directly “hunt down” a specialist consultant from a pre-defined rota for expert advice via a phone call, ensuring GPs can direct their patients to the right care first time. This service is available for gynaecology in almost 50 NHS areas across the country.

In Coventry, for example, a 54-year-old patient presented with obvious advanced gynaecological cancer. While the two-week wait referral had already been made, the GP couldn’t move the appointment sooner than 14 days later.

Meanwhile, the patient started deteriorating, and the GP considered an urgent admission. The GP used Consultant Connect and, within seconds, was connected to a gynaecologist, who then arranged for the patient to be scanned that day. The patient got the care they needed and avoided an acute admission.

In June 2023, the service expanded to cover a menopause advice and guidance line as referral data in one local area showed increased referrals relating to menopause-specific questions, many of which did not require to be seen in a hospital setting.

This meant that trusts weren’t seeing patients who needed to be seen, and patients with menopause symptoms were on waiting lists for a prolonged duration without management plans.

With the new Consultant Connect Menopause line, GPs can get through to a consultant with special interest in menopause matters within 26 seconds.

Data shows that 87 per cent of calls resulted in the GP receiving “enough” advice for their patient to benefit from an immediate treatment plan via their GP rather than waiting for a hospital appointment with a specialist unnecessarily.

Another way to tackle the wait problem is to leverage remote ways of working, which opens access to a new pool of workforce that otherwise wouldn’t exist.

Consultant Connect runs a network of NHS consultants who review gynaecology referrals remotely, with no need to travel to local hospitals and with consultants choosing their own working hours. This is often attractive to consultants who work part-time in hospital or are on parental leave, for example.

For patients, it means they get access to treatment plans faster: the remote working consultant determines the urgency of a referral and writes up a management plan, which means that treatment can start immediately.

Often, the health problem can be resolved through this plan, and for those still needing to be seen, it means they come to their first appointment on a more informed basis.

At the same time, it ensures patients are on the correct pathway, and any diagnostic test needed for a diagnosis are initiated in a timely manner.

Last year, Consultant Connect’s team triaged over 5,000 gynaecology referrals across the UK, resulting in 43 per cent of referrals being safely removed from the waiting list.

Many of these patients were returned to their GP with a treatment plan devised by the consultant. By fast-tracking urgent cases, women are not put through unnecessary stress and pain while waiting to be referred to a gynaecologist. Among these referrals, one in ten cases were upgraded to the urgent and suspected cancer pathways.

By reviewing current systems to make them more joined up and to allow for efficient ways of working, we can speed up care for women and make sure that clinicians have the right tools to help the NHS deal with the mounting gynaecology backlog.

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Opinion

‘We are not allowed to talk about our bodies’: why we need to address social media censorship

By Clio Wood, women’s health advocate and founder of &Breathe

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Social media censorship is just another example of women’s issues being sidelined and women being made, yet again, to feel small.

The gender data gap is huge and, if you’ve ever read the great Caroline Criado Perez’s book, Invisible Women, you’ll know what I mean. It touches every day of a female life.

That impact includes social media too. Because while the social media platforms are notoriously secretive about their internal workings, it’s a pretty safe bet that social media algorithms, like most of the rest of life, are built on male data and trained on male behaviours.

This means that as long as women have different behaviours and priorities of what they want to see on these platforms, we’re going to find it a struggle.

Meta and Tiktok are silencing women’s health and sexual wellbeing content. Censorship harms women’s health: it increases women’s pain, and disempowers women, which in turn means the gender health gap cannot close. What annoys you when you’re on your phone scrolling has long-lasting impact for us and our children.

I’ve experienced this censorship first hand on Instagram, with my reach being restricted for simply posting a body confidence reel of me dancing in a bikini.

That in itself – one example of many – is infuriating, but what’s especially galling is that everyday men’s health topics are left uncensored, and hyper sexualised women’s bodies, unsolicited “dick pics” and fake accounts using nearly naked female profile pictures are making their way into social media feeds and inboxes unchecked. The hypocrisy of the situation is clear.

All the while charities are being forced to use male nipples instead of female ones, and female-led period brands are losing hundreds of thousands of pounds when their ad accounts get deleted.

Creators, charities, medical practitioners and brands are being censored constantly through algorithms picking up words like sex, vagina, vulva, or period. Which are all normal human functions or body parts and integral to these creators’ missions. You can’t be a period care brand without talking about periods.

CensHERship aims to alter the trajectory of the current algorithms and end the routine censorship of women’s health content online

Creators end up using written symbols and numbers to disguise these words and bleep them out in speech to try to get around this censorship.

It’s examples like this that finally led me – after many years of finding this situation ridiculous – to do something about it.

Together with Anna O’Sullivan, we’ve created CensHERship, a campaign which aims to alter the trajectory of the current algorithms and hopefully restore some balance to what is allowed on social media. Our ultimate aim is to bring the platforms to the table for discussion by this time next year.

