Scotland's New Women's Health Plan Puts Real Women at the Center—Here's What's Changing

Scotland is launching an ambitious new phase of its Women's Health Plan (2026-2029) that directly responds to what women themselves are asking for—better access to care, clearer health education, and support tailored to every stage of life. The plan addresses a critical gap: gynecology waiting lists have exploded by 193% since the pandemic began in February 2020, while conditions like endometriosis affect approximately 10% of women and girls of reproductive age worldwide.

Why Are Women's Health Services Under Such Strain?

The numbers tell a sobering story. In Scotland, there are 359,313 women currently in the menopausal age range of 45 to 54 years, yet many struggle to access timely gynecology care. Beyond waiting lists, the economic impact is staggering. A 2024 report by the NHS Confederation found that absenteeism due to gynecological conditions costs the economy nearly £11 billion annually. The report also revealed that for every £1 invested in obstetrics and gynecology services per woman, there's an estimated return on investment of £11.31. If Scotland invested just an additional £1 per woman in these services, the economy could see an extra £319 million in total gross value added.

The strain on services reflects a broader reality: women face unique health challenges across their entire lifespan that men simply don't experience in the same way. From menstrual health in adolescence to menopause management in midlife to bone and brain health in older age, women need specialized support at every turn.

What Health Challenges Are Women Facing Across Their Lifespans?

Scotland's new plan recognizes that women's health needs shift dramatically over time. The average woman has her first period at age 12 and reaches menopause at age 51. But the health inequalities don't stop there. Women in Scotland have a life expectancy of 80.8 years compared to 76.8 for men, yet they spend more of those extra years in poor health.

Key health disparities affecting Scottish women include:

• Mental Health Burden: Women experience significantly higher rates of anxiety and depression than men, with anxiety among young women more than double that of their male counterparts.
• Bone and Brain Health: Women are more likely than men to develop osteoporosis and dementia, with Alzheimer's disease and dementia being the leading causes of death in women.
• Cancer Risk: Breast cancer is the most common cancer diagnosis for women in Scotland, requiring ongoing screening and prevention efforts.
• Chronic Pain and Physical Activity: Women are more likely to live with chronic pain compared with men, and almost two-thirds of adult women are overweight or obese.
• Fall-Related Injuries: Women lose 11,574 years of health due to falls compared to 10,925 for men, with more than twice as many women admitted to hospitals for hip fractures than men.

The plan also highlights a troubling disparity in hip fracture outcomes: socioeconomically deprived patients suffer hip fractures 5.6 years earlier than the least deprived patients, which may impact overall life expectancy.

What Are Girls and Young Women Actually Asking For?

Scotland's health planners didn't just look at statistics—they listened to women directly. Through focus groups involving girls aged 12 and older through women in their 90s, young women consistently requested more support and education to understand their health, particularly menstrual health. In response, Phase Two of the plan includes a specific action to review, update, and promote women's health content on RSHP.scot, helping girls and young women better understand their bodies and know where to access help and support. The plan will also develop new, more detailed educational resources on menstrual health and periods.

This grassroots feedback shaped the entire direction of the plan. Women told planners they want more support to live well and optimize their health for the future—not just treat problems after they arise.

How Will the Plan Address Older Women's Needs?

Phase Two includes a greater focus on the needs of older women, recognizing that over a third (33.38%) of Scotland's female workforce is over 50 years old. The plan specifically targets support for pelvic floor health, brain health, and bone health to help women enjoy more years of healthy life. This is particularly important given that the number of people aged 50 and older who suffer hip fractures has increased by just over 25% between 2017 and 2023.

The plan also acknowledges that women disproportionately carry caregiving responsibilities. In 2023-24, 73% of all carers were female, and 80% of working-age carers were women. Women typically begin caregiving responsibilities at age 45, 12 years earlier than men. The new plan aims to support women's health while they're managing these demanding roles.

What About Disabled Women and Underrepresented Groups?

The plan recognizes significant gaps in care for disabled women. Disabled women in the United Kingdom make up 20% of women of reproductive age, yet there is limited data available regarding their experiences in Scotland. Particularly concerning is the fact that women with a learning disability have a life expectancy 23 years shorter than women in the general population.

One focus group participant described how structural discrimination affects access to women's health services, explaining that she was unable to get onto the examination table for a cervical smear test due to lack of accessibility planning. She eventually stopped attending women's health appointments because of the ableism she experienced. The new plan specifically commits to considering the needs of disabled women during implementation, particularly regarding access to cervical screening and gynecology service transformation.

The plan also acknowledges that transgender, intersex, and non-binary people in Scotland face substantial health and social inequalities and specific barriers to accessing health services, though the document notes there is limited evidence on their experiences in Scotland due to gaps in data collection.

How Will Healthcare Providers Use "Touchpoints" to Improve Women's Health?

One innovative strategy in the plan involves maximizing what health officials call "touchpoints"—routine appointments like cervical smear tests—to promote preventative health and future wellness. Rather than treating these appointments as isolated screening events, NHS Boards will use them as opportunities to discuss broader health optimization, staying well, and preventative options with women. This approach aims to deliver more holistic women's health care and catch health issues earlier.

Scotland's new Women's Health Plan represents a significant shift toward listening to women's actual needs and addressing the systemic barriers that have left gynecology services overwhelmed and many women without adequate support. By investing in education, accessibility, and preventative care across the entire female lifespan, the plan aims to reduce health inequalities and help women thrive at every age.