

Eliska Felcmanova
Practice Nurse
Sullivan Way Surgery
Central Wigan, Greater Manchester
The Challenge
In her role as a Practice Nurse at a GP surgery in Wigan Central, Eliska recognised that there were several issues affecting access to women’s health services. It is an area of significant deprivation and health inequalities. As part of her work on the CARE programme Eliska decided to look into this in more detail and think how to address this challenge.
Patients often did not access sexual health services due to long waits for treatment or because they were unaware of the help available for wider women’s health issues. In addition, patients in her practice reported difficulties in accessing not only Sexual Health Services locally but also gaps in the provision of specific women’s health services, such as menopause or prenatal health support.
Patients experienced long waits on existing treatment pathways and were often not seen at Sexual Health clinics as they did not meet the criteria. The existing sexual health services locally only provided medical devices (such as the fitting of IUDs) for contraceptive purposes. Eliska was also aware that there were few trained Long-Acting Reversible Contraception fitters in her locality.
Eliska reviewed PCN data specifically on women aged between 40 and 55 years and based on a few health indicators such as BMI, smoking status, and blood pressure. The findings revealed that this cohort of patients represented 10% of the PCN population and whilst being less clinically complex, they were likely to contact the GP practice 30% more than other groups. This demand was growing at three times the average level seen in the general population. In addition, Eliska was aware that there was access issues for the current services provided and wanted to improve this for women of all ages locally. Using a partnership approach, she was instrumental in the development of a business case with her PCN and Healthier Wigan.
This business case was to bid for central funding to set up a Women’s Health Hub. Based on an integrated model, the bid proposed bringing together three services into one streamlined system with a single point of access, aiming for better coordination and quality of care.
29 of Wigan’s 200 neighbourhoods fall within the 10 per cent most deprived neighbourhoods in England.
(Wigan Council, 2013)
The Innovation
The Women’s Sexual Health service contract award process was lengthy and included a six-month transition period for the new provider, which has delayed the delivery of new services. This testing period is still ongoing and is expected to continue until the New Year.
Demand has continued to increase in primary care, so Eliska approached Federated Care to increase support available in GP practices for women of all ages in her PCN.
As the Menopause Lead for her GP Practice, Eliska has raised awareness with her GP colleagues about not only prescribing for menopause but has also provided education about the condition and other women’s health issues, encouraging additional referrals to her clinics. She now receives referrals from colleagues who detect women’s health issues as part of other clinics. She encourages face-to-face contact with patients, using opportunities such as routine smear testing in the practice to discuss women’s health.
Eliska also utilises the Whooping Cough vaccination clinics to discuss women’s health and wellbeing with teenagers, especially since teenage pregnancy rates are high in Wigan Central.
Recognising the benefits of group consultations for long-term conditions, Eliska identified that this approach could benefit the women with unmet health needs in her community. In 2023, she was given space in her surgery’s waiting area for an hour-long Women’s Health group session held once a month during lunchtime. Having completed Lifestyle Medicine training, Eliska incorporates a holistic approach to improve health and wellbeing during these sessions, with a particular focus on preventing diabetes and other non-communicable diseases.
She runs these sessions in collaboration with a newly qualified nursing associate, whom she mentored. Despite relatively low attendance at this early stage, patient feedback has been positive, with many expressing that they find the sessions helpful. Eliska hopes to expand the sessions to different days and times to accommodate more patients in the future.

The Impact
- Patient
- Improved access to Women’s Health services for patients of all ages
- Increased awareness of support available using a personalised approach
- Improved levels of self-management of health conditions
- System
- Reduction in the number of patient contacts within Primary Care
- Increased staff activation and awareness of women’s health issues in Primary Care
- Improvement in addressing health inequalities
- Practitioner
- Increased confidence in overcoming challenges to deliver improved care for this group of patients, in an area of significant deprivation.
(2013) Wigan Council. Available at: https://www.local.gov.uk/sites/default/files/documents/wigan-council-reformulati-af3.pdf (Accessed: 16 October 2024).