WOMEN’S HEALTH NEEDS ASSESSMENT

In December 2024, the National Strategic Clinical Network for Women’s Health published the first ‘NHS Wales Women’s Health Plan’ (the Plan). The Plan is a ten-year vision (2025-2035) that outlines an NHS Wales approach to improving the health outcomes for women in Wales.  Women's Health Plan for Wales launched - NHS Wales Performance and Improvement The 10-year plan has been two years in the making and follows the publication of the Welsh Government’s Quality Statement for Women’s and Girls’ Health in 2022. This made clear that approaches to healthcare need to change so women can access the care they need in a timely way; that the health service is responsive to their choices and needs and that research and development reflects women and girls’ lived experiences.  It is an NHS Plan, which has been co-ordinated and led by the National Strategic Clinical Network for Women’s Health (the Women’s Health Network) with involvement from NHS staff, colleagues, experts in the field, and third sector organisations. It builds upon the work of the ‘Discovery Report’, which captured the voices of 4000 women and girls in Wales. The Plan will be delivered over ten years, through 64 short, medium and long– term actions. It will follow a life course approach, with a focus on delivery of services from 16 years of age, often an important time of transition within health services for girls. The Plan has 8 priority areas: 1. Menstrual Health 2. Endometriosis and Adenomyosis 3. Contraception, Post-Natal Contraception and Abortion Care 4. Preconception Health 5. Pelvic Health and Incontinence 6. Menopause 7. Violence Against Women, Domestic Abuse and Sexual Violence 8. Ageing Well and Long-term Conditions Across the Life Course The Plan outlines the key health inequalities experienced by women in Wales at a population level, and highlights some of the disparities in health that are emerging. It also highlights opportunities for closing the gender gap, improving health across our NHS services. The Plan will be delivered locally by the Cardiff and Vale University Health Board. To support and complement this national workstream, two Health Needs Assessments are required to ensure that the needs of our population are understood and addressed appropriately – a Sexual Health Needs Assessment, and a Women’s Health Needs Assessment. The two reports are closely linked and inter-dependent with regards to topics, key stakeholders and populations of interest. There will likely be overlap with regards to the production of the report (e.g. focus groups) and areas of discussion (e.g. contraception) which could create unnecessary duplication from two separate providers. However, due to the current service arrangements, it is required to have these two reports separately to allow all aspects of sexual health services to be reviewed, as recommendations on one element of the service would impact the whole service. Therefore, a single provider will be sought to produce both reports as outlined below. The aim of the Health Needs Assessments will be to: • Understand the met and unmet needs of residents across Cardiff and the Vale of Glamorgan in relation to the 8 priority areas of the Women’s Health Plan for Wales, using a range of methodologies • Understand what services are currently being delivered for the defined population to address these • Assess the gaps in services in meeting the identified needs of the population • Develop evidence-based recommendations to support strategic planning to meet the needs of the local population, in alignment with local, regional and national priorities The Requirement The awarded bidder will: • Participate and engage in regular progress meetings with key stakeholders • Work with key stakeholder to agree the scope, data, key literature and priorities to create the reports • Provide regular updates to key stakeholders and promptly escalate any issues or challenges with the delivery of the reports • Produce annotated outlines, interim and final reports as per agreed timelines (see below) The scope of the two Health Needs Assessments are outlined below a. Sexual health needs assessment (SHNA) • Sexual health outcomes, behaviours, and service usage in Cardiff and the Vale of Glamorgan • Access to contraception, Sexually Transmitted Infections (STI) testing and treatment, and sexual health education • Priority populations include o young people (under 25 years of age); o women of reproductive age (15-54 years old); o LGBTQ+ communities. o ethnic minority groups. o health inclusion groups including asylum seekers, those experiencing homelessness; those in contact with the criminal justice system; Gypsy, Roma and Traveller communities; those affected by sex work o people living in areas of high deprivation as described by the Welsh Index of Multiple Deprivation • Integration with broader public health initiatives (e.g. mental health, substance use, safeguarding, chemsex) b. Women’s Health Needs assessment (WHNA) • The needs of the population and the current services addressing these around o Menstrual Health o Endometriosis and adenomyosis o [Contraception, post-natal contraception and abortion care] - will be drawn from the SHNA o Preconception health o Pelvic Health and Incontinence o Menopause o Violence against Women, Domestic Abuse and Sexual Violence – elements to be drawn from the SHNA as appropriate o Long term conditions across the life course  Mental health and wellbeing  Cardiovascular disease and diabetes  Dementia  Musculoskeletal health  Cancer The key stakeholders for both HNAs include (but are not limited to): • Cardiff and Vale University Health Board • General Practitioners and Primary Care • Public Health Wales • Cardiff Council and Vale of Glamorgan Council • Local schools, colleges and youth services • Community leaders and service users • Third sectors groups Additional stakeholders for the SHNA may include: • YMCA Cardiff, Terrence Higgins Trust Cymru, Brook Cymru • LGBTQ+ support groups • Fast Track Cardiff and Vale A range of local, regional and national data sources will be expected to be used to develop the two HNAs. Quantitative data sources will include demographic assessment of the population, epidemiological assessment of disease and conditions incidence and prevalence, local and national audit data, healthcare service utilisation, prescribing data, and relevant health outcome data. Qualitative data will include focus groups with relevant population groups as discussed with the stakeholder group; interviews with key service delivery professionals, online surveys of public and staff; particular focus on seeking qualitative data from under-represented groups. Literature reviews will be undertaken for both HNAs. This will identify the current evidence basis for the interventions and services which best meet the identified needs of the population. The literature reviews will need to encompass academic and ‘grey’ literature. A mixed methodology will be expected to be used, incorporating epidemiological, comparative and corporate health needs assessment approaches to ensure a comprehensive and robust analysis is undertaken. This will require: • Review of local and national data sets • Reviews of services offered elsewhere in Wales/UK with comparable population needs • Stakeholder engagement and feedback through online and in-person routes, including interviews, focus groups and surveys • Literature and evidence review A key theme for both HNAs will be to understand the health inequalities experienced by different populations. This will need to be prominent within the data collection, analysis, presentation and final report production. Funding of up to £100,000.00 (including VAT) is available to develop the two Health Needs Assessments and deliver this work within 5 months of project initiation. The value of the contract will include all associated costs to the provider e.g. venue, accommodation and travel (if needed). It is anticipated this work can be delivered predominantly remotely. However some activities required in the production of this report e.g. qualitative data collection from focus groups may require in-person attendance. If the awarded bidder is within reasonable travel distance, there may be value in holding an initial project inception meeting or key stakeholder consultation in-person.