Women in Redbridge want person-centred care
In 2024, Healthwatch England asked Healthwatch Redbridge to interview women across the borough about their experiences as part of an investigation into declining cervical screening rates.
Speaking to local women about their hesitancy to attend screenings, their stories of screenings and the impact on their health we heard about the barriers women faced to accessing this life-saving care.
We heard how appointment letters were inaccessible, how poor communication about the procedure from services led to fear and uncertainty for women with learning disabilities and how misconceptions prevented women from different communities across Redbridge from attending.
We realised that much more needed to be done to ensure women's voices were heard and barriers to accessing health and social care services were addressed. We devised a 3 phase project, starting by extending our work on cervical screening to hear from more women from more communities, followed by work on breast screening and perimenopause and menopause.
Our latest report, 'Women's Health: Cervical Screening' represents the voices of women who spoke up about the barriers they face throughout the first phase of this project. Their experiences highlight key issues around information provision, misconceptions and accessibility.
It is clear to us that addressing these barriers will require system wide change, and co-operation from service providers and community organisations across Redbridge, at all levels.
Speaking on the findings of the report, Chair of Healthwatch Redbridge, Gita Malhotra said:
"The evidence shared in these pages reveals not only persistent inequalities but also systemic barriers that prevent many women from accessing timely, respectful, and culturally competent screening. From communication gaps and inaccessible facilities to cultural stigma and lack of trust, it is clear that we must take a more inclusive and informed approach. These are not just health issues — they are matters of equity and justice."
Key findings from our research
Invitation to screenings: The data collected from various global communities highlight significant disparities in cervical screening uptake. Our findings recorded much lower response rates amongst Learning Disabled (LD) women (25%) and wheelchair users (40%)
Translated Information: African/African Caribbean (36%), Bengali (22%), Romanian (66%), Somali (41%), stated they would want information in their own languages so they were more informed about the procedure and could make informed choices.
Improvement to provision of information: Over half of women (55%) from the LD community and wheelchair users reported there was lack of accessible information.
Speculum Sizes: A third of all women interviewed (34%) reported that they did not know that different speculum sizes were available which could improve their overall screening experience.
Accessibility: Women who are wheelchair users reported a lack of reasonable access within practices and poor understanding of their conditions when communicating with health professionals.
Health Literacy: Most participants (91%) reported that health literacy was an issue, such as not knowing what Human Papillomavirus (HPV) was, and what the screening would look for.
Patient experience: Some individuals reported services having a poor approach to culturally sensitive beliefs and practices and lack of trauma informed care.
Home Testing Kits: Many participants (39%) reported they were willing to use home testing kits when they are rolled out by the NHS.
Our Recommendations
Improvement of access and person-centred service provision
- Ensure staff are well-trained in culturally sensitive, trauma-informed care and represent diverse communities.
- Tailor strategies to prevent women in temporary accommodation missing screenings due to relocations.
- Provide flexible appointment options for women, outside of standard working hours.
- Expand outreach to community-based services ensuring invitations reach eligible women from seldom heard communities in a timely way.
- Improve accessibility of clinics and equipment across health centres and GP surgeries.
- Promote home testing kits by running national and local campaigns to inform people about the availability and ease of using testing kits at home.
Information & Awareness
- Improve information provision with feedback mechanisms in patient forums.
- Co-design materials and services for women with community organisations.
- Ensure translated materials readily available and use community health workers to engage with communities.
- Eradicate misconceptions through educational campaigns in community hubs, ensuring all women receive the necessary care.
- All communication in Redbridge must consistently include AIS-approved standard information to ensure equity of access and inclusion for all women.
Data Quality
- Data recording needs to improve particularly in capturing information related to ethnicity and disability providing valuable insights into healthcare inequalities to ensure fair access to services and tailor interventions to meet the needs of diverse populations effectively.
