Hubs bring together services for heavy periods, menopause, prolapse and incontinence, and contraception provision. This approach provides a more specialist offer than most GPs. They also provide education and support to primary care and work across a population footprint to take a public health role in preconception care, contraception and cervical screening.

Hubs ensure women are seen at the right time, in the right place, and by the right healthcare professional. They reduce unnecessary secondary care referrals.

Nationally every integrated care board is expected to set up at least 1 women’s health hub through a national pilot scheme. Development at a neighbourhood level has enabled delivery models to flex according to local need.

One example is Tower Hamlets Women’s Health Hub, launched in December 2023. In this model, all non-urgent referrals to gynaecology are first triaged by senior clinicians in the hub through a single point of access. A high proportion are then offered an appointment in the hub or are managed by their GP, with support, education and advice given to the GP by Advice and Guidance services. Through this new model, women receive care more quickly in a multidisciplinary neighbourhood setting and are diverted away from elective waiting lists.

Key learnings

• Strong leadership and ensuring collaboration between primary and secondary care teams are essential for delivering shared outcomes.
• Hubs harness the skills of multidisciplinary teams, comprising GPs, women’s health physiotherapists, nurses, health care assistants, gynaecologists, and sexual and reproductive health doctors. Hubs also have a broader strategic role in upskilling the local primary care workforce to improve routine women’s health care.
• Collaborative commissioning between NHS and local authorities enables hubs to streamline multiple issues into 1 appointment, which is more efficient for women and the NHS.
• Hubs oversee a population footprint and are well-positioned to manage women across a whole pathway of care from prevention and self-care to primary and secondary care as required, as well as taking a lead on reducing inequalities.
• It is essential to involve people in service design so that wraparound pathways of care are designed according to the needs of people rather than services.
• Hubs make use of digital tools, such as virtual engagement events and virtual group consultations, to provide advice and care at scale and cost-effectively.
• At a national level, it is important to provide clarity on the “what” but be flexible on the “how”. This approach encourages local innovation.

Impact

The Tower Hamlets model illustrates how hubs have improved care pathways for women and created efficiencies in the system. The hub reports that prior to launch, 85% of gynaecology referrals were seen in secondary care gynaecology, and 15% were supported via Advice and Guidance services by their GP. After 12 months of the service (3,515 referrals) the hub reports:

• 25% of referrals needed to be seen in the secondary care gynaecology service, a 60% reduction. This has reduced waiting lists, which have come down by 30% in just a few months
• 37% of referrals were managed in primary care with support by Advice and Guidance
• 35% of referrals were seen in the Tower Hamlets Women’s Health Hub
• 3% of referrals were directed to other services

User feedback has also been positive, for example:

Publication reference: PRN01756_ii