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The experiences of Mumsnetters and other UK women are helping to address barriers to GP care

(4 Posts)
MEDIA: Annahmolly Wed 04-Jun-14 17:23:56

Last year, Maternity Action and the Women's Health and Equality Consortium asked women across the UK to tell us about their experiences of primary healthcare. The report resulting from this research has now published and can be found, among other places, on the Maternity Action website. Many of our respondents were Mumsnet users, and here is some of what you told us.

The challenges of juggling work, care and health
Your responses gave an insight into the practicalities of combining work and childcare with looking after your own health, and that of your children. Around 40% of the women we heard from found it ‘very hard’, or ‘relatively hard’, to get an appointment with their GP. A surprising number said that their surgery only offers the limited choice between turning up for a same-day appointment, and waiting several weeks. Clearly, this is problematic for a number of reasons.

“The prospect of going to one of their 'drop-in sessions' and waiting an indefinite amount of time is not a good one. It is very hard to tell my work that I will need a morning off to see the doctors but being unable to be more specific about appointment times.”

“I get allowed an hour free from work to take doctor’s appointments - but I don't drive and there's no way I can get to the doctors on the bus, have a 10 minute appointment (which is probably running late anyway) and then get back to work again on the bus in that time! Just doesn't seem worth it unless I believe I'm seriously ill.”

Some respondents also said they would not be paid if taking time off and could not afford to lose a whole day's pay. As a result, many women sought help later and less often than they would have liked – sometimes with the consequence of minor health problems worsening and requiring more costly and long-term treatment.

Appointment systems also fail to accommodate those with young children. Many mothers said that booking times clashed with the school run, usually requiring patients to call at 8.30. Others pointed out how unaccommodating GPs can be when children are ill.

“The wait for non urgent appointments is 2-3 weeks. Otherwise patients are required to turn up in person at the GP surgery at 8am to book an urgent appointment which will be at any time during the day requiring 2 trips - this is completely inhumane as a mother coping with ill children.”

73% of women with young children said they usually have to bring their child into their own appointment. This is unsurprising, given the short notice. However, having children present can make it difficult to talk about issues like mental health, sexual health and violence in the home – issues which, according to our respondents, are hard enough to seek help for as it is.

Seeing a female doctor
Physical, sexual, and emotional health are all private matters, and 62% said that they feel more comfortable talking to a female health professional.

“I generally want to see a female GP for anything where I will have to undress. Definitely for gynaecological issues.”

“I usually like to see a female GP. If I just have a general medical problem like a chest infection then I don't mind which doctor I see. But if I have a more personal problem I prefer to see a female GP.”

There was also some anecdotal evidence of male GPs being reluctant to examine women intimately, which in one case had led to misdiagnosis and the wrong prescription. Despite the fact that many women are hesitant to see male GPs for certain problems, 20% of respondents said that they cannot request a female doctor at their practice – some surgeries do not actually have one, and in smaller areas there may be few practices to choose from. A further 14% did not know whether their practice allows them to request a woman GP.

Sexuality and sexual orientation
The issue of sexuality can be difficult to talk about, and this especially seemed to be the case for lesbian and bisexual women. Many said that previous experiences of ‘snide remarks’ and rudeness about their sexual orientation had made them reluctant to talk to GPs and nurses about anything that would require them to disclose it. This could be anything from cervical screening, which is very often combined with contraception advice, to discussions about mental health, during which the home situation and relationships tend to be discussed. One woman in a focus group for Lesbian and Bisexual women had been unable to seek help for depression for this reason. Another had avoided smear tests for ten years.

Mental health
Mental health was a prominent issue among our respondents – 71% in our survey had experienced at least one such problem at some point in their lives. It was encouraging to see that the majority had sought help from their GP, and that many credited their doctor with improving or even saving their life. However, it was clear that some women were unable to access such excellent support - 23% of sufferers had not sought help, often for reasons relating to stigma, and the fear of not being taken seriously. One mother feared that her capacity as a mother would be called into question, and another had waited a year for therapy after a suicide attempt.

“Expected he would just say ‘it’s natural in a woman of your age’ - whatever age I was!”

“Telling me that 'anxiety isn't a medical condition' is not appropriate. It's hard enough to talk about mental health but when GPs don't take you seriously it's even harder.”
Domestic Violence

22% of the women in our survey had experienced domestic violence. GPs have a role in referring to appropriate organisations, as well as addressing the emotional aspects of such as situation. Out of the small number who did seek help from their doctor, about two thirds had a positive experience. However, many more women were intensely embarrassed about what had happened to them and did not want anyone to know what was happening. Many also doubted whether doctors could help with such issues at all, and thought it was too difficult a topic to bring up during a short 5-10 minute appointment.

“Worried about stigma, being judged, not finding the right words, getting too upset… What could they do at the time?”

“I didn't realise, at the time, that it was an option. I also didn't realise that I was being abused.”

We would like to thank everyone who took part in the research, which will enable us to get concrete information about women’s everyday experiences to NHS England and the Department of Health. It is our hope that the report, and our recommendations in it, will help the healthcare providers and policymakers to meet their commitments to providing the best possible care to women in the UK.

You can download the full report, entitled Women's Voices on Health - Addressing Barriers to Accessing Primary Care HERE

You can listen to a podcast about the report HERE

FatalCabbage Wed 04-Jun-14 17:34:23

Inspired by this campaign I recently made a complaint about my GP practice (access to appointments, information offered about alternatives). I just heard back that they are changing their booking procedures, appointment profile, and staff training.

Access to primary care is so important. GPs may be strained but timely, appropriate treatment is more effective and cheaper overall anyway.

TheCheckerdyHorse Wed 04-Jun-14 18:04:24

What advice would you give to a woman who has been raped by a HCP?

Is there any provision for such women?

Is there any acknowledgement of this as an issue? Any collation of statistics, or recommended resources?

Clearly for any woman who was raped by a HCP, it's hard to trust, which makes accessing medical care very difficult.

Annahmolly Fri 06-Jun-14 12:47:10

Hi TheCheckerdyHorse,

Rape is always an issue for the police and it is possible to get support from organisations such as Rape Crisis (http://www.rapecrisis.org.uk/, Helpline: Freephone 0808 802 9999 betwwen 12 - 2.30pm and 7 - 9.30pm).

I am not aware of any statistics specifically on rape or assault in the healthcare context, or any resources on this specifically. I think the main issue should be that the woman is given counselling and support to take her case forward. If this happens, she is more likely to be able to live her life normally, including accessing health services.

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