We launched a survey in late January 2024 to try to collect as much information as we can about the incidences of muting and censorship that female creators are experiencing, whether they are educators, charities, brands or medical professionals. The results emphasised that this is a widespread issue taking in all of women’s health and sexual wellbeing.

In tandem we hosted an intimate roundtable to launch the CensHERship campaign and found, to our astonishment, that the problem goes much deeper than social media. Women’s health and sexual wellbeing brands are being refused bank accounts, insurance and being kicked off payment platforms without warning.

Social media censorship is just the tip of the iceberg. It’s just one more example of women’s issues being sidelined and women being made, yet again, to feel small.

We’re not being allowed the freedom to talk about our own bodies and health, because speaking up goes against the male-gaze archetype of the female role and body. Let’s end CensHERship once and for all.

Clio Wood is a women’s health advocate, journalist, author and Founder of &Breathe.

Anna O’Sullivan is a communications and marketing professional and writes FutureFemHealth 

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Opinion

Revolutionising women’s health: the rise of femtech innovations

By Jo Barnard, founder and creative director of Morrama

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In the fast-evolving landscape of female technology, 2024 is poised to mark a pivotal year in growth and innovation.

Investors are increasingly recognising the vast potential of a typically overlooked audience, which encompasses 45+ year-old women with disposable income and actively seeking solutions.

As the femtech sector continues to gain momentum, we can anticipate the introduction of innovative features, products and services – such as intelligent menstrual cups, connected pads addressing menstrual cramps and wearables with hot flush detection capabilities, all with an growing focus on the unique needs of the individual.

Removing the guesswork through data

Whilst we mustn’t devalue leading medical advice on female health – including period complications, fertility, and menopause – they can feel like one-size-fits-all treatments that are only offered in the more severe cases. In reality, women’s health is a very personal and nuanced journey. The next few months promise the advent of smarter versions of pre-existing products, in an effort to help women understand their bodies better.

Take Emm, for instance. The company created a menstrual cup embedded with sensors to track menstrual flow, providing users with valuable insights into their menstrual health.

Similarly, wearables such as FemSense utilise advanced algorithms to predict ovulation with 99.7 per cent accuracy. These cutting-edge digital and physical devices help unlock new insights into the complexities of the female body, paving the way for more informed decision-making and improved health outcomes.

Addressing gaps in conventional treatments

While the femtech sector continues to push the boundaries of innovation, it also seeks to address long-standing gaps in the provision of medical solutions for various female health issues.

Conventional treatments, such as contraceptive pills for managing period pains, IVF for fertility problems or hormone replacements for menopause often fall short in meeting the diverse needs of women.

Against this backdrop, femtech brands are pioneering a more specialised and inclusive approach – as highlighted by brands like Tina, which I explore into more detail below – tailoring products to specific demographics, including people of colour, individuals with physical constraints and those with distinct religious beliefs.

Prioritising design, technology, and user experience

Central to the femtech revolution is a strategic focus on design and technology, aimed at enhancing the quality of life for women across the globe. Leading brands such as Emm, Embr and Tina are at the forefront of this movement, developing solutions that not only empower women but also drive positive societal change.

Tina’s aim, for example, is to create inclusive design for all bodies and abilities, engineered with anatomy in mind. Their tampon applicator takes into account correct angles and depth, and prides itself in being “first-period friendly”, reducing the stigma surrounding women’s health for the next generations.

These brands can only achieve this by opening up the conversation and incorporating feedback from diverse communities in order to deliver products that resonate with women from all walks of life.

In addition, this year’s Consumer Electronics Show (CES) in January offered valuable insights into the evolving landscape of femtech, where innovation is not solely defined by radical disruptions but by incremental improvements to existing products and services.

Highlights from the show included: Movano Health’s Evie Ring, a smart health ring utilising AI to analyse women’s menstrual and sleep data; and Vivoo’s new at-home smart UTI test, showing that a dipstick test can be beautiful and utilising the capabilities of smartphones to give more accurate readings.

With femtech brands historically focusing on function over aesthetics, it’s positive to see companies considering smarter delivery mechanisms, more thoughtful design and more personalised educational pathways. The result is that women feel more empowered and valued as individuals.

Importance of research and evidence-based practice

However, as femtech continues to grow and develop, it’s also crucial not to lose sight of the importance of scientific rigour and evidence-based practice. For every truly science-based solution there will inevitably be a flood of lower quality copycats and brands promoting products that serve only as a placebo.

Building trust in femtech solutions requires a commitment to transparency, accountability and continuous improvement. Only by investing in rigorous scientific enquiry can we ensure that femtech products and services meet the highest standards of safety, efficacy and reliability.

A bright future for femtech

I’m excited for the future of femtech. As we look ahead to the next few months and beyond, let us embrace innovation, inclusivity, open-mindedness and evidence-based practice as our guiding principles.

More than ever, the industry has the potential to usher in a new era of personalised, proactive and women-centred healthcare, making a meaningful impact on women’s quality of life as well as the broader population as well.

